Chronic Back Pain Exercises - Starting Position - Brace
“It is always controversial and challenging to recommend against the use of interventions that are already established in the market. Guideline groups may be reluctant to make strong recommendations against the continued use of interventions where there is little reliable evidence of effectiveness but also no clear evidence of ineffectiveness and harm. Such reluctance is likely driven both by the wish to avoid withholding treatments that may be of benefit and by the agendas of professional groups and other stakeholders. However, the costs associated with LBP treatment have spiraled in recent decades and yet no major impact has been made in associated levels of disability. Logically, this speaks to a problem of over treatment; to an expanding global clinical industry, sections of which may be supported only by the confounders of natural recovery, regression to the mean and internal study biases, rather than genuine clinical utility”
Source:
O'Connell, Neil & Cook, Chad & Wand, Benedict & Ward, Stephen. (2017). Clinical guidelines for low back pain: A critical review of consensus and inconsistencies across three major guidelines. Best Practice & Research Clinical Rheumatology. 30. 10.1016/j.berh.2017.05.001. https://www.researchgate.net/publication/317507418_Clinical_guidelines_for_low_back_pain_A_critical_review_of_consensus_and_inconsistencies_across_three_major_guidelines
Back Pain:
Rathod A K, Dhake R P (April 04, 2018) Radiographic Incidence of Lumbar Spinal Instability in Patients with Non-spondylolisthetic Low Backache. Cureus 10(4): e2420. doi:10.7759/cureus.2420
https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet
other non spine causes: https://misjournal.net/article/view/2036
https://www.semanticscholar.org/paper/Clinical-Tests-for-the-Musculoskeletal-System%3A-Buckup/bfa51d9271660d569438708a29ebd5a0ff660edc
Xrays with degenerative disease: Perera, Romain & Dissanayake, Poruwalage & Senarath, Upul & Wijayaratne, Lalith & Karunanayake, Aranjan & Dissanayake, Vajira. (2017). Associations between disc space narrowing, anterior osteophytes and disability in chronic mechanical low back pain: A cross sectional study. BMC Musculoskeletal Disorders. 18. 10.1186/s12891-017-1562-9.
Stratford PW, Riddle DL. A Roland Morris Disability Questionnaire Target Value to Distinguish between Functional and Dysfunctional States in People with Low Back Pain. Physiother Can. 2016;68(1):29–35. doi:10.3138/ptc.2014-85
https://fpnotebook.com/Neuro/Exam/SnsryExm.htm
Treatment for acute and subacute pain and chronic back pain:
Borczuk P. An evidence-based approach to the evaluation and treatment of low back pain in the emergency department. Emerg Med Pract. 2013 Jul;15(7):1-23; Quiz 23-4. Epub 2013 Jun 10.
https://annals.org/aim/fullarticle/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice
https://www.spine.org/Research-Clinical-Care/Quality-Improvement/Clinical-Guidelines
https://www.spine.org/Portals/0/assets/downloads/ResearchClinicalCare/Guidelines/LowBackPain.pdf
https://www.guidelinecentral.com/summaries/low-back-pain-medical-treatment-guidelines/#section-420
http://content.guidelinecentral.com/guideline/get/pdf/2653
Malfliet A, Ickmans K, Huysmans E, et al. Best Evidence Rehabilitation for Chronic Pain Part 3: Low Back Pain. J Clin Med. 2019;8(7):1063. Published 2019 Jul 19. doi:10.3390/jcm8071063
https://www.sciencedirect.com/science/article/pii/S2214031X18300883
https://www.sciencedirect.com/science/article/pii/S2214031X18300883
Behavior therapy/pain management education:
https://www.sciencedirect.com/science/article/pii/S2212144719301528
https://www.actmindfully.com.au/upimages/2016_Complete_Worksheets_for_Russ_Harris_ACT_Books.pdf
walking : Vanti C1, Andreatta S. The effectiveness of walking versus exercise on pain and function in chronic low back pain: a systematic review and meta-analysis of randomized trials. Disabil Rehabil. 2019 Mar;41(6):622-632. doi: 10.1080/09638288.2017.1410730. Epub 2017 Dec 5.
Manipulation: Rubinstein SM, de Zoete A, van Middelkoop M, Assendelft WJJ, de Boer MR, van Tulder MW. Benefits and harms of spinal manipulative therapy for the treatment of chronic low back pain: systematic review and meta-analysis of randomised controlled trials. BMJ. 2019;364:l689. Published 2019 Mar 13. doi:10.1136/bmj.l689
CBT: Groot, D., van Hooff, M.L., Kroeze, R.J. et al. Long-term results of an intensive cognitive behavioral pain management program for patients with chronic low back pain: a concise report of an extended cohort with a minimum of 5-year follow-up. Eur Spine J 28, 1579–1585 (2019). https://doi.org/10.1007/s00586-019-05967-6
https://www.actmindfully.com.au/upimages/Nuts_and_Bolts_of_Creative_Hopelessness_-_May_2017_version.pdf
https://www.tamethebeast.org/#tame-the-beast
https://oregon.providence.org/our-services/p/providence-persistent-pain/persistent-pain-toolkit/patient-and-families-toolkit/
McLeod, S. A. (2018, Oct 08). Pavlov's dogs. Simply Psychology. https://www.simplypsychology.org/pavlov.html
Exercises: Majeed A S, Ts A, Sugunan A, Ms A. The effectiveness of a simplified core stabilization program (TRICCS-Trivandrum Community-based Core Stabilisation) for community-based intervention in chronic non-specific low back pain. J Orthop Surg Res. 2019;14(1):86. Published 2019 Mar 22. doi:10.1186/s13018-019-1131-z
Exercises for low back and upper back pain: Relay health physical therapy from UCSF
printable orthoinfo spine exercise program: https://www.orthoinfo.org/globalassets/pdfs/2017-rehab_spine.pdf
Tests:
https://www.sciencedirect.com/science/article/pii/S2214031X18300883
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5893484/
https://radiology.ucsf.edu/patient-care/patient-safety/mri/absolute-contraindications#accordion-temporary-transvenous-pacing-leads
https://www.aafp.org/patient-care/clinical-recommendations/all/cw-back-pain.html
https://practicalneurology.com/articles/2018-sept/when-to-refer-patients-with-pain-for-emg
Medicines for Chronic Back Pain:
Qaseem A, Wilt TJ, McLean RM, et al, for the Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166:514–530. [Epub ahead of print 14 February 2017]. doi: https://doi.org/10.7326/M16-2367
Source: Chou R, Deyo R, Friedly J, et al. Systemic Pharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline. Ann Intern Med. 2017;166:480–492. [Epub ahead of print 14 February 2017]. doi: https://doi.org/10.7326/M16-2458
Surgery vs conservative therapy in 8-11 years (no better):
Review of European randomized trials:
Anne F. Mannion, Jens Ivar Brox, Jeremy C.T. Fairbank, Comparison of spinal fusion and nonoperative treatment in patients with chronic low back pain: long-term follow-up of three randomized controlled trials, The Spine Journal, Volume 13, Issue 11, 2013, Pages 1438-1448, ISSN 1529-9430, https://doi.org/10.1016/j.spinee.2013.06.101. (http://www.sciencedirect.com/science/article/pii/S1529943013012230)
2016 commentary: http://www.qsphysio.com.au/wp-content/uploads/2016/08/Mannion-et-comm-fusion-vs-cons-2016.pdf, regarding an essentially observational non randomized additional 2016 swedish study https://www.sciencedirect.com/science/article/abs/pii/S1529943015013716)
Mirza, Sohail K., MD, MPH. Systematic Review of Randomized Trials Comparing Lumbar Fusion Surgery to Nonoperative Care for Treatment of Chronic Back Pain. Spine: April 1, 2007 - Volume 32 - Issue 7 - p 816-823. doi: 10.1097/01.brs.0000259225.37454.38; https://journals.lww.com/spinejournal/Abstract/2007/04010/Systematic_Review_of_Randomized_Trials_Comparing.18.aspx
Effectively Non randomized US trials:
Lurie JD, Tosteson TD, Tosteson A, Abdu WA, Zhao W, Morgan TS. Long-term outcomes of lumbar spinal stenosis: Eight-year results of the Spine Patient Outcomes Research Trial (SPORT). Spine (Phila Pa 1976). 2015. 40: 63-76. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4288009/
Surgery better at 8 years for degnerative spondylolisthesis and carefully selected disc herniation (effectively non-randomized US based):
Abdu WA, Sacks OA, Tosteson ANA, et al. Long-Term Results of Surgery Compared With Nonoperative Treatment for Lumbar Degenerative Spondylolisthesis in the Spine Patient Outcomes Research Trial (SPORT). Spine (Phila Pa 1976). 2018;43(23):1619–1630. doi:10.1097/BRS.00000000000026821. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6185822/
Lurie JD, Tosteson TD, Tosteson AN, et al. Surgical versus nonoperative treatment for lumbar disc herniation: eight-year results for the spine patient outcomes research trial [published correction appears in Spine (Phila Pa 1976). 2015 Jan;40(1):E59]. Spine (Phila Pa 1976). 2014;39(1):3–16. doi:10.1097/BRS.0000000000000088. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921966/
Failed Back:
https://www.amjmed.com/article/S0002-9343(08)00043-0/pdf
for failed back after prior spine surgery and which questionnaires to use:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398030/
AND
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6644221/
long term outcomes of spinal surgery,
better for leg pain than for back pain and disability:
https://link.springer.com/article/10.1007/s00586-018-5680-3
Long-term follow-up suggests spinal fusion is associated with increased adjacent segment disc degeneration but without influence on clinical outcome: Results of a combined follow-up from 4 randomized controlled trials. Mannion A, et al. Spine 2014;39(17):1373-83.
Maintaining back pain free status:
https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet#3102_7