Clinical Guidelines

Effect of Intensive Patient Education vs Placebo Patient Education on Outcomes in Patients With Acute Low Back Pain: A Randomized Clinical Trial

By Frank M. Painter|July 8, 2023|Acute Low Back Pain, Clinical Guidelines|

Effect of Intensive Patient Education vs Placebo Patient Education on Outcomes in Patients With Acute Low Back Pain: A Randomized Clinical Trial

SOURCE: JAMA Neurol 2019 (Feb 1); 76 (2): 161–169
Adrian C. Traeger, PhD; Hopin Lee, PhD; Markus Hübscher, PhD; Ian W. Skinner, PhD; G. Lorimer Moseley, PhD; Michael K. Nicholas, PhD; Nicholas Henschke, PhD; Kathryn M. Refshauge, PhD; Fiona M. Blyth, PhD; Chris J. Main, PhD; Julia M. Hush, PhD; Serigne Lo, PhD; James H. McAuley, PhD

Neuroscience Research Australia,
Sydney, New South Wales, Australia.

Sydney School of Public Health,
Faculty of Medicine and Health,
The University of Sydney,
Sydney, New South Wales, Australia.

FROM: Pain 2019 (Dec)

FROM: Cochrane Database 2020 (Apr)

FROM: European Journal of Pain 2017 (Feb)

FROM: American Family Physician 2019 (Mar 15)

FROM: Pain 2013 (Jul)

Importance: Many patients with acute low back pain do not recover with basic first-line care (advice, reassurance, and simple analgesia, if necessary). It is unclear whether intensive patient education improves clinical outcomes for those patients already receiving first-line care.

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LOW BACK PAIN Section and the:

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Evidence-Based Nonpharmacologic Strategies

By Frank M. Painter|May 27, 2018|Clinical Guidelines, Pain Management|

Evidence-Based Nonpharmacologic Strategies for Comprehensive Pain Care: The Consortium Pain Task Force White Paper

The Chiro.Org Blog

SOURCE: Explore (NY). 2018 (Mar 1) [Epub]

Heather Tick, MD, Arya Nielsen, PhD, Kenneth R. Pelletier, PhD, MD, Robert Bonakdar, MD, Samantha Simmons, MPH, Ronald Glick, MD, Emily Ratner, MD, Russell L. Lemmon, MD, Peter Wayne, PhD, Veronica Zador, BSc

Departments of Family Medicine,
Anesthesiology and Pain Medicine,
University of Washington School of Medicine,
Seattle, WA.

Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action from state and federal agencies including the

Department of Defense (DOD,
Veterans Health Administration (VHA),
National Institutes of Health (NIH),
Food and Drug Administration (FDA) and the
Centers for Disease Control and Prevention (CDC).

There is pressure for pain medicine to shift away from reliance on opioids, ineffective procedures and surgeries toward comprehensive pain management that includes evidence-based nonpharmacologic options. This White Paper details the historical context and magnitude of the current pain problem including individual, social and economic impacts as well as the challenges of pain management for patients and a healthcare workforce engaging prevalent strategies not entirely based in current evidence. Detailed here is the evidence-base for nonpharmacologic therapies effective in postsurgical pain with opioid sparing, acute non-surgical pain, cancer pain and chronic pain.

Therapies reviewed include

acupuncture therapy,
massage therapy,
osteopathic and chiropractic manipulation,
meditative movement therapies Tai chi and yoga,
mind body behavioral interventions,
dietary components and
self-care/self-efficacy strategies.

Transforming the system of pain care to a responsive comprehensive model necessitates that options for treatment and collaborative care must be evidence-based and include effective nonpharmacologic strategies that have the advantage of reduced risks of adverse events and addiction liability.

The evidence demands a call to action to increase awareness of effective nonpharmacologic treatments for pain, to train healthcare practitioners and administrators in the evidence base of effective nonpharmacologic practice, to advocate for policy initiatives that remedy system and reimbursement barriers to evidence-informed comprehensive pain care, and to promote ongoing research and dissemination of the role of effective nonpharmacologic treatments in pain, focused on the short- and long-term therapeutic and economic impact of comprehensive care practices.

There are more articles like this @ our:

Low Back Pain Page
and the:

Low Back Pain Guidelines Page

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Take the Guideline Challenge

By Frank M. Painter|May 16, 2017|Clinical Guidelines, Low Back Pain|

Take the Guideline Challenge

The Chiro.Org Blog

SOURCE: ACA News ~ May 15, 2017

By Christine Goertz, DC, PhD

Dr. Goertz is senior scientific advisor for the ACA. She also serves as vice chancellor for research and health policy at Palmer College of Chiropractic and is the CEO of the Spine Institute for Quality (Spine IQ)

In my last blog post, I talked about the unprecedented opportunity the chiropractic profession has to make a critical difference in areas of great public health impact, such as low back pain. I strongly believe that if we do the right thing right now, the chiropractic profession is uniquely positioned to significantly impact the quality of spine care delivery, increasing access to chiropractic care for millions of patients who desperately need conservative treatment for spine-related conditions. The flipside is that if we don’t take right action now, chiropractic risks becoming a marginalized profession that’s on the outside looking in as other health care providers take ownership of musculoskeletal conditions and spinal manipulation.

So what is right action? Recently, I asked this question of several of my colleagues who influence policy at the highest levels of research and/or health care delivery in the United States. One of those people was Francis Collins, MD, PhD, director of the National Institutes of Health. [1] Dr. Collins responded by saying:

Chiropractic’s commitment to evidence-based practice and to addressing gaps in the scientific basis of chiropractic care is vital for the progress of the field. Robust research on the safety and effectiveness of chiropractic therapies in the management of common musculoskeletal complaints must continue to be a high priority for the profession. Advancing evidence-based chiropractic care will further the integration of chiropractic into medical systems at a time when the need for effective approaches to improve outcomes for patients with chronic pain could not be more pressing.

There are more articles like this @ our:

Low Back Pain Guidelines Page and the:

Best Practices in Chiropractic Page

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