Low Back Pain: Management and Prevention Challenge

Hey guys,
As many of your know, I hold a role within the APTA as an Editorial Board Member for MoveForwardPT.com .  In this role, I have had the opportunity to write, edit and manage some of the content that is being provided to the consumers of our care.
My current project:   I am currently editing and updating the consumer book on LBP entitled, “Low Back Pain: Management and Prevention” (please note: the book linked is the original).  LBP is the number one reason someone seeks our care and we should be the leaders in providing relevant & accurate information regarding the best practice and management of this condition.
My Challenge to You: I would like to hear from the readers of this site (licensed Physical Therapists) about your overall view of this guide.   Is it still relevant to your practice?  Is it relevant to the best evidence for the care of this condition?  Is this the information we should be providing to consumers?  If no, what should we be recommending and provide some citations to support.
The audience: Your patients.  What should they know about this condition?  What should they expect from us?
My Rules: Let’s discuss ideas/concepts; not individuals.   As the editor of this piece, I will ultimately be making the final decisions of this guide.  That stated, you guys know your stuff.  Assist me in getting relevant information to the consumer.
-Joseph Brence, PT, DPT, FAAOMPT, COMT, DAC

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  • Pretty good book overall. However, maybe blending what is in the clinical practice guideline for low back pain which came out in April of 2012 and the content of this current version (2012) might be a nice update. Also, maybe a bit more detail on fear avoidance and anxiety surrounding back pain that patients deal with and how pain science education can be offered as part of manual therapy and exercise might be a good update for patients to know about. Also mentioning avoidance of passive treatments such as chiropractic and massage and how evidence really is in favor of active treatment with a blend of passive treatments (spinal manipulation) is needed

    Steve Goldrick March 24, 2015 1:05 pm Reply
  • I would like to see more attention to prevention : in the past 2 years I have been exposed to neuroscience from France that explains in huge detail the role of the postural sensors in maintaining spine symmetry and alignment,correct postural curves.When the postural sensors are correctly calibrated forces on the spine and limbs are hugely reduced preventing spinal joint and disc breakdown as well as correcting existing abnormal curves. The work is known as Posturology, and the training I took here in Canada is the work from France http://www.posturepro.ca.
    Its the most intelligent approach to spine care I have seen in my 35 years in physiotherapy and I am getting SUSTAINABLE results with a wide range of patients from those with chonic pain to athletes.
    Its time to go back to neurology and the perfect system we have to deliver spine alignment in a non invasive way.

    Siobhan O'Connell March 24, 2015 7:11 pm Reply
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  • Hi Joe
    We met in Pittsburgh two years ago, and in San Diego more recently. Here is an original article that I wrote for the Orthopaedic Division Review for the Canadian Physiotherapy Association in the fall. I would say that the evidence is strong that you cannot educate about chronic low back pain without talking about a biopsychosocial perspective; however, the pelvic floor as a nociceptive generator in the biological realm must be considered. I have included the article from the Orthopaedic Division Review (ODR) for your review and consideration of how much information to include on the pelvic floor.
    I am also the principle investigator of a study at McMaster University in Hamilton, Ontario looking at Chronic Low back pain in Women: A Urogynecological problem, an orthopaedic problem, or both. So far, we have collected 30 data sets (with a goal of 100 data sets in the next six months), and the data suggests that 96% of women with LBP have pelvic floor problems (as confirmed by internal palpation) and 90% of these women have hypertonicity in the pelvic floor not hypotonicity. We have to stop offering patients Kegels as one of the solutions for CLBP, when an assessment is not done first of the pelvic floor. I have included the study protocol as well for your perusal.
    Cheers CV
    Carolyn Vandyken, BHSc, PT, Cred MDT, CCMA (acup) |Pelvic Health Leader, Ontario|The Centre for Pelvic Health~A Facility of Lifemark Health| 163 Hespeler Rd. Cambridge, ON N1R 3H7|P:519-624-8798|F:519-624-8832
    “Healing doesn’t mean the damage never existed. It means the damage no longer controls your life”. Akshay Dubey
    From: Forward Thinking PT <comment-reply@wordpress.com> Reply-To: Forward Thinking PT <comment+ey4bj56zta560a9n6afo9s1@comment.wordpress.com> Date: Tuesday, March 24, 2015 at 12:39 PM To: Carolyn Vandyken <Carolyn.Vandyken@LifeMark.ca> Subject: [New post] Low Back Pain: Management and Prevention Challenge
    josephbrence posted: “Hey guys, As many of your know, I hold a role within the APTA as an Editorial Board Member for MoveForwardPT.com . In this role, I have had the opportunity to write, edit and manage some of the content that is being provided to the consumers of our ca”

    Carolyn Vandyken April 5, 2015 10:13 pm Reply
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  • Hi Joseph, really interesting approach.
    I wanted to recommend you one of our latest works on the osteopathic treatment of the low back pain, that might be helpful in order to get to know the large number of osteopathic techniques that can help on the low back pain management.
    The book is called “Osteopathic treatment of low back pain and sciatica caused by disc prolapse” and you can find it here: http://www.medoslibrosalud.com/es/osteopat%C3%ADa/114-osteopathic-treatment-of-the-low-back-pain-and-sciatica-caused-by-disc-prolapse.html
    Hope is helpful!

    Medos November 6, 2015 7:05 am Reply

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