Patient Characteristics Are Associated With Differences in Perceptions of Reassurance After a Consultation for Low Back Pain: Analysis of an Observational Study in Primary Care.

Background: People with low back pain (LBP) report different perceptions of reassurance after a consultation. We aimed to determine whether patient characteristics are associated with differences in patient perceptions of reassurance.

Methods: Secondary analysis of 2048 adults presenting with back pain to a chiropractor.

Evaluating the effect of incentives on recruiting people with low back pain with limited English proficiency as part of the COMFORT cluster randomised controlled trial: a study protocol for a study within a trial (SWAT).

Background: Previous research has reported that Australians with limited English proficiency are less likely to be included in clinical trials due to language, literacy, and cultural factors. In the pain field, participants with limited English proficiency are three times more likely to be excluded from research, whereas in low back pain trials, 1 in 5 participants are excluded. This low representation can limit the generalisability of research findings to Australia's diverse population, and strategies are required to facilitate the inclusion of participants with limited English proficiency in clinical trials.

Long-term effectiveness of non-surgical interventions for chronic low back pain: a systematic review and meta-analysis.

Background: Chronic low back pain is a long-term recurrent condition. Interventions with sustained benefits are needed to reduce the associated personal and societal burden. We aimed to assess the long-term effectiveness of non-surgical interventions for reducing pain intensity and disability in adults with chronic low back pain.

Exploring Values Clarification and Health-Literate Design in Patient Decision Aids: A Qualitative Interview Study.

BackgroundThis study explores patient and clinician perceptions of a patient decision aid, focusing on 2 features that are often absent: a health-literate approach (e.g., using plain language, encouraging question asking) and a tool that explicitly shows how treatment options align with patient values.

Audit and feedback: effects on professional practice.

Background: Audit and feedback (A&F) is a widely used strategy to improve professional practice. This is supported by prior Cochrane reviews and behavioural theories describing how healthcare professionals are prompted to modify their practice when given data showing that their clinical practice is inconsistent with a desirable target. Yet there remains uncertainty regarding the effects of A&F on improving healthcare practice and the characteristics of A&F that lead to a greater impact.

Leg Muscle Volume, Intramuscular Fat and Force Generation: Insights From a Computer-Vision Model and Fat-Water MRI.

Background: Maintaining skeletal muscle health (i.e., muscle size and quality) is crucial for preserving mobility.

"Gleaning a lot from the history and physical exam," and "reasonably confident without imaging": a qualitative study of primary care clinicians' management of patients with low back pain.

Background: Routine seeking of imaging for patients with low back pain is not concordant with the evidence-based recommendation that imaging is rarely of diagnostic value. Inappropriate imaging is a waste of resources and can lead to undesirable downstream effects for individuals and health systems. To develop effective strategies to reduce unwarranted referrals for imaging in primary care, we must understand the drivers for, and barriers to, guideline-adherent practice.

The Effectiveness of Spinal Manipulative Therapy in Treating Spinal Pain Does Not Depend on the Application Procedures: A Systematic Review and Network Meta-analysis.

To assess whether spinal manipulative therapy (SMT) application procedures (ie, target, thrust, and region) impacted changes in pain and disability for adults with spine pain. Systematic review with network meta-analysis. We searched PubMed and Epistemonikos for systematic reviews indexed up to February 2022 and conducted a systematic search of 5 databases (MEDLINE, EMBASE, CENTRAL [Cochrane Central Register of Controlled Trials], PEDro [Physiotherapy Evidence Database], and Index to Chiropractic Literature) from January 1, 2018, to September 12, 2023.

Diagnostic imaging in the management of older adults with low back pain: analysis from the BAck Complaints in Elders: Chiropractic - Australia cohort study.

Background: Diagnostic imaging is commonly used in the management of low back pain (LBP), with approximately one-quarter of those who present to primary care referred for imaging. Current estimates of imaging frequency commonly exclude older adults; however, pathology detected with imaging (e.g.

Clinician experiences in providing reassurance for patients with low back pain in primary care: a qualitative study.

Questions: What reassurance is being delivered by physiotherapists and chiropractors to people with non-specific low back pain? How is it being delivered? What are the barriers and enablers to delivering reassurance to people with non-specific low back pain?

Design: A qualitative study.

Participants: Thirty-two musculoskeletal clinicians (16 physiotherapists and 16 chiropractors) who manage low back pain in primary care.

Method: Semi-structured interviews were conducted about their experiences delivering reassurance.

Reassurance use and reassurance-related outcomes for low back pain in primary care: A scoping review.

We used a scoping review design to map the available evidence describing the use of reassurance in clinical practice, interventions to increase the delivery of reassurance, and reassurance-related outcome measures. We searched CINAHL, MEDLINE, EMBASE and Cochrane Central from inception to October 2024. Publications were included if they described the use of reassurance or reassurance-related outcome measures in patients with non-specific low back pain (LBP) presenting to primary care.

Perceptions of advice for acute low back pain: a content analysis of qualitative data collected in a randomised experiment.

Objectives: To explore how people perceive three different forms of advice for acute low back pain (LBP).

Design: Content analysis of qualitative data collected in a three-arm randomised experiment.

Participants: 2200 participants with acute LBP (ie, pain duration for ≤6 weeks) were randomly assigned to receive three types of advice: guideline advice and guideline advice with the addition of either brief pain science or ergonomics messages.

Long-term Trajectories of Low Back Pain in Older Men: A Prospective Cohort Study With 10-Year Analysis of the Osteoporotic Fractures in Men Study.

Although low back pain (LBP) may persist or recur over time, few studies have evaluated the individual course of LBP over a long-term period, particularly among older adults. Based on data from the longitudinal Osteoporotic Fractures in Men (MrOS) Study, we aimed to identify and describe different LBP trajectories in older men and characterize members in each trajectory group. A total of 5 976 community-dwelling men (mean age = 74.

Chiropractors' perceptions on the use of spinal radiographs in clinical practice: a qualitative study.

Background: Radiography is commonly used in the assessment of spinal disorders, despite a lack of high-quality evidence demonstrating improved clinical outcomes or additional benefit to the patient. There is disagreement amongst chiropractors regarding the appropriate use of radiography for clinical management. This study aims to qualitatively explore chiropractors' perceptions on the use of spinal radiographs in clinical practice with respect to how they determine when to order radiographs; and how they use radiographs to inform clinical management.

Association of back pain with all-cause and cause-specific mortality among older men: a cohort study.

Objective: We evaluated whether more severe back pain phenotypes-persistent, frequent, or disabling back pain-are associated with higher mortality rate among older men.

Methods: In this secondary analysis of a prospective cohort, the Osteoporotic Fractures in Men (MrOS) study, we evaluated mortality rates by back pain phenotype among 5215 older community-dwelling men (mean age, 73 years, SD = 5.6) from 6 sites in the United States.

Development of low back pain curriculum content standards for entry-level clinical training.

Background: The management of low back pain (LBP) is highly variable and patients often receive management that is not recommended and/or miss out on recommended care. Clinician knowledge and behaviours are strongly influenced by entry-level clinical training and are commonly cited as barriers to implementing evidence-based management. Currently there are no internationally recognised curriculum standards for the teaching of LBP content to ensure graduating clinicians have the appropriate knowledge and competencies to assess and manage LBP.

Clinical Observation, Management and Function Of low back pain Relief Therapies (COMFORT): A cluster randomised controlled trial protocol.

Introduction: Low back pain (LBP) is commonly treated with opioid analgesics despite evidence that these medicines provide minimal or no benefit for LBP and have an established profile of harms. International guidelines discourage or urge caution with the use of opioids for back pain; however, doctors and patients lack practical strategies to help them implement the guidelines. This trial will evaluate a multifaceted intervention to support general practitioners (GPs) and their patients with LBP implement the recommendations in the latest opioid prescribing guidelines.

Adding Brief Pain Science or Ergonomics Messages to Guideline Advice Did Not Increase Feelings of Reassurance in People With Acute Low Back Pain: A Randomized Experiment.

To investigate the effects of adding pain science or ergonomics messages to guideline advice on feelings of reassurance and management intentions among people with acute low back pain (LBP). Three-arm parallel-group randomized experiment. We recruited people with acute LBP (pain for ≤6 weeks) to participate in an online experiment.

Patient and provider characteristics associated with therapeutic intervention selection in a chiropractic clinical encounter: a cross-sectional analysis of the COAST and O-COAST study data.

Background: Chiropractors use a variety of therapeutic interventions in clinical practice. How the selection of interventions differs across musculoskeletal regions or with different patient and provider characteristics is currently unclear. This study aimed to describe how frequently different interventions are used for patients presenting for chiropractic care, and patient and provider characteristics associated with intervention selection.

Stressful life events and low back pain in older men: A cross-sectional and prospective analysis using data from the MrOS study.

Background: Stressful life events, such as loss of a partner, loss of a pet or financial problems, are more common with increasing age and may impact the experience of pain. The aim of the current study is to determine the cross-sectional and prospective association between stressful life events and low back pain reporting in the Osteoporotic Fracture in Men Study, a cohort of older men aged ≥65 years.

Methods: At a study visit (March 2005-May 2006), 5149 men reported whether they had experienced a stressful life event or low back pain in the prior 12 months.

The effectiveness of spinal manipulative therapy procedures for spine pain: protocol for a systematic review and network meta-analysis.

Background: Spinal manipulative therapy (SMT) is a guideline-recommended treatment option for spinal pain. The recommendation is based on multiple systematic reviews. However, these reviews fail to consider that clinical effects may depend on SMT "application procedures" (i.

Feasibility of testing the effectiveness of a theory-informed intervention to reduce imaging for low back pain: a pilot cluster randomised controlled trial.

Background: General medical practitioner (GP) recruitment and subsequent data collection in clinical practice are challenging and may limit successful completion of a large-scale trial. The aim of this study was to assess the feasibility of undertaking a cluster randomised controlled trial to test an intervention to reduce non-indicated imaging for low back pain in general medical practice.

Methods: A pilot cluster randomised controlled trial was performed, with recruitment of GPs and randomisation of GP clinics.

Physiotherapists have some hesitations and unmet needs regarding delivery of exercise programs for low back pain prevention in adults: A qualitative interview study.

Background: Although there is some qualitative research on physiotherapists' experiences of delivering low back pain treatment, we do not know the extent that these findings apply to low back pain prevention.

Objective: To explore physiotherapists' understanding, attitudes and experiences related to delivering low back pain prevention programs.

Design: Qualitative interview study.

General practitioner experiences using a low back pain management booklet aiming to decrease non-indicated imaging for low back pain.

Background: Imaging is overused in the management of low back pain, resulting in overdiagnosis, increased healthcare utilisation, and increased costs. Few effective interventions to decrease inappropriate use have been developed and have typically not been developed using behaviour change theory. An intervention to reduce non-indicated imaging for low back pain was developed using behavioural change theory, incorporating a novel low back pain management booklet to facilitate patient education and reassurance.