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Musculoskeletal Pain

Measuring Musculoskeletal Pain in Infants, Children, and Adolescents

By |December 26, 2022|Chronic Pain, Musculoskeletal Pain, Pediatrics|

Measuring Musculoskeletal Pain in Infants, Children, and Adolescents

The Chiro.Org Blog


SOURCE:   J Orthop Sports Phys Ther 2017 (Oct); 47 (10): 712–730

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Zoe A. Michaleff, BAppSc (Phty), PhD, Steven J. Kamper, BSc, BAppSc, PhD, et al.

Primary Care Centre,
Research Institute for Primary Care and Health Sciences,
Keele University,
Keele, Staffordshire
ST5 5BG United Kingdom.



Accurate, reliable, and timely assessment of pain is critical for effective management of musculoskeletal pain conditions. The assessment of pain in infants, children, and adolescents with and without cognitive impairment can be particularly challenging to clinicians for a number of reasons, including factors related to the consultation (eg, heterogeneous patient population, time constraints), the clinician (eg, awareness/knowledge of available pain scales), standardized assessment scales (eg, availability, psychometric properties, and application of each scale), the patient (eg, developmental stage, ability to communicate), and the context in which the interaction took place (eg, familiarity with the setting and physiological and psychological state).

As a result, pain is frequently not assessed or measured during the consultation and, in many instances, underestimated and undertreated in this population. The purpose of this article is to provide clinicians with an overview of scales that may be used to measure pain in infants, children, and adolescents.

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PEDIATRICS Section

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Low-value Care in Musculoskeletal Health Care: Is There a Way Forward?

By |September 20, 2022|Chiropractic Management, Musculoskeletal Pain|

Low-value Care in Musculoskeletal Health Care: Is There a Way Forward?

The Chiro.Org Blog


SOURCE:   Pain Practice 2022 (Sep); 22 (Suppl 2): 65–70

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Jan Hartvigsen PhD, Steven J. Kamper PhD, Simon D. French PhD

Department of Sports Science and Clinical Biomechanics,
Center for Muscle and Joint Health,
University of Southern Denmark,
Odense M, Denmark.



Background:   Low-value care that wastes resources and harms patients is prevalent in health systems everywhere.

Methods:   As part of an invited keynote presentation at the Pain in Motion IV conference held in Maastricht, Holland, in May 2022, we reviewed evidence for low-value care in musculoskeletal conditions and discussed possible solutions.

Results:   Drivers of low-value care are diverse and affect patients, clinicians, and health systems everywhere. We show that low-value care for back pian, neck pain, and osteoarthritis is prevalent in all professional groups involved in caring for people who seek care for these conditions. Implementation efforts that aim to reverse low-value care seem to work better if designed using established conceptual and theoretical frameworks.

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LOW BACK PAIN Section and the:

SPINAL PAIN MANAGEMENT Section

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Swiss Chiropractic Practice-based Research Network and Musculoskeletal Pain Cohort Pilot Study: Protocol of a Nationwide Resource to Advance Musculoskeletal Health Services Research

By |August 27, 2022|Low Back Pain, Musculoskeletal Pain|

Swiss Chiropractic Practice-based Research Network and Musculoskeletal Pain Cohort Pilot Study: Protocol of a Nationwide Resource to Advance Musculoskeletal Health Services Research

The Chiro.Org Blog


SOURCE:   BMJ Open 2022 (Jul 13); 12 (7): e059380


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Rahim Lalji, Léonie Hofstetter, Alice Kongsted, Viktor von Wyl, Milo A Puhan, and Cesar A Hincapié

Department of Chiropractic Medicine,
Balgrist University Hospital and University of Zurich,
Zurich, Switzerland.



Introduction:   Musculoskeletal (MSK) pain conditions, a leading cause of global disability, are usually first managed in primary care settings such as medical, physiotherapy, and chiropractic community-based practices. While chiropractors often treat MSK conditions, there is limited real-world evidence on the topic of health service outcomes among patients receiving this type of care. A nationwide Swiss chiropractic practice-based research network (PBRN) and MSK pain patient cohort study will have potential to monitor the epidemiological trends of MSK pain conditions and contribute to healthcare quality improvement. The primary aims of this protocol are to (1) describe the development of an MSK-focused PBRN within the Swiss chiropractic setting, and (2) describe the methodology of the first nested study to be conducted within the PBRN-an observational prospective patient cohort pilot study.

Methods and analysis:   This initiative is conceptualised with two distinct phases. Phase I focuses on the development of the Swiss chiropractic PBRN, and will use a cross-sectional design to collect information from chiropractic clinicians nationwide. Phase II will recruit consecutive patients aged 18 years or older with MSK pain from community-based chiropractic practices participating in the PBRN into a prospective chiropractic cohort pilot study. All data collection will occur through electronic surveys offered in the three Swiss official languages (German, French, Italian) and English. Surveys will be provided to patients prior to their initial consultation in clinics, 1 hour after initial consultation, and at 2, 6 and 12 weeks after initial consultation.

Ethics and dissemination:   Ethics approval has been obtained from the independent research ethics committee of Canton Zurich (BASEC-Nr: 2021-01479). Informed consent will be obtained electronically from all participants.

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SPINAL PAIN MANAGEMENT Section

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Individual Expectation: An Overlooked Factor

By |April 26, 2017|Hypoalgesia, Musculoskeletal Pain, Patient Expectations|

Individual Expectation: An Overlooked, But Pertinent, Factor in the Treatment of Individuals Experiencing Musculoskeletal Pain

The Chiro.Org Blog


SOURCE:   Phys Ther. 2010 (Sep); 90 (9): 1345–1355


Joel E. Bialosky Mark D. Bishop Joshua A. Cleland

Department of Physical Therapy,
University of Florida,
Gainesville, FL 32610-0154, USA


Physical therapists consider many factors in the treatment of patients with musculoskeletal pain. The current literature suggests expectation is an influential component of clinical outcomes related to musculoskeletal pain for which physical therapists frequently do not account. The purpose of this clinical perspective is to highlight the potential role of expectation in the clinical outcomes associated with the rehabilitation of individuals experiencing musculoskeletal pain. The discussion focuses on the definition and measurement of expectation, the relationship between expectation and outcomes related to musculoskeletal pain conditions, the mechanisms through which expectation may alter musculoskeletal pain conditions, and suggested ways in which clinicians may integrate the current literature regarding expectation into clinical practice.


 

From the Full-Text Article:

Background

Physical therapy interventions for musculoskeletal pain conditions often address impairments with the implication that pain and function will improve in response to stretching a tight muscle or strengthening a weak muscle. Realistically, the mechanisms through which physical therapy interventions alter musculoskeletal pain are likely multifaceted and dependent upon a variety of factors related to the therapist, the patient, and the environment. [1] The current literature indicates factors other than the correction of physical impairments influence clinical outcomes in the conservative management of patients experiencing musculoskeletal pain. For example, psychological factors such as fear are useful in directing treatment. [2, 3] Similarly, factors related to patient expectations are associated with both clinical outcomes, [4, 5] satisfaction with treatment, [6, 7] and influence of behavior. [8, 9]

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Chiropractic and Spinal Pain Management

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