Unraveling the Complexity of Low Back Pain

O’Sullivan, Peter; Cañeiro, J P; O’Keeffe, Mary; O’Sullivan, Kieran

doi:10.2519/jospt.2016.0609

Cited by 121 publications

(81 citation statements)

References 51 publications

(56 reference statements)

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“…altered movement patterns) and central (e.g. maladaptive beliefs) pain mechanisms are associated with CLBP (Sheeran, Sparkes, Caterson, Busse‐Morris, and Deursen (); O'Sullivan, Caneiro, O'Keeffe, & O'Sullivan, ; Meier et al, ). While a particular mechanism may be dominant in certain persons, many individuals present themselves with a mixed pattern of peripherally and centrally mediated pain (Nijs et al, ).…”

Section: Discussionmentioning

confidence: 99%

Lumbar range of motion in chronic low back pain is predicted by task‐specific, but not by general measures of pain‐related fear

Matheve

Baets

Bogaerts

et al. 2019

European Journal of Pain

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Background Most studies fail to show an association between higher levels of pain‐related fear and protective movement behaviour in patients with chronic low back pain (CLBP). This may be explained by the fact that only general measures of pain‐related fear have been used to examine the association with movement patterns. This study explored whether task‐specific, instead of general measures of pain‐related fear can predict movement behaviour. Methods Fifty‐five patients with CLBP and 54 healthy persons performed a lifting task while kinematic measurements were obtained to assess lumbar range of motion (ROM). Scores on the Photograph Daily Activities Series‐Short Electronic Version (PHODA‐SeV), Tampa Scale for Kinesiophobia and its Activity Avoidance and Somatic Focus subscales were used as general measures of pain‐related fear. The score on a picture of the PHODA‐SeV, showing a person lifting a heavy object with a bent back, was used as task‐specific measure of pain‐related fear. Results Lumbar ROM was predicted by task‐specific, but not by general measures of pain‐related fear. Only the scores on one other picture of the PHODA‐SeV, similar to the task‐specific picture regarding threat value and movement characteristics, predicted the lumbar ROM. Compared to healthy persons, patients with CLBP used significantly less ROM, except the subgroup with a low score on the task‐specific measure of pain‐related fear, who used a similar ROM. Conclusions Our results suggest to use task‐specific measures of pain‐related fear when assessing the relationship with movement. It would be of interest to investigate whether reducing task‐specific fear changes protective movement behaviour. Significance This study shows that lumbar range of motion in CLBP is predicted by task‐specific, but not by general measures of pain‐related fear. This suggests that both in clinical practice and for research purposes, it might be recommended to use task‐specific measures of pain‐related fear when assessing the relationship with movement behaviour. This may help to disentangle the complex interactions between pain‐related fear, movement and disability in patients with CLBP.

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Section: Discussionmentioning

confidence: 99%

Lumbar range of motion in chronic low back pain is predicted by task‐specific, but not by general measures of pain‐related fear

Matheve

Baets

Bogaerts

et al. 2019

European Journal of Pain

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“…In the last decades, a wide range of biopsychosocial factors have been shown to be associated with either the incidence or recurrence of MSD (8). This includes psychological factors such as health beliefs, mood, and the tendency to worry about common somatic symptoms (somatizing tendency) (9, 10); mental comorbidities (11), sleep problems (12), and pain sensitivity and/or augmented central processing of sensory information (13,14).…”

Section: Van Der Beek Et Almentioning

confidence: 99%

A research framework for the development and implementation of interventions preventing work-related musculoskeletal disorders

Beek¹,

Dennerlein²,

Huysmans³

et al. 2017

Scand J Work Environ Health

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We are the first to describe a research framework for prevention of work-related musculoskeletal disorders (MSD) in which different research disciplines are linked. This framework can help to improve theories and strengthen the development and implementation of prevention strategies for work-related MSD. Original article Scand J Work Environ Health. 2017;43(6):526-539. doi:10.5271/sjweh.3671 A research framework for the development and implementation of interventions preventing work-related musculoskeletal disorders Objectives Work-related musculoskeletal disorders (MSD) are highly prevalent and put a large burden on (working) society. Primary prevention of work-related MSD focuses often on physical risk factors (such as manual lifting and awkward postures) but has not been too successful in reducing the MSD burden. This may partly be caused by insufficient knowledge of etiological mechanisms and/or a lack of adequately feasible interventions (theory failure and program failure, respectively), possibly due to limited integration of research disciplines. A research framework could link research disciplines thereby strengthening the development and implementation of preventive interventions. Our objective was to define and describe such a framework for multi-disciplinary research on work-related MSD prevention. Affiliation MethodsWe described a framework for MSD prevention research, partly based on frameworks from other research fields (ie, sports injury prevention and public health). ResultsThe framework is composed of a repeated sequence of six steps comprising the assessment of (i) incidence and severity of MSD, (ii) risk factors for MSD, and (iii) underlying mechanisms; and the (iv) development, (v) evaluation, and (vi) implementation of preventive intervention(s). ConclusionsIn the present framework for optimal work-related MSD prevention, research disciplines are linked. This framework can thereby help to improve theories and strengthen the development and implementation of prevention strategies for work-related MSD.

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“…Based on the need for a more organized and targeted health care delivery13 and the need for a cultural shift in the management of LBP,103 this model has the capability to help the clinician recognize if and when multidisciplinary care is needed and provide a roadmap that puts into context the complexity of recovery in this heterogeneous population. This theoretical model could provide better structure and certainly a more comprehensive one than the current CS 105.…”

Section: Resultsmentioning

confidence: 99%

“…Recently, Rabey et al stated that “a flexible, biopsychosocial classification system may allow profiling across multiple relevant dimensions, to facilitate targeted care based on the dominant factors present in individual profiles” 22. Previous authors have urged for a more contemporary vision of LBP management while focusing on the relative importance of multidimensional profiling 103. With respect to these comments, we consider that our model is client-centered, multidimensional, and most importantly, gives to the clinician a structure to better target the multiple dimensions associated with LBP, while remaining relatively simple.…”

Section: Part 3: Potential Advantages Of This Integrative Model and Imentioning

confidence: 99%

Rehabilitation management of low back pain – it’s time to pull it all together!

Tousignant-Laflamme

Martel

Joshi

et al. 2017

JPR

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In the past, rehabilitation research initiatives for low back pain (LBP) have targeted outcome enhancement through personalized treatment approaches, namely through classification systems (CS). Although the use of CS has enhanced outcomes, common management practices have not changed, the prevalence of LBP is still high, and only selected patients meet the CS profile, namely those with a nociceptive context. Similarly, although practice guidelines propose some level of organization and occasionally a timeline of care provision, each mainly provides best practice for isolated treatment approaches. Moreover, there is no theoretical framework that has been proposed that guides the rehabilitation management process of mechanical LBP. In this commentary, we propose a model constituted of five domains (nociceptive drivers, nervous system dysfunction drivers, comorbidities drivers, cognitive–emotional drivers, and contextual drivers) grounded as mechanisms driving pain and/or disability in LBP. Each domain is linked to the International Classification of Functioning, Disability and Health, where once a patient is deemed suitable for rehabilitation, the clinician assesses elements of each domain in order to identify where the relative treatment efforts should be focused. This theoretical model is designed to provide a more comprehensive management overview, by appreciating the relative contribution of each domain driving pain and disability. Considering that the multiple domains driving pain and disability, and their interaction, requires a model that is comprehensive enough to identify and address each related issue, we consider that the proposed model has several positive implications for rehabilitation of this painful and highly prevalent musculoskeletal disorder.

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Unraveling the Complexity of Low Back Pain

Cited by 121 publications

References 51 publications

Lumbar range of motion in chronic low back pain is predicted by task‐specific, but not by general measures of pain‐related fear

Lumbar range of motion in chronic low back pain is predicted by task‐specific, but not by general measures of pain‐related fear

A research framework for the development and implementation of interventions preventing work-related musculoskeletal disorders

Rehabilitation management of low back pain – it’s time to pull it all together!

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Unraveling the Complexity of Low Back Pain

Cited by 121 publications

References 51 publications

Lumbar range of motion in chronic low back pain is predicted by task‐specific, but not by general measures of pain‐related fear

Lumbar range of motion in chronic low back pain is predicted by task‐specific, but not by general measures of pain‐related fear

A research framework for the development and implementation of interventions preventing work-related musculoskeletal disorders

Rehabilitation management of low back pain &ndash; it&rsquo;s time to pull it all together!

Contact Info

Product

Resources

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Rehabilitation management of low back pain – it’s time to pull it all together!