The Lancet Series call to action to reduce low value care for low back pain: an update

Buchbinder, Rachelle; Underwood, Martin; Hartvigsen, Jan; Maher, Chris G

doi:10.1097/j.pain.0000000000001869

Cited by 155 publications

(135 citation statements)

References 81 publications

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“…1 , 2 At the same time, good health is increasingly understood as the ability to adapt to changing life circumstances and to self-manage in the face of social, physical, and emotional challenges. 3 , 4 In the case of persistent low back pain (LBP), such an approach implies that successful interventions are not mainly about clinicians diagnosing and curing patients, but about a partnership between individuals and clinicians that helps people engaging in valued activities. 5 Thus, living with persistent or recurrent LBP may involve care-seeking, but people manage their health conditions outside the context of health care most of the time, and interventions for persistent LBP should enable them to do that well.…”

Section: Introductionmentioning

confidence: 99%

Self-management at the core of back pain care: 10 key points for clinicians

Kongsted

Hansen

Kjær

et al. 2021

Brazilian Journal of Physical Therapy

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Highlights Self-management support is person-centred care reinforcing patient autonomy. Avoid strong clinician control and help patients developing self-efficacy. Let patients’ value-based goals and shared decisions guide management. Help patients make sense of symptoms and reframe unhelpful perspectives. Use supervised exercises as a tool to practice problem-solving skills

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Section: Introductionmentioning

confidence: 99%

Self-management at the core of back pain care: 10 key points for clinicians

Kongsted

Hansen

Kjær

et al. 2021

Brazilian Journal of Physical Therapy

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“…1 Direct medical expenditures for low back and neck pain in the United States were estimated at $124 billion in 2016, representing the highest health care expenditure in the country. 2 , 3 The burden and costs associated with LBP are magnified by the fact that conventional medical care currently has little to offer these patients. Commonly used treatments, including prescription medications such as opioids, are of questionable benefit and can lead to harm.…”

Section: Introductionmentioning

confidence: 99%

Patient-Reported Physician Treatment Recommendations and Compliance Among U.S. Adults with Low Back Pain

Goertz

Long

English

et al. 2021

The Journal of Alternative and Complementary Medicine

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Objectives: Numerous recently published clinical care guidelines, including the 2017 American College of Physicians (ACP) Guideline for Low Back Pain (LBP), call for nonpharmacological approaches to pain management. However, little data exist regarding the extent to which these guidelines have been adopted by patients and medical doctors. The study objective was to determine patient-reported treatment recommendations by medical doctors for LBP and patient compliance with those recommendations.Design: This study used a cross-sectional web and mail survey.Settings/Location: The study was conducted among Gallup Panel members across the United States. Subjects: Survey participants included 5377 U.S. adults randomly selected among Gallup Panel members. Of those, 545 reported a visit to a medical doctor within the past year for low back pain and were asked a series of follow-up questions regarding treatment recommendations.Interventions: Participants were asked about medical doctor recommendations for both drug (acetaminophen, nonsteroidal anti-inflammatory drugs [NSAIDs], opioids, benzodiazepines, Gabapentin, Neurontin, and cortisone injections) and nondrug (self-care treatments, massage, acupuncture, spinal manipulation, and physical therapy) treatments.Outcome Measures: Participants were asked to indicate if their medical doctor recommended each drug and nondrug therapy for their LBP and if they had followed each of those treatment recommendations.Results: Ninety-six percent of patients who visited a medical doctor for LBP received a recommendation for one or more pain treatments, with 81% reporting that their medical doctor recommended both drug and nondrug therapies. Seventy-six percent of respondents were recommended acetaminophen or NSAIDs, 79% were recommended self-care treatments, 37% were recommended massage, acupuncture, or spinal manipulation, and 60% were recommended physical therapy. Nearly two-thirds of our sample reported that their doctor had recommended prescription medications, including opioids, benzodiazepines, Gabapentin, Neurontin, or cortisone injections. Reported adherence to treatment recommendations ranged from 68% for acupuncture to 94% for NSAIDs.Conclusions: One year after publication of the ACP's Guideline on LBP, patients report that medical doctors recommended both pharmacological and nonpharmacological treatment approaches to patients with LBP. In the majority of cases, a combination of prescription medications and self-care were recommended, illustrating the need for additional research on the effectiveness of multi-modal treatment strategies. Patients reported that they were largely compliant with medical doctor recommendations, underscoring the influence that medical doctors have in directing patient care for LBP. These findings indicate that further work is also needed to explore the impact of

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“…Musculoskeletal pain is a complex health problem that causes discomfort, results in poor quality of life, and affects millions of people worldwide [1][2][3]. This pain can arise in different musculoskeletal structures (e.g., muscles, bones, joints, ligaments and tendons, and periarticular tissues) [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Effects of Nutritional Interventions in the Control of Musculoskeletal Pain: An Integrative Review

2020

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Food consumption has significant positive effects on an individual’s health status, including the reduction of symptoms associated with musculoskeletal pain. However, specific food groups indicated for the treatment of pain are not yet determined. Hence, this review aimed to analyze the effects of nutritional interventions with specific diets, oils and/or fatty acids, and foodstuffs in natura in the reduction of musculoskeletal pain. An integrative review was conducted in the following databases: Embase, PubMed, LILACS, and Google Scholar. Clinical trials written in English, Spanish, and Portuguese and published between 2000 and March 2020 were included in this review. Seventeen studies were included. Among these, a reduction of musculoskeletal pain with different types of nutritional interventions, such as vegan and Mediterranean diets and the consumption of blueberry, strawberry, passion fruit peel extract, argan oil, fish oil (omega-3), olive oil, and undenatured type II collagen and vitamin D gel capsules, was observed in 14 studies. Eight studies evaluated the profiles of several inflammatory markers, and of these, decreased interleukin (IL)-6, IL-1β, and tumor necrosis factor-α levels were observed in two studies. This review suggests that different nutritional interventions with specific diets, oils and/or fatty acids, and foodstuffs in natura reduce musculoskeletal pain, specifically in adults with osteoarthritis. Besides pain improvement, nutritional interventions, including the consumption of strawberry and vitamin D gel capsules, decrease the levels of several inflammatory markers.

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The Lancet Series call to action to reduce low value care for low back pain: an update

Cited by 155 publications

References 81 publications

Self-management at the core of back pain care: 10 key points for clinicians

Self-management at the core of back pain care: 10 key points for clinicians

Patient-Reported Physician Treatment Recommendations and Compliance Among U.S. Adults with Low Back Pain

Effects of Nutritional Interventions in the Control of Musculoskeletal Pain: An Integrative Review

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