Peter O'Sullivan, expert in chronic low back pain, discusses the causes, classification, and treatment of chronic low back pain. He debunks myths around 'core stability' and emphasizes the importance of a multidimensional approach to treatment. He also talks about the role of manual therapy, educating patients, and integrating multiple dimensions in the classification and treatment of back pain.
A holistic approach that addresses the individual factors contributing to chronic low back pain is recommended, integrating cognitive and functional approaches.
Addressing stress levels, developing relaxation techniques, and providing pain education can lead to significant improvements in pain and function.
Teaching patients to let go of rigid movement patterns and adopt more relaxed and functional movement strategies can reduce pain levels.
Deep dives
Understanding the Multi-Dimensional Nature of Pain
The podcast discusses the shift in understanding chronic low back pain from a biomechanical perspective to a more multi-dimensional understanding. This shift is supported by contemporary evidence that highlights the importance of considering pain mechanisms, pain beliefs, psychosocial factors, and individual profiles in the management of pain disorders.
The Role of Cognitive and Functional Approaches
The podcast emphasizes the importance of integrating cognitive and functional approaches in the treatment of chronic low back pain. Rather than solely relying on manual therapy or stability exercises, a holistic approach that empowers patients to move normally, change their pain beliefs, develop active coping strategies, and focus on functional movements is recommended. This approach recognizes the individuality of each patient and aims to address the underlying factors contributing to their pain.
The Impact of Stress and Fear on Pain
The podcast highlights the significant impact of stress and fear on pain disorders. It discusses how chronic stress can sensitize the nervous system, leading to increased muscle tension, widespread pain, and altered body maps. By addressing stress levels, developing relaxation techniques, and providing pain education, patients can experience significant improvements in pain and function.
Different movement profiles can influence pain levels
This podcast episode discusses how movement profiles can affect pain levels. Rigid movement patterns can contribute to increased pain, while relaxed and normal movement patterns can lead to decreased pain. The speaker emphasizes the importance of teaching patients how to let go of rigid movement patterns and adopt more relaxed and functional movement strategies. Breathing strategies and visualization techniques are also mentioned as tools to aid in relaxation.
Identifying different pain profiles and tailoring treatment accordingly
The podcast delves into the importance of identifying different pain profiles in patients with chronic low back pain. One profile is described as primarily nociceptive, where pain is experienced with specific movements and activities. Another profile involves central drivers of pain, characterized by constant or fluctuating pain that may be more widespread in nature. The speaker highlights the need to tailor treatment based on these pain profiles, with a focus on addressing physical behaviors and lifestyle factors for the nociceptive profile, and incorporating strategies to target central pain and psychological factors for the central pain profile.
What is contributing to your patients low back pain? How do you know when manual therapy, education, exercise, motor control programs, CBT or any other approach for chronic LBP will be helpful? In episode 14 of the Physio Edge podcast, Peter O’Sullivan and David Pope discuss chronic low back pain, Peter’s research into this area, and the approach of Peter and his team to getting over chronic low back pain. Some of the topics we dug into include:
Causes, classification and treatment of chronic low back pain (CLBP)
Common treatment errors
Identifying mechanical contributors
When manual therapy is helpful
Myths around “core stability” for CLBP
What is the current evidence base for CLBP classification and treatment
Tips for treatment of CLBP
A lot of other great treatment advice for CLBP….
Listen to it now, and subscribe free to the podcast in iTunes