Alternative Interventions to Treat Chronic Back Pain for Return to Work ASOT 2014 VISION IN ACTION...
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Transcript of Alternative Interventions to Treat Chronic Back Pain for Return to Work ASOT 2014 VISION IN ACTION...
Alternative Interventions to Treat Chronic Back Pain for Return to Work
ASOT 2014 Vision in Action Conference
Casey Smith, OTSJanuary 24th, 2014
Topic Development
Leading cause of disability in Americans under 45 years old.Fieldwork experience Personal experience Interest in Alternative (non-Pharmacological) treatments
Objectives
Main causes for chronic back pain
Literature SearchWhat does the evidence
say?Practicality of
interventionsFieldwork experienceImplications for Future
PractitionersQuestions?
Chronic Low Back Pain
Chronic pain is any pain lasting longer than 6 months
CausesImplications for OTHow it is measured?
Literature Search
Search Engines: Academic Search Premier: EBSCOhost, PubMed,
AJOT, JRRD
Key Search Terms: Chronic pain, chronic back pain, return to work, work
hardening, work rehabilitation, work related injury, yoga, yoga and pain management, aquatic therapy, PENS, electrical nerve stimulation, and core strengthening
What does the Evidence Say?
Clinically EffectiveAquatic therapyMultimodal Work Hardening with Cognitive behavioral approachYogaBalneotherapyPENSCore strengthening
Clinically SignificantSurface Perceptive Tool vs. Back School program
Practicality of Interventions
Replicating some of these studies would be challenging (Balneotherapy, Surface Perceptive tool, Aquatic Therapy).
Pain outcomes/measures are subjectiveStudies carried out in other countriesSmall sample sizesLength of treatment and duration, and follow
up Did not monitor variable of pharmaceuticalsHow easily could these be implemented?
Fieldwork Experience
Christian Health Center of Louisville - SNF Heat, Ice, Ultrasound and TENS, pharmaceuticals
Frazier Newburg Road Clinic – Work Hardening Program Lumbar stabilization exercises, core
strengthening, heat, ice, weight lifting, walking, stretching, and work simulation tasks including lifting and carrying weighted objects
Future Implications for Practitioners
Open to new alternative treatments for back pain
Emerging research studies Continued research
Dry needling? Program development for new facilities Local programs
References
Baena-Beato, P., Arroyo-Morales, M., Delgado-Fernández, M., Gatto-Cardia, M., & Artero, E. G. (2013). Effects of different frequencies (2-3 Days/Week) of
aquatic therapy program in adults with chronic low back pain. A non-randomized comparison trial. Pain Medicine, 14(1), 145-158. doi: 10.1111/pme.12002
Bethge, M., Herbold, D., Trowitzsch, L., Jacobi, C. (2011). Work status and health related quality of life following multimodal work hardening: A
cluster randomized trial. Journal of Back and Musculoskeletal Rehabilitation. 24, 161-172. doi: 10.3233/BMR-2011-0290
Denneson, L. M., Corson, K., Dobscha, S.K. (2011). Complementary and alternative medicine use among veterans with chronic
noncancer pain. Journal of Rehabilitation Research & Development, 48(9), 1119–1128. doi:
10.1682/JRRD.2010.12.0243
Morone, G., Iosa, M., Paolucci, T., Fusco, A., Alcuri, R., Spadini, E., & ... Paolucci, S. (2012). Efficacy of perceptive rehabilitation in the treatment of chronic
nonspecific low back pain through a new tool: a randomized clinical study. Clinical Rehabilitation, 26(4), 339-350. doi: 10.1177/0269215511414443
Tefner, I., Németh, A., Lászlófi, A., Kis, T., Gyetvai, G., & Bender, T. (2012). The effect of spa therapy in chronic low back pain: a randomized controlled, single-
blind, follow-up study. Rheumatology International, 32(10), 3163-3169. doi:10.1007/s00296-011-2145-y
Tilbrook, H. E., Cox, H., Hewitt, C. E., Kang'ombe, A., Ling-Hsiang, C., Jayakody, S., & ... Torgerson, D. J. (2011). Yoga for chronic low back pain. Annals Of
Internal Medicine, 155(9), 569-W-167.
Unsgaard-Tondel, M., Nilsen, T.I.. Magnussen, J., Vasseljen, O. (2012). Is activation of transversus abdominis and obliquus internus abdominis associated with
long-term changes in chronic low back pain? A prospective study with 1-year follow-up. British Journal of Sports Medicine. 46, 729-734. doi:
10.1136/bjsm.2011.085506
Weiner, D.K., Rudy, T.E., Glick, R.M., Boston, J.R., Lieber, S.J., Morrow, L.A., Taylor, S. (2003). Efficacy of percutaneous electrical nerve stimulation for the
treatment of chronic low back Pain in older adults. Journal of the American Geriatrics Society, 51(5), 599-608. doi: 10.1034/j.1600- 0579.2003.00202.x