Patients’ perceptions of self-management of chronic low back pain: evidence for enhancing patient education and support

Background: Chronic low back pain is among the most common chronic musculoskeletal disorders worldwide. It is prevalent in Thailand, affecting up to 30% of the general population, with much higher rates among manual labourers. Pain self-management, including education, exercise, medication and other components, is an effective strategy for reducing pain intensity and disability rates for chronic low back pain sufferers. Objective: To investigate pain self-management strategies among chronic lower back pain sufferers in Thailand. Methods: The study design was a qualitative interview-based technique. The study setting was an orthopaedic outpatient department at a university hospital in Northern Thailand. Participants (n = 19) were selected based on recruitment criteria, and data was collected using demographic forms and in-depth interviews. Thematic analysis was used for qualitative analysis, with Wilcoxon signed-rank test used to assess changes in pain levels. Results: Participants used a combination of pain self-management modalities, including exercise, modified food consumption, increased rest, herbal treatments, hot and cold compression, Thai massage, and acupressure, along with psychological and spiritual coping tools like meditation and making merit. Ability to use these interventions was dependent on medical support from practitioners as well as social and other support. A small, but significant, mean difference in pain was also observed. Conclusion: Findings point to the possibility that there are significant cultural differences in pain self-management modalities and their effectiveness.

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Involving clinical staff members in the management of low back pain in general practice: a qualitative interview study

10.21203/rs.2.11548/v1 ◽

2019 ◽

Author(s):

Randi Hessellund Knudsen ◽

Janus Laust Thomsen ◽

Camilla Aakjaer Andersen ◽

Tamana Afzali ◽

Allan Riis

Keyword(s):

General Practice ◽

Low Back Pain ◽

Back Pain ◽

Patient Education ◽

Clinical Staff ◽

Barriers And Facilitators ◽

Self Management ◽

Low Back ◽

Staff Members ◽

Member Involvement

Abstract Background Low back pain (LBP) is the leading cause of disability worldwide. Patient education and self-management have the potential to improve the care of patients. However, high workload and little available time for consultations are argued to challenge the delivery of optimal care in general practice. Involving clinical staff members in the management of diabetes and of patients with hypertension has shown to be feasible. Consequently, involving clinical staff members in providing education and information to patients may improve the delivery of patient information and education. However, this require a shift in the division of tasks and general practitioners’ (GPs’) barriers and facilitators for this is currently unknown. The aim is to explore GPs’ barriers and facilitators to involve clinical staff members in the treatment of LBP in general practice. Methods This is a qualitative, semi-structured interview study. We used the phenomenological approach to study experiences and attitudes towards changing the management of patients with LBP from the GPs’ perspectives. Analysis was conducted using inductive descriptive methods. Results We conducted five 60-minute interviews with Danish GPs. All GPs had experience with task delegation, but it varied which tasks the GPs delegated and to which types of clinical staff members. The following barriers towards clinical staff member involvement were identified: Patients with LBP is a heterogeneous group with a variety of treatment needs, the examination and treatment can be considered as one coherent process, and it would require external support. Involving clinical staff members can release GP time. Another facilitator was the possibility for improving the uptake of clinical guidelines and involvement of practice nurses was considered to improve the provision of patient education and lead to greater patient self-management. Conclusion While some GPs currently consider delegation to clinical staff members a good idea in the treatment of LBP, others prefer the existing treatment strategy without clinical staff member involvement. Consequently, healthcare providers need to address existing barriers and facilitators for involving clinical staff members when advocating for a future multi professional treatment strategy of LBP in general practice.

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Predictors of self-management in patients with chronic low back pain: study protocol

The Spine Journal ◽

10.1016/j.spinee.2016.01.026 ◽

2016 ◽

Vol 16 (4) ◽

pp. S45

Author(s):

Anirban Banerjee ◽

Paul Hendrick ◽

Holly Blake

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Study Protocol ◽

Chronic Low Back Pain ◽

Self Management ◽

Low Back

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Reducing sedentary behaviour to decrease chronic low back pain: the stand back randomised trial

Occupational and Environmental Medicine ◽

10.1136/oemed-2017-104732 ◽

2018 ◽

Vol 75 (5) ◽

pp. 321-327 ◽

Cited By ~ 16

Author(s):

Bethany Barone Gibbs ◽

Andrea L Hergenroeder ◽

Sophy J Perdomo ◽

Robert J Kowalsky ◽

Anthony Delitto ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Sedentary Behaviour ◽

Chronic Low Back Pain ◽

Controlled Trial ◽

Randomised Trial ◽

Sitting Time ◽

Self Management ◽

Low Back

ObjectiveThe Stand Back study evaluated the feasibility and effects of a multicomponent intervention targeting reduced prolonged sitting and pain self-management in desk workers with chronic low back pain (LBP).MethodsThis randomised controlled trial recruited 27 individuals with chronic LBP, Oswestry Disability Index (ODI) >10% and desk jobs (sitting ≥20 hours/week). Participants were randomised within strata of ODI (>10%–<20%, ≥20%) to receive bimonthly behavioural counselling (in-person and telephone), a sit-stand desk attachment, a wrist-worn activity-prompting device and cognitive behavioural therapy for LBP self-management or control. Self-reported work sitting time, visual analogue scales (VAS) for LBP and the ODI were assessed by monthly, online questionnaires and compared across intervention groups using linear mixed models.ResultsBaseline mean (SD) age was 52 (11) years, 78% were women, and ODI was 24.1 (10.5)%. Across the 6-month follow-up in models adjusted for baseline value, work sitting time was 1.5 hour/day (P<0.001) lower comparing intervention to controls. Also across follow-up, ODI was on average 8 points lower in intervention versus control (P=0.001). At 6 months, the relative decrease in ODI from baseline was 50% in intervention and 14% in control (P=0.042). LBP from VAS was not significantly reduced in intervention versus control, though small-to-moderate effect sizes favouring the intervention were observed (Cohen’s d ranged from 0.22 to 0.42).ConclusionAn intervention coupling behavioural counselling targeting reduced sedentary behaviour and pain self-management is a translatable treatment strategy that shows promise for treating chronic LBP in desk-bound employees.Trial registration numberNCT0224687; Pre-results.

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