Non-pharmacological treatment of low back pain in primary care

O’Keeffe, Mary

doi:10.1136/dtb.2018.000015

Cited by 9 publications

(6 citation statements)

References 34 publications

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“…The LBP therapeutic approach for physical therapists should be a priority, since, according to the World Health Organization [10], it is not only a musculoskeletal health problem, but also involves other dimensions of the individual. In addition, is one of the most common health problems worldwide [3,4]. As described by Popescu and Lee [11], its prevalence is very high, reaching 84% in adults.…”

Section: Of 15mentioning

confidence: 99%

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Effectiveness of Global Postural Re-Education in Chronic Non-Specific Low Back Pain: Systematic Review and Meta-Analysis

González-Medina

Pérez-Cabezas

Ruiz-Molinero

et al. 2021

JCM

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Background: The aim of this systematic review and meta-analysis was to evaluate the global postural re-education (GPR) program’s effectiveness compared to other exercise programs in subjects with persistent chronic low back pain. Methods: A systematic review and meta-analysis were carried out using PRISMA2020. An electronic search of scientific databases was performed from their inception to January 2021. Randomized controlled trials that analyzed pain and patient-reported outcomes were included in this review. Four meta-analyses were performed. The outcomes analyzed were disability due to back pain and pain. The risk of bias and quality of evidence were evaluated. The final search was conducted in March. Results: Seven trials were included, totaling 334 patients. The results showed improvement in pain measured by Visual Analogue Scale (VAS) (Standardised Mean Difference (SMD) = −0.69; 95% Confidence Interval (CI), −1.01 to −0.37; p < 0.0001), Numerical Pain Scale (NRS) (SMD = −0.40; 95% CI, −0.87 to 0.06); p = 0.022), VAS + NRS (SMD = −1.32; 95% CI, −1.87 to −0.77; p < 0.0001) and function (Roland Morris Disability Questionnaire (RMDQ)) (SMD = −0.55; 95% CI, −0.83 to −0.27; p < 0.0001) after GPR treatment. Conclusion: This meta-analysis provides reliable evidence that GPR may be an effective method for treating LBP by decreasing pain and improving function, with strong evidence.

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Section: Of 15mentioning

confidence: 99%

“…The program implies an active involvement of the patient [2]. This physical therapy modality has been used to improve the health status of patients with various pathologies [2][3][4][5][6], although the available studies do not provide sufficient evidence to draw firm conclusions.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Global Postural Re-Education in Chronic Non-Specific Low Back Pain: Systematic Review and Meta-Analysis

González-Medina

Pérez-Cabezas

Ruiz-Molinero

et al. 2021

JCM

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“…Despite the range of such treatments, their efficacy is limited and, globally, chronic LBP remains one of the the most common causes of disability 5. Of particular concern is the increasing use of ineffective and often harmful interventions (eg, surgery and long-term treatment with opioids) in the management of non-specific LBP 6…”

Section: Contextmentioning

confidence: 99%

No benefit from amitriptyline for chronic low back pain?

Khong

Lall

2020

DTB

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“…Persistent LBP negatively impacts patients’ quality of life, activity levels, ability to work, and earning potential [ 27 ] creating deleterious personal, social, and economic consequences [ 29 – 31 ]. Existing chronic LBP (cLBP) treatments are inadequate [ 32 ], and those focusing on symptom management typically provide modest relief [ 31 , 33 , 34 ]. Consequently, multimodal cLBP management strategies incorporating the biopsychosocial perspective are required [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

Musculoskeletal practitioners’ perceptions of contextual factors that may influence chronic low back pain outcomes: a modified Delphi study

et al. 2023

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Background Optimal shaping of contextual factors (CFs) during clinical encounters may be associated with analgesic responses in treatments for musculoskeletal pain. These CFs (i.e., the patient-practitioner relationship, patient’s and practitioner’s beliefs/characteristics, treatment characteristics, and environment) have not been widely evaluated by musculoskeletal practitioners. Understanding their views has the potential to improve treatment quality and effectiveness. Drawing on a panel of United Kingdom practitioners’ expertise, this study aimed to investigate their perceptions of CFs during the management of patients presenting with chronic low back pain (LBP). Methods A modified two-round online Delphi-consensus survey was conducted to measure the extent of panel agreement regarding the perceived acceptability and influence of five main types of CFs during clinical management of patients with chronic LBP. Qualified musculoskeletal practitioners in the United Kingdom providing regular treatment for patients with chronic LBP were invited to take part. Results The successive Delphi rounds included 39 and 23 panellists with an average of 19.9 and 21.3 years of clinical experience respectively. The panel demonstrated a high degree of consensus regarding approaches to enhance the patient-practitioner relationship (18/19 statements); leverage their own characteristics/beliefs (10/11 statements); modify the patient’s beliefs and consider patient’s characteristics (21/25 statements) to influence patient outcomes during chronic LBP rehabilitation. There was a lower degree of consensus regarding the influence and use of approaches related to the treatment characteristics (6/12 statements) and treatment environment (3/7 statements), and these CFs were viewed as the least important. The patient-practitioner relationship was rated as the most important CF, although the panel were not entirely confident in managing a range of patients’ cognitive and emotional needs. Conclusion This Delphi study provides initial insights regarding a panel of musculoskeletal practitioners’ attitudes towards CFs during chronic LBP rehabilitation in the United Kingdom. All five CF domains were perceived as capable of influencing patient outcomes, with the patient-practitioner relationship being perceived as the most important CF during routine clinical practice. Musculoskeletal practitioners may require further training to enhance their proficiency and confidence in applying essential psychosocial skills to address the complex needs of patients with chronic LBP.

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Non-pharmacological treatment of low back pain in primary care

Cited by 9 publications

References 34 publications

Effectiveness of Global Postural Re-Education in Chronic Non-Specific Low Back Pain: Systematic Review and Meta-Analysis

Effectiveness of Global Postural Re-Education in Chronic Non-Specific Low Back Pain: Systematic Review and Meta-Analysis

No benefit from amitriptyline for chronic low back pain?

Musculoskeletal practitioners’ perceptions of contextual factors that may influence chronic low back pain outcomes: a modified Delphi study

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