The Contemporary Management of Nonspecific Lower Back Pain

Oliveira, Ronaldo Fernando de; Fandim, Junior Vitorino; Fioratti, Iuri; Fernandes, Lívia G; Saragiotto, Bruno Tirotti; Costa, Leonardo Oliveira Pena

doi:10.2217/pmt-2019-0016

Cited by 11 publications

(5 citation statements)

References 40 publications

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“…The content of this intervention included videos and animations based on pain education, promotion of physical activity, and general exercises. The pain education component was based on the e-pain intervention developed by Reis et al [12], which had 9 main features: (1) acceptance, (2 and 3) pain education, (4) sleep hygiene, (5) recognition of stress and negative emotions, (6) increased positive coping in lifestyle, (7) exercise, (8) communication, and (9) prevention.…”

Section: Intervention Group: Internet-based Pain Education and Exerci...mentioning

confidence: 99%

“…The management of chronic musculoskeletal pain is primarily multimodal, with noninvasive and nonpharmacological therapies as first-line options. These therapies include exercise, pain education, psychological, and physical therapies [7][8][9][10][11]. Although these recommendations from clinical practice guidelines are clear and usually do not involve complex programs [12,13], many people do not have access to adequate and affordable treatments.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility, Usability, and Implementation Context of an Internet-Based Pain Education and Exercise Program for Chronic Musculoskeletal Pain: Pilot Trial of the ReabilitaDOR Program

Fioratti¹,

Miyamoto²,

Fandim³

et al. 2022

JMIR Form Res

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Background Internet-based self-management programs and telerehabilitation initiatives have increased and have been extensively used for delivering health care in many areas. These programs overcome common barriers that patients face with traditional face-to-face health care, such as travel expenditures, lack of time, and high demand on the public health system. During the COVID-19 pandemic, this mode of web-based health care delivery had become more popular. However, there is still a lack of studies testing this mode of delivery in low- and middle-income countries. To gain a better understanding of the context, feasibility, and factors involved in the implementation of a web-based program, pilot and implementation studies are necessary. These studies can better inform whether a strategy is feasible, acceptable, and adequate for its purposes and for optimizing resource allocation. Objective This study aims to evaluate the feasibility, usability, and implementation context of a self-management internet-based program based on exercises and pain education (ReabilitaDOR) in people with chronic musculoskeletal pain and to compare this program with a program using only a web-based self-management booklet. Methods The study design was a parallel pilot study of a prospectively registered, assessor-blinded, 2-arm randomized controlled trial with economic evaluation. This study was performed using waiting lists of physiotherapy and rehabilitation centers and advertisements on social media networks. The participants were 65 patients with chronic musculoskeletal pain aged between 18 and 60 years. The effects of an 8-week telerehabilitation program based on exercises and pain education (intervention group) were compared with those of a program based only on a web-based self-management booklet (control group). The main outcome measures were implementation outcomes of patients’ perceptions of acceptability, appropriateness, feasibility, and usability of the program and the societal costs and feasibility of the main trial at 8-week posttreatment follow-up. Adverse events were also analyzed. Results In total, 56 participants were analyzed at the 8-week follow-up. The intervention group showed responses with a mean of 4.5 (SD 0.6) points for acceptability, 4.5 (SD 0.5) points for appropriateness, and 4.5 (SD 0.6) points for feasibility measured on a 1 to 5 scale. All patients in the intervention group showed satisfactory responses to the system usability outcome. There is satisfactory evidence for the feasibility of the main trial. For costs related to the interventions, health care, patients, and loss of productivity at 8 weeks, we found a total expenditure of US $278.30 per patient in the intervention group and US $141.52 per patient in the control group. No adverse events were reported during the intervention period. Conclusions We found that the ReabilitaDOR program is feasible, appropriate, and acceptable from the users’ implementation perspective. This system was considered usable by all the participants, and the main trial seemed feasible. Cost data were viable to be collected, and the program is likely to be safe. Trial Registration ClinicalTrials.gov NCT04274439; https://clinicaltrials.gov/ct2/show/NCT04274439

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Section: Intervention Group: Internet-based Pain Education and Exerci...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Feasibility, Usability, and Implementation Context of an Internet-Based Pain Education and Exercise Program for Chronic Musculoskeletal Pain: Pilot Trial of the ReabilitaDOR Program

Fioratti¹,

Miyamoto²,

Fandim³

et al. 2022

JMIR Form Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…The buoyancy of the water allows a greater range of motion by supporting body weight, and changing the depth helps to develop resistance [110]. The aquatic environment enables the subject to perform activities that would be difficult or impossible on land, and it has been shown that the optimal exercise strength can be accomplished by controlling the speed of motion in water [111].…”

Section: Hydrotherapymentioning

confidence: 99%

Low Back Pain: A Comprehensive Review on the Diagnosis, Treatment Options, and the Role of Other Contributing Factors

Ali-Seyed

Mohamed

2021

Open Access Maced J Med Sci

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BACKGROUND: In recent years, low back pain (LBP) is a growing major health issue around the world and mostly addressed in primary healthcare settings. This may be due to changing work environment including the nature of long sitting work hours, especially in the booming information and technology (IT) and Business Process Outsourcing (BPO) industry. LBP is normally considered as a combination of various types of pain and its related conditions, which eventually lead to disabilities. AIM: In this article, the aim is to discuss the current and future perspectives of LBP mainly on diagnosis and therapeutic front of LBP. METHODS: A search was performed using electronic databases, which include PubMed Central and Google Scholar, using the related key words “back pain and low back pain.” All related peer reviewed published articles were included regardless of the language, region, or the publication date. RESULTS: Although the management of LBP both in terms of diagnosis as well as in the therapeutic options has witnessed considerable progress but challenges are still exist not only within countries but also in the regions and continents among various medical professionals. However, in the past few years, a huge array of coordinated but randomized multi-center clinical studies were performed and various detailed insight investigations have been done, and substantial clinical guidelines have become available. Hence, a new view on evidence-based management approach for LBP has significantly improved recently and discussed here. CONCLUSION: Based on the available evidence and literature, this comprehensive review discusses the present and future perspectives of LBP mainly on diagnosis and therapeutic front for LBP. In addition, current intervention and prevention plans have failed to lessen the considerable burden of LBP and hence several areas which require more details, which deserves additional discussion to augment us through an understanding of this very important topic on improvements of multi tasked outcomes to benefit the affected patients.

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“…The utility of incorporating such behavioral health screenings into chronic pain practices may facilitate increased access to appropriate behavioral health treatment, resulting in reduced pain, improvement in function, and overall quality of life improvement (87). When looking at patients with chronic lower back pain, depression and anxiety were associated with changes in pain disability at one-year follow-up, further encouraging universal screening for both disorders (97). With multidisciplinary pain management becoming more prominent, the evidence supporting CBT as an effective treatment for chronic pain patients should be considered as a possible supplemental intervention in the treatment plan (98,99).…”

Section: Barriers and Opportunities To Clinical Implementationmentioning

confidence: 99%

Utilizing Multidisciplinary Medicine in Pain Management: A Narrative Review

et al. 2021

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BACKGROUND: The role of psychological factors influencing chronic pain has been well documented. This review includes a historical perspective and current examination of the literature on psychological and behavioral health characteristics and their influence on chronic pain. OBJECTIVES: To identify psychological and behavioral health factors involved with chronic pain, as well as the challenges and opportunities of integrating multidisciplinary care into a pain management practice. STUDY DESIGN: Narrative review of peer-reviewed literature examining psychological and behavioral health factors associated with poor clinical outcomes with an emphasis on orthopedics. METHODS: The Medline database was reviewed to identify peer-reviewed research that discussed psychological and behavioral health factors relevant to pain management or orthopedics. RESULTS: The evidence provided suggests that these constructs should receive strong consideration when managing chronic pain. The incorporation of such factors may improve patient care and clinical outcomes and reduce total health care costs. LIMITATIONS: This narrative review is not systematic in nature, but rather focused on the impacts on orthopedics and pain management. CONCLUSIONS: Psychological and behavioral health factors should be an integral component of a pain management practice as there is substantial overlap between depression and anxiety with chronic pain. Positive affect, such as resilience, may act as a buffer and confer some protection against the sequelae of chronic pain. There is evidence that psychological screeners offer further insight into the patient condition and would contribute to the treatment plan. The novel role of a behavioral health navigator in a pain management clinic is worthy of further exploration as it has proved beneficial in other chronic health conditions. KEY WORDS: Pain management, chronic pain, psychological, multidisciplinary, behavioral health navigator, resiliency, opioids

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The Contemporary Management of Nonspecific Lower Back Pain

Cited by 11 publications

References 40 publications

Feasibility, Usability, and Implementation Context of an Internet-Based Pain Education and Exercise Program for Chronic Musculoskeletal Pain: Pilot Trial of the ReabilitaDOR Program

Feasibility, Usability, and Implementation Context of an Internet-Based Pain Education and Exercise Program for Chronic Musculoskeletal Pain: Pilot Trial of the ReabilitaDOR Program

Low Back Pain: A Comprehensive Review on the Diagnosis, Treatment Options, and the Role of Other Contributing Factors

Utilizing Multidisciplinary Medicine in Pain Management: A Narrative Review

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