A Controlled Examination of Medical and Psychosocial Factors Associated With Low Back Pain in Combination With Widespread Musculoskeletal Pain

Fortin, Martin; Hahne, Julia; Wepner, Florian

doi:10.2522/ptj.20080100

Cited by 26 publications

(16 citation statements)

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“…In addition to chronic pain and fatigue, individuals with CLBP show higher levels of anger, fear, despair, and lack a sense of control. (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) It is generally recognized that CLBP is a dynamic, fluctuating condition with multifactorial etiology and complex pathogenesis. Normally, mechanistic models for CLBP have tended to focus on the mechanicalsensory aspects of musculoskeletal tissues.…”

Section: Chronic Low Back Painmentioning

confidence: 99%

Better or Worse: a Study of Day-to-Day Changes over Five Months of Rosen Method Bodywork Treatment for Chronic Low Back Pain

Fogel

2013

IJTMB

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Background: Fluctuations of good days and bad days-in physical symptoms and emotional states-are common for individuals with chronic illness. This pilot study examines these fluctuations during bodywork treatment.Purpose: We analyzed changes in daily selfreports over a period of five months for five individuals who received weekly treatments of Rosen Method Bodywork (RMB), which uses touch and words to enhance body awareness of physical sensations and emotional states.Subjects and Design: Five subjects (aged 31-56) who had chronic low back pain (CLBP) received 16 weekly treatments given by three experienced RMB practitioners.Measures: Pre-and posttreatment assessments covered demographics, disability, and pain. Clients also completed daily bedtime assessments of pain, fatigue, emotional state, and sense of control during the entire treatment period.Results: All clients reported reductions in pain and/or disability in post-compared to pretreatment. In spite of a high level of day-to-day variability in the daily assessments, there were significant reductions in pain and fatigue, and significant increases in positive emotional state and sense of control across the treatment period. In reaching this end, however, some clients had slow and steady improvements, some improved more rapidly, while others got worse before they got better.Conclusions: The natural course of healingwith its inevitable fluctuations in symptoms-is part of a process leading to successful treatment outcomes. Rosen Method Bodywork may be especially helpful in developing and accepting both sensory and emotional body awareness changes that facilitate overall improvement.KEY WORDS: Rosen Method Bodywork; chronic low back pain; pain; fatigue; emotion; sense of control iNTrODuCTiON Fluctuations of good days and bad days are common for individuals with chronic illness. (1,2) While these ups and downs are also likely to occur during treatment, there is relatively little research about this in any health care modality. This study examines day-to-day variability in the perception of physical sensation and emotional state, in a sample of five individuals with chronic low back pain (CLBP) across a period of five months in which they received 16 weekly sessions of Rosen Method Bodywork (RMB). Chronic Low Back painIt is estimated that 60%-80% of the population will experience CLBP over the life course. As many as 25% of individuals will not find relief from conventional treatments. (3,4) CLBP has both sensoryphysical and emotional symptoms. In addition to chronic pain and fatigue, individuals with CLBP show higher levels of anger, fear, despair, and lack a sense of control. (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) It is generally recognized that CLBP is a dynamic, fluctuating condition with multifactorial etiology and complex pathogenesis. Normally, mechanistic models for CLBP have tended to focus on the mechanicalsensory aspects of musculoskeletal tissues. Psychosocial factors contribute emotional distress in these patients from sources including job diss...

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Section: Chronic Low Back Painmentioning

confidence: 99%

Better or Worse: a Study of Day-to-Day Changes over Five Months of Rosen Method Bodywork Treatment for Chronic Low Back Pain

Fogel

2013

IJTMB

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“…However, the physical therapy literature on psychiatric disorders as they relate to musculoskeletal disorders focuses mainly on low back pain (LBP). 7,8 In an examination of a large number of physical and psychological factors, one prospective case-control study points to the importance of psychological variables as a risk factor for chronic LBP and widespread musculoskeletal pain. 8 Previous research has also concurred with this study in implicating psychological variables as risk factors for LBP and neck pain.…”

Section: Psychiatric Disorders As They Relate To Musculoskeletal Dysfmentioning

confidence: 99%

“…7,8 In an examination of a large number of physical and psychological factors, one prospective case-control study points to the importance of psychological variables as a risk factor for chronic LBP and widespread musculoskeletal pain. 8 Previous research has also concurred with this study in implicating psychological variables as risk factors for LBP and neck pain. 9,10 These articles provide a link between psychological disorders and patients seeking physical therapy for musculoskeletal dysfunctions.…”

Section: Psychiatric Disorders As They Relate To Musculoskeletal Dysfmentioning

confidence: 99%

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Case Report: Schizophrenia Discovered during the Patient Interview in a Man with Shoulder Pain Referred for Physical Therapy

Shah

Nakamura²

2010

Physiotherapy Canada

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Purpose: The purpose of this case report is to demonstrate the importance of a thorough patient interview. The case involves a man referred for physical therapy for a musculoskeletal dysfunction; during the patient interview, a psychiatric disorder was recognized that was later identified as schizophrenia. A secondary purpose is to educate physical therapists on the recognizable signs and symptoms of schizophrenia. Client description: A 19-year-old male patient with chronic shoulder, elbow, and wrist pain was referred for physical therapy. During the interview, the patient reported that he was receiving signals from an electronic device implanted in his body. Measures and outcome: The physical therapist's initial assessment identified a disorder requiring medical referral. Further management of the patient's musculoskeletal dysfunction was not appropriate at this time. Intervention: The patient was referred for further medical investigation, as he was demonstrating signs suggestive of a psychiatric disorder. The patient was diagnosed with schizophrenia by a psychiatrist and was prescribed Risperdal. Implications: This case study reinforces the importance of a thorough patient interview by physical therapists to rule out non-musculoskeletal disorders. Patients seeking neuromusculoskeletal assessment and treatment may have undiagnosed primary or secondary psychiatric disorders that require recognition by physical therapists and possible medical referral.Key Words: patient interview, physical therapy assessment, psychiatric disorder, referral source, schizophrenia Shah N, Nakamura Y. Case report: schizophrenia discovered during the patient interview in a man with shoulder pain referred for physical therapy. Physiother Can. 2010;62:308-315 RÉ SUMÉObjectif : L'objectif de cette é tude de cas consiste à dé montrer l'importance de ré aliser des entrevues en profondeur avec les patients. Le cas é tudié concerne un homme dirigé vers la physiothé rapie en raison d'une dysfonction musculosquelettique. Au cours de l'entrevue avec ce patient, un problè me psychiatrique a é té dé celé ; par la suite, de la schizophré nie a é té diagnostiqué e. Le deuxiè me objectif de cette é tude de cas est d'é duquer et de sensibiliser les physiothé rapeutes aux signes et aux symptô mes aisé ment reconnaissables de la schizophré nie. Description du client : Le patient est un jeune homme de 19 ans qui souffre de douleurs chroniques à l'é paule, au coude et au poignet et qui avait é té dirigé en physiothé rapie. Au cours de l'entrevue, le patient a dé claré qu'il recevait des signaux provenant d'un appareil é lectronique implanté dans son corps. Mesures et ré sultats : L'é valuation pré liminaire du physiothé rapeute a permis d'identifier un problè me qui né cessitait que le patient soit redirigé vers un mé decin. Une gestion plus poussé e de la dysfonction musculosquelettique de ce patient a é té jugé e inapproprié e à cette é tape. Intervention : Le patient a é té dirigé vers une investigation mé dicale plus approfondie, puisqu'il m...

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“…Several comorbid conditions, highly prevalent in women, are associated with pain, like musculoskeletal disorders [8], obesity [9], and psychological distress [10,11]. Socioeconomic factors, where usually women score lower than men, are also associated with pain, such as education, income and employment status [9].…”

Section: Introductionmentioning

confidence: 99%

Co-morbidity and pain sites in long-term gynecological cancer survivors and women in the general population

Rannestad¹,

Skjeldestad

2012

Gynecologic Oncology

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A Controlled Examination of Medical and Psychosocial Factors Associated With Low Back Pain in Combination With Widespread Musculoskeletal Pain

Abstract: Patients with CLBP and WMP should be examined for indicated physical and psychosocial factors. Therapeutic management should consider them in the early stage of the disease. These findings also might apply to patients with fibromyalgia or myofascial pain.

Cited by 26 publications

References 70 publications

Better or Worse: a Study of Day-to-Day Changes over Five Months of Rosen Method Bodywork Treatment for Chronic Low Back Pain

Better or Worse: a Study of Day-to-Day Changes over Five Months of Rosen Method Bodywork Treatment for Chronic Low Back Pain

Case Report: Schizophrenia Discovered during the Patient Interview in a Man with Shoulder Pain Referred for Physical Therapy

Co-morbidity and pain sites in long-term gynecological cancer survivors and women in the general population

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