Chronic low back pain beliefs and management practices in Africa: Time for a rethink?

2019 ◽  
Vol 17 (4) ◽  
pp. 376-381 ◽  
Author(s):  
Josephine Ahenkorah ◽  
Fiona Moffatt ◽  
Claire Diver ◽  
Paapa Kwesi Ampiah
2020 ◽  
Vol 33 (5) ◽  
pp. 785-791 ◽  
Author(s):  
Nuray Alaca ◽  
Hande Kaba ◽  
Ayce Atalay

BACKGROUND AND OBJECTIVES: Low back pain (LBP) is one of the leading forms of chronic pain and is among the leading causes of pain and disability. In this study, we investigated the associations between the severity of disability and fear of movement and pain beliefs as well as the impact of the fear of movement and pain beliefs on the quality of life in patients with chronic LBP. METHODS: A total of 89 patients (42.29 ± 16.05 years) with chronic low back pain were included in the study. The instruments used in the assessments include the Visual Analogue Scale (VAS), the Oswestry Disability Index (ODI), the Tampa Kinesiophobia Scale (TKS), the Pain Belief Questionnaire (PBQ), and the SF 36-Short Form. Patients were assigned into three groups by disability severity based on ODI scores. Statistical analysis was performed using SPSS 15. RESULTS: No statistically significant intergroup differences were found in TKS and PBQ scores (p> 0.05). A positive correlation was found between TKS scores, age (r: 0.227/p< 0.05), PBQ organic (r: -0.250/p< 0.05) scores. CONCLUSIONS: Our study revealed high levels of kinesiophobia and similar pain beliefs, independent of the severity level of disability. We believe that cognitive-behavioral therapy that may reduce fear-avoidance behaviors and convert negative pain beliefs into positive ones should be added to rehabilitation procedures for LBP.


2019 ◽  
Vol 33 (6) ◽  
pp. 1088-1097 ◽  
Author(s):  
Amanda Williams ◽  
Hopin Lee ◽  
Steven J Kamper ◽  
Kate M O’Brien ◽  
John Wiggers ◽  
...  

Purpose: To assess the causal mechanisms of a healthy lifestyle intervention for patients with chronic low back pain and knee osteoarthritis, who are overweight or obese. Methods: We conducted causal mediation analyses of aggregated data from two randomized controlled trials (RCTs); which included 160 patients with chronic low back pain, and 120 patients with knee osteoarthritis. The intervention consisted of brief advice and referral to a six-month telephone-based healthy lifestyle coaching service. We used causal mediation to estimate the indirect, direct and path-specific effects of hypothesized mediators including: self-reported weight, diet, physical activity, and pain beliefs. Outcomes were pain intensity, disability, and quality of life (QoL). Results: The intervention did not reduce weight, improve diet or physical activity or change pain beliefs, and these mediators were not associated with the outcomes. Sensitivity analyses showed that our estimates were robust to the possible effects of unknown and unmeasured confounding. Conclusions: Our findings show that the intervention did not cause a meaningful change in the hypothesized mediators, and these mediators were not associated with patient-reported outcomes.


1995 ◽  
Vol 25 (4) ◽  
pp. 371-387 ◽  
Author(s):  
J. Strong ◽  
R. G. Large

Objective: This article explores the coping construct held by individuals with chronic low back pain. The research addresses two criteria identified as important for coping research: it looks at people's appraisals and responses to the specific stressor of living with chronic low back pain, and it seeks to identify what these individuals actually think and do in response to the ongoing stressor of living with chronic pain. Method: Fifteen people with chronic low back pain who responded to a media release participated in focus group discussions on coping with chronic pain. Results: Analysis indicated the desirability, if not need, for a somatic focus, the reliance on higher order cognitive strategies for planful action, and the use of a varied repertoire of coping strategies. Conclusions: These findings are discussed both in terms of adjustment to chronic illness and in relation to current pain management practices.


2018 ◽  
Vol 4 (12) ◽  
pp. 18-23
Author(s):  
Marie Abdolghaderi ◽  
Seyed-Mousa Kafi ◽  
Alia Saberi ◽  
Saeed Ariaporan ◽  
◽  
...  

Pain ◽  
2002 ◽  
Vol 97 (1) ◽  
pp. 23-31 ◽  
Author(s):  
David Andrew Walsh ◽  
Jenny Clare Radcliffe

2018 ◽  
Author(s):  
A Williams ◽  
H Lee ◽  
SJ Kamper ◽  
KM O’Brien ◽  
J Wiggers ◽  
...  

AbstractWe assessed the causal mechanisms of a healthy lifestyle intervention for patients with chronic low back pain and knee osteoarthritis (OA), who are overweight or obese. We conducted causal mediation analyses of aggregated data from two RCTs; which included 160 patients with chronic low back pain, and 120 patients with knee OA. Participants were randomised via one central randomisation schedule, to the intervention, or usual care. The intervention consisted of brief advice and referral to a 6-month telephone-based healthy lifestyle coaching service. Participants in the back pain trial were also offered a single physiotherapy consultation. The hypothesised primary mediator was self-reported weight, and alternative mediators were diet, physical activity, and pain beliefs. Outcomes were pain intensity, disability, and quality of life (QoL). Data were analysed using causal mediation analyses with sensitivity analyses for sequential ignorability. All mediation models were specified a priori. The intervention had no effect on pain intensity, disability or physical QoL. The intervention significantly improved mental QoL, however, the intervention effect was not channelled via the selected mediators. The intervention did not reduce weight, or the alternative mediators (diet, physical activity, pain beliefs), and these mediators were not associated with the outcomes (with one exception; poor diet was associated with lower mental QoL). The sensitivity analyses showed that our estimates were stable across all possible levels of residual confounding. Our findings show that the intervention did not cause a meaningful change in the hypothesised mediators, and these mediators were not associated with patient outcomes.


2016 ◽  
Vol 96 (9) ◽  
pp. 1397-1407 ◽  
Author(s):  
Samantha Bunzli ◽  
Sarah McEvoy ◽  
Wim Dankaerts ◽  
Peter O'Sullivan ◽  
Kieran O'Sullivan

Abstract Background Cognitive functional therapy (CFT) has been shown to reduce pain and disability in people with chronic low back pain. Objectives The purpose of this study was to investigate participants' experience of CFT by comparing participants who reported differing levels of improvement after participation in CFT, potentially yielding insight into the implementation of this approach. Design This was a noninterventional, cross-sectional, qualitative study with an interpretive description framework. Methods Individuals who had participated in CFT in 2 physical therapy settings (in Ireland and Australia) were recruited through purposive sampling based on disability outcomes postintervention (n=9), and theoretical sampling (n=5). This sampling strategy was used to capture a range of participant experiences but was not used to define the final qualitative groupings. Semistructured interviews were conducted 3 to 6 months postintervention. Results Three groups emerged from the qualitative analysis: large improvers, small improvers, and unchanged. Two themes encapsulating the key requirements in achieving a successful outcome through CFT were identified: (1) changing pain beliefs and (2) achieving independence. Changing pain beliefs to a more biopsychosocial perspective required a strong therapeutic alliance, development of body awareness, and the experience of control over pain. Independence was achieved by large improvers through newly cultivated problem-solving skills, self-efficacy, decreased fear of pain, and improved stress coping. Residual fear and poor stress coping meant that small improvers were easily distressed and lacked independence. Those who were unchanged continued to feel defined by their pain and retained a biomedical perspective. Conclusions A successful outcome after CFT is dependent on instilling biopsychosocial pain beliefs and developing independence among participants. Small improvers may require ongoing support to maintain results. Further study is needed to elucidate the optimal approach for those who were unchanged.


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