Alternative Interventions to Treat Chronic Back Pain for Return to Work ASOT 2014 VISION IN ACTION CONFERENCE Casey Smith, OTS January 24 th, 2014.

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

Questions

Email:

[email protected]

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