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Lower Back Pain

16/06/2016 by Pivotal Motion
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If you have had it once you are likely to experience a recurrence. That is the general consensus among many health professionals, and it is what the research indicates.

Acute low back pain can be a very debilitating condition. It is estimated that approximately 80% of Australians will experience low back pain (LBP) at some point in their lives.

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Today, there is a great emphasis on the importance of evidence based practice and the development of practice guidelines for health professionals to treat low back pain most effectively.

How to assess/treat back pain

A variety of health professionals are equipped to assess and treat back pain.

In Brisbane, doctors, physiotherapists or chiropractors are frequently involved in the management of back pain, in addition to other health professionals in more chronic cases.

This means that a variety of treatment methods are available for the general public.

Medications, manual therapy, exercise and electrotherapy are some common management options. Within these modalities, there exists an extensive range of therapy and exercise techniques, therapy equipment and potential drug prescriptions.

However, the research indicates that not all these treatments are effective in battling low back pain.

Here’s what we found:

  • Chou et, al. (2007) concluded that “medications with good evidence of short-term effectiveness for low back pain are NSAIDs, skeletal muscle relaxants (for acute low back pain), and tricyclics anti-depressants for chronic low back pain.
  • A 2011 review concluded that traditional non-steroidal anti-inflammatory drugs (NSAIDS) are more effective in treating back pain than NO medications at all. However, there was moderate evidence to suggest that there were no more effective than other medications such as paracetamol, which have fewer side effects. The authors suggest that NSAIDS may be effective for short term management of acute and chronic LBP without sciatica. ( Roelofs et al. 2011)
  • Multi-disciplinary treatment (physiotherapy, exercise therapy and medications) and behavioural treatment (cognitive behavioural therapy) were found to be successful interventions in treating chronic low back pain. Insufficient evidence was found to condone the use of laser therapy and lumbar supports. (Middelkoop et. al 2007)
  • It has been suggested that a delay in the activation of abdominal muscle (transverses abdominis) was associated in those experiencing LBP (Ferreira et. al 2010) and that isolated training of this muscle contributes to improving spinal stability and causing reductions in pain and disability. (Marshall et. al 2010).
  • Several studies have confirmed that cognitive behavioural therapy (CBT) treatments have positive results on back pain. Some interventions include positive thinking, mindfulness and coping strategies. In patients with LBP, CBT has proven to improve quality of life and reduce pain levels in the short term. However, there is insufficient evidence to indicate that its effect is significantly better than an exercise program in the moderate to long term. (Henschke et.al 2009)

The war against back pain can be a difficult process without the appropriate treatment. The current evidence exists to guide this process and achieve treatment goals.

At Pivotal Motion Physiotherapy located in Newmarket Brisbane, we construct individual, evidence based treatment plans based on a patient’s progress. The research continues to evolve, and with it advances our approach to managing this debilitating condition.

References

Chou, R., Hoffman, L.H. (2007) Medications for acute and chronic low back pain: A review of the evidence for an American pain society/ American College of physicians clinical practice guideline. Annals of Internal Medicine. 107:504-514.

Roelofs, P.D.M.M.,  P., Deyo, R.A., Koes, B. W., Scholten, R. J. P. M., van Tulder, M. W. (2011) Non-steroidal anti-inflammatories for low back pain (Review). Cochrane Database of Systematic Reviews. Issue 2.

Middelkoop, M., Rubinstein, S., Kuijpers, T., Verhagen, A., Ostelo, R., Koes, B., Tulder, M. (2011). A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain. European Spine Journal. 20:19-39

Ferreira, P.H., Ferreira, M. L., Maher, C.G., Refshauge, K., Herbert, R. D., Hodges, P.W. (2010) Changes in recruitment of transversus abdominis correlate with disability in people with chronic low back pain. British Journal of Sports Medicine. 44:1166-1172.

Marhsall, P., Murphy, B. (2010) Delayed abdominal muscle onsets and self-report measures of pain and disability in chronic low back pain. Journal of Electromyography and kinesiology.20 (5): 833-839.

Henschke N, Ostelo RWJG, van Tulder MW, Vlaeyen JWS, Morley S, Assendelft WJJ, Main CJ. Behavioural treatment for chronic low-back pain. Cochrane Database of Systematic Reviews 2010, Issue 7.

 

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