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Low back pain

updated

Tags: etiology, treatment, back pain, mind, pro, pain problems, spine

Two articles on PainSci cite Vlaeyen 2018: (1) Complete Guide to Low Back Pain(2) Vulnerability to Chronic Pain

PainSci notes on Vlaeyen 2018:

This is a thorough chronic low back pain treatment primer for clinicians. The writing is dry but clear, and although a lot of expert opinion is interjected, there’s also an obvious effort to be rigorously evidence-based. There were very few red flags for me as a skeptic

The paper focusses on “the development of new diagnostic procedures, evidence-based screening methods and more targeted interventions,” and broadly conclude that there’s a need for “a multidisciplinary approach to the management of low back pain that integrates biological, psychological and social aspects.” Too broadly, I think: the paper doesn’t really deliver much in the way of better diagnosis or more “targeted” treatment, and in fact I found the treatment content to be the most anemic part of the paper.

The authors certainly do a good job of explaining why the “injury model” isn’t adequate anymore, but there’s nothing new about that (back pain experts have been debunking the injury model since the 90s). And their review of mechanisms of pain is quite good.

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

Low back pain affects individuals of all ages and is a leading contributor to disease burden worldwide. Despite advancements in assessment and treatment methods, the management of low back pain remains a challenge for researchers and clinicians alike. One reason for the limited success in identifying effective treatments is the large variation in the manifestations, possible causes, precipitating and maintaining factors, course, prognosis and consequences in terms of activity interference and quality of life. However, despite these challenges, steady progress has been achieved in the understanding of back pain, and important steps in the understanding of the psychological and social risk factors, genetics and brain mechanisms of low back pain have been made. These new findings have given impetus to the development of new diagnostic procedures, evidence-based screening methods and more targeted interventions, which underscore the need for a multidisciplinary approach to the management of low back pain that integrates biological, psychological and social aspects.

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