Behaviour change and self-management interventions in persistent low back pain

Introduction: One of the contributing factors to the burden of low back pain (LBP) is the failure to provide patients with appropriate education and advice about diagnosis and management. To date, no information exists about whether the content of patients’ information and educational material provided in physiotherapy clinics in Saudi Arabia is in line with the Clinical Practice Guidelines and contemporary practice. Therefore, the aim of this study was to investigate the content of educational material provided by physiotherapy clinics, hospitals, or distributed by healthcare associations to people with LBP in Saudi Arabia, to determine whether this information is adequate to reassure patients and inform self-management. This study also seeks to explore whether these materials are consistent with CPGs for people with LBP. Methodology: A sample of educational items (English or Arabic) in Saudi Arabia was collected. Content analysis was conducted to analyze data based on manifest content. Result: Seventeen educational materials were included, originating from diverse sources; the Ministry of Health hospitals (n = 10), military hospitals (n = 4), private hospitals (n = 2), and multidisciplinary healthcare association (n = 1). Six main sub-themes were identified: epidemiological/anatomical data about LBP (n = 6); causes/risk factors (n = 10); exercise (n = 14) and physical activity-related recommendations (n = 3); treatment-related recommendations (n = 2); general health and lifestyle-related recommendations (n = 8); and postural and ergonomics-related recommendations (n = 13). Ultimately, one theme was formulated, namely, the content of educational materials was hindering reassurance and self-management for people with LBP. The items reviewed were heavily influenced by the biomedical model of pain. Conclusion: The educational materials reviewed failed to properly report information about LBP from a biopsychosocial perspective and were inadequate to assure patients or inform self-management.

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The ‘back home’ leaflet: developing a self-management leaflet for people with acute low back pain

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-1997-9118 ◽

1997 ◽

Vol 9 (1) ◽

pp. 61-63

Author(s):

J.A. Chapman ◽

L. Smith ◽

P. Little ◽

E. Cantrell ◽

J. Langridge ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Self Management ◽

Low Back ◽

Acute Low Back Pain

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Self-management and chronic low back pain: a qualitative study

Journal of Advanced Nursing ◽

10.1111/j.1365-2648.2010.05316.x ◽

2010 ◽

Vol 66 (7) ◽

pp. 1478-1486 ◽

Cited By ~ 50

Author(s):

Marie Crowe ◽

Lisa Whitehead ◽

Mary Jo Gagan ◽

David Baxter ◽

Avin Panckhurst

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Qualitative Study ◽

Chronic Low Back Pain ◽

Self Management ◽

Low Back

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Effectiveness of smartphone apps for the self-management of low back pain in adults: a systematic review

Disability and Rehabilitation ◽

10.1080/09638288.2021.2005161 ◽

2021 ◽

pp. 1-10

Author(s):

Claudia Didyk ◽

Lucy Kate Lewis ◽

Belinda Lange

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

The Self ◽

Self Management ◽

Low Back ◽

Smartphone Apps

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Supporting self-management of low back pain with an internet intervention in primary care: a protocol for a randomised controlled trial of clinical and cost-effectiveness (SupportBack 2)

BMJ Open ◽

10.1136/bmjopen-2020-040543 ◽

2020 ◽

Vol 10 (8) ◽

pp. e040543

Author(s):

Adam W A Geraghty ◽

Lisa Roberts ◽

Jonathan Hill ◽

Nadine E Foster ◽

Lucy Yardley ◽

...

Keyword(s):

Primary Care ◽

Low Back Pain ◽

Back Pain ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Internet Intervention ◽

Self Management ◽

Low Back ◽

Telephone Support ◽

Randomised Controlled

IntroductionSelf-management and remaining physically active are first-line recommendations for the care of patients with low back pain (LBP). With a lifetime prevalence of up to 85%, novel approaches to support behavioural self-management are needed. Internet interventions may provide accessible support for self-management of LBP in primary care. The aim of this randomised controlled trial is to determine the clinical and cost-effectiveness of the ‘SupportBack’ internet intervention, with or without physiotherapist telephone support in reducing LBP-related disability in primary care patients.Methods and analysisA three-parallel arm, multicentre randomised controlled trial will compare three arms: (1) usual primary care for LBP; (2) usual primary care for LBP and an internet intervention; (3) usual primary care for LBP and an internet intervention with additional physiotherapist telephone support. Patients with current LBP and no indicators of serious spinal pathology are identified and invited via general practice list searches and mailouts or opportunistic recruitment following LBP consultations. Participants undergo a secondary screen for possible serious spinal pathology and are then asked to complete baseline measures online after which they are randomised to an intervention arm. Follow-ups occur at 6 weeks, 3, 6 and 12 months. The primary outcome is physical function (using the Roland and Morris Disability Questionnaire) over 12 months (repeated measures design). Secondary outcomes include pain intensity, troublesome days in pain over the last month, pain self-efficacy, catastrophising, kinesophobia, health-related quality of life and cost-related measures for a full health economic analysis. A full mixed-methods process evaluation will be conducted.Ethics and disseminationThis trial has been approved by a National Health Service Research Ethics Committee (REC Ref: 18/SC/0388). Results will be disseminated through peer-reviewed journals, conferences, communication with practices and patient groups. Patient representatives will support the implementation of our full dissemination strategy.Trial registration numberISRCTN14736486.

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