Low back pain (LBP) is highly prevalent and enormously expensive to society: total payments made by Workcover for injuries to the low back were in excess of $530 million in NSW in 1996. Chronic LBP (pain lasting more than 3 months) accounts for up to 90% of these costs. Prevention of a large part of this costly problem could be achieved by effective treatment at the earlier sub-acute phase of LBP (6 weeks to 3 months duration). Exercise and advice are two widely-used treatments for sub-acute LBP ....Low back pain (LBP) is highly prevalent and enormously expensive to society: total payments made by Workcover for injuries to the low back were in excess of $530 million in NSW in 1996. Chronic LBP (pain lasting more than 3 months) accounts for up to 90% of these costs. Prevention of a large part of this costly problem could be achieved by effective treatment at the earlier sub-acute phase of LBP (6 weeks to 3 months duration). Exercise and advice are two widely-used treatments for sub-acute LBP, yet remarkably, their efficacy is unknown. For the first time, this study will rigorously evaluate the effectiveness of both a supervised exercise program and advice to return to normal activity for sub-acute LBP. When this study is completed, Australian practitioners will be able to adopt evidence based practice when managing sub-acute LBP. In addition, the study's results will enable practitioners to select the most effective treatment for each individual patient. The results of this study should lead to a large reduction in the incidence of chronic LBP, therefore the results should lead to significant savings in terms of social and economic costs.Read moreRead less
Chronic pain is a common and debilitating condition. One in five people in the Australian community have been found to experience chronic pain at any one time. Although there is no evidence of a consistent increase in rates of chronic pain, the rate of permanent disability has increased dramatically in recent decades. This has contributed to the growing cost of chronic pain. For example, back pain is the most common reason for filing workers' compensation claims and leads to loss of 101.8 millio ....Chronic pain is a common and debilitating condition. One in five people in the Australian community have been found to experience chronic pain at any one time. Although there is no evidence of a consistent increase in rates of chronic pain, the rate of permanent disability has increased dramatically in recent decades. This has contributed to the growing cost of chronic pain. For example, back pain is the most common reason for filing workers' compensation claims and leads to loss of 101.8 million workdays annually. The annual costs of medical care for back pain alone have been estimated at $AUD50 billion in the US and $10 billion in Australia. Not only is chronic pain a considerable economic burden, it is also a considerable personal burden to patients. Pain is one of the strongest predictors of poor quality of life and has consistently been found to be associated with high rates of depression. Although there is a large body of research that investigates what factors are associated with chronic pain, there is surprisingly little research that investigates the mechanisms that cause chronicity. Theories of chronic pain suggest that psychological characteristics increase the propensity for people to develop chronic pain. Specifically, theories argue that those people who tend to be fearful of pain will over-attend to painful sensations and avoid pain-provoking activities and as a result are at risk of developing chronic pain. This study will test those theories. If it is found that over-attending to pain does predispose patients to develop chronic pain, this will have important implications for preventing the development of chronic pain. These findings could help to devise early interventions to prevent chronicity and thereby reduce the economic burden to health services and the emotional burden to patients in terms of reduced quality of life.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
Back pain reduces Australia�s GDP by $3.2 Billion per annum with over $1 billion being spent each year on low back pain treatments. While it makes sense to devote resources to prevention, unfortunately most prevention strategies do not work.We need a new approach based upon a better understanding of what triggers an episode of back pain. By studying risk factors that occur immediately prior to an episode of low back pain this project will increase understanding of what triggers an episode and op ....Back pain reduces Australia�s GDP by $3.2 Billion per annum with over $1 billion being spent each year on low back pain treatments. While it makes sense to devote resources to prevention, unfortunately most prevention strategies do not work.We need a new approach based upon a better understanding of what triggers an episode of back pain. By studying risk factors that occur immediately prior to an episode of low back pain this project will increase understanding of what triggers an episode and open the way for new, effective prevention programs.Read moreRead less
Low back pain is a major global health problem and the leading cause of disability worldwide . This project will trial a new treatment for back pain that is specifically aimed at risk factors for developing ongoing back problems. Previously shown to be successful in patients suffering persistent back problems, this promising new treatment will be trialled in patients soon after they develop lower back pain as a preventative approach.
Why Do People Keep Hurting Their Back: A Longitudinal Study Of Biological, Psychological And Social Predictors
Funder
National Health and Medical Research Council
Funding Amount
$739,946.00
Summary
We aim to identify why people continue to suffer episodes of back pain. If we can identify factors that predict the course of back pain we can target treatments to the right people to reduce the burden of this common condition. We will follow people for a year after an acute episode. We will measure novel issues like control of trunk muscles, inflammatory response, and how the nervous system deals with pain. We will also investigate how these factors interact with social and psychological issues
Improving Outcomes In Low Back Pain: Targeting Specific Therapies To Patient Subgroups
Funder
National Health and Medical Research Council
Funding Amount
$435,061.00
Summary
Low back pain is a major health problem worldwide. There is a lack of effective treatments and a “one size fits all” approach to treatment is being used. This innovative research program aims to change the way back pain is treated, by identifying specific types of back pain, determining the effectiveness of treatments for these types of back pain, and translating a targeted approach to management into clinical practice to improve the health of individuals with back pain.