About 1 in 10 Australians have persisting or chronic low back pain. Most are managed in primary care and the most frequently prescribed treatment is exercise. Chronic low back pain remains a major health problem because not all patients respond to each treatment so on average treatment effects are small. At present there are no guidelines to help clinicians select the best treatment for a patient. As a result a lot of time and money is wasted on treatments which ultimately fail to help the patie ....About 1 in 10 Australians have persisting or chronic low back pain. Most are managed in primary care and the most frequently prescribed treatment is exercise. Chronic low back pain remains a major health problem because not all patients respond to each treatment so on average treatment effects are small. At present there are no guidelines to help clinicians select the best treatment for a patient. As a result a lot of time and money is wasted on treatments which ultimately fail to help the patient. We have begun a research program to solve this primary health care problem. We have focussed on exercise because the treatment is widely available in primary care and of modest cost. The program includes basic research to understand the mechanism of action of exercise and clinical trials testing the effectiveness of different types of exercise. The proposed study falls into the latter category, and is a direct comparison of the two most promising types of exercise used in Australia. The study will also identify clinical features that modify treatment effects, a finding that will allow clinicians to identify which type of exercise is more likely to be effective for an individual patient. This study offers a potential solution to a major health problem with enormous economic and social costs.Read moreRead less
A Clinical Trial Of Manipulative Therapy And/or NSAIDs For Significant Acute Low Back Pain
Funder
National Health and Medical Research Council
Funding Amount
$521,625.00
Summary
Acute low back pain is a disabling condition with many sufferers being unable to perform their family or work duties due to severe pain. Treatment of acute LBP is also costly, this condition being one of the most frequent problems managed by general practitioners. Guidelines about how to treat patients with acute low back pain have suggested that advice and paracetamol should be the first line of treatment. In patients with insufficient pain relief two of the most frequently used additional trea ....Acute low back pain is a disabling condition with many sufferers being unable to perform their family or work duties due to severe pain. Treatment of acute LBP is also costly, this condition being one of the most frequent problems managed by general practitioners. Guidelines about how to treat patients with acute low back pain have suggested that advice and paracetamol should be the first line of treatment. In patients with insufficient pain relief two of the most frequently used additional treatments are anti-inflammatory medication and manipulative physiotherapy. However, to date it is not known whether the addition of one or both of these treatments results in faster recovery for the patient. Our clinical trial will clarify whether the addition of (i) anti-inflammatory medication and-or (ii) manipulative physiotherapy, to advice and paracetamol given by the doctor results in a faster recovery for the patient with acute low back pain. This results of this study will make it possible for general practitioners to manage acute low back pain in an evidence-based way.Read moreRead less
Pain And Trunk Muscle Control: Effects, Mechanisms And Consequences
Funder
National Health and Medical Research Council
Funding Amount
$296,452.00
Summary
Twenty-one percent of Australians report long-term back problems. This makes back pain the most common chronic pain in Australia and most prevalent disorder among the National Health Priority Areas. For the majority with recurrent and chronic problems, the cause is unknown but changes in control of the spine are thought to be important. It is well accepted that pain and injury to the low back affect the way that we control the back muscles and this leads to changes in spinal function. However, d ....Twenty-one percent of Australians report long-term back problems. This makes back pain the most common chronic pain in Australia and most prevalent disorder among the National Health Priority Areas. For the majority with recurrent and chronic problems, the cause is unknown but changes in control of the spine are thought to be important. It is well accepted that pain and injury to the low back affect the way that we control the back muscles and this leads to changes in spinal function. However, despite considerable investigation of this problem, there is a distinct lack of consensus for how the control of movement is changed during pain, why it changes, and whether these changes lead to further problems in the long term. The objective of this series of studies is to determine how the adaptation to pain changes the control of the spine. We will use a range of techniques that include tests of the strategies used by the brain to control the spine and mathematical models to estimate the effect that these changes have on the spine when people are given back pain by injecting sterile salty water into the back muscles. These studies will be backed up by measures of mechanical properties of the spine and by comparison to people with clinical pain. This combination of methods has not been used previously and is likely to help resolve the problem of how muscle control is chaged in back pain. We will also test a range of hypotheses regarding how pain has its effect on muscle activity. A final series of studies aims to determine whether the failure of these changes in muscle control to resolve after an epiosde of back pain leads to increased recurrence of pain in the long-term. The importance of this project is highlighted by the significance of back pain as a major health issue, the lack of consensus regarding the effect and mechanisms of pain on trunk muscle control (despite extensive investigation), and the potential for the findings to guide rehabilitation and management.Read moreRead less