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The evolving role of physical therapists in the long-term management of chronic low back pain: longitudinal care using assisted self-management strategies
Journal article   Open access   Peer reviewed

The evolving role of physical therapists in the long-term management of chronic low back pain: longitudinal care using assisted self-management strategies

Paul F Beattie, Sheri P Silfies and Max Jordon
Revista brasileira de fisioterapia (São Carlos (São Paulo, Brazil)), v 20(6), pp 580-591
Nov 2016
DOI: https://doi.org/10.1590/bjpt-rbf.2014.0180
PMID: 28001268
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1590/bjpt-rbf.2014.0180View
Published, Version of Record (VoR)CC BY V4.0,  Open

Abstract

Chronic Pain - physiopathology Chronic Pain - therapy Exercise Therapy Humans Low Back Pain - physiopathology Low Back Pain - therapy Pain Management Physical Therapists
Longitudinal studies have shown that the symptoms of chronic low back pain (CLBP) will follow an episodic trajectory characterized by periods of high and low pain intensity that can persist for many years. There is a growing belief that the contemporary approach of limiting physical therapy to short, but intense courses of treatment for (CLBP) may be sub-optimal because these limited "windows" of clinical care are not congruent with the natural history of this condition. Recent research has suggested that people with CLBP undergo substantial, and individualized long-term variations in the neural processing of nociception over time. This has led to the concept of a "unique biosignature of pain" that may explain much of the variation in a person's clinical picture. These and other findings have led to the reconceptualization of CLBP as an individualized, and continually evolving condition that may be more suitably managed by empowering the patient toward self-management strategies that can be modified as needed over time by the PT. The purpose of this Master Class Paper is to describe an emerging approach for the treatment of CLBP that emphasizes the formation of a long-term therapeutic alliance between the patient and the PT with an emphasis on individualized, patient-preferred approaches for activity-based self-management as an alternative to the contemporary approach of short, intense episodes of care directed toward pain reduction. Longitudinal care using assisted self-management strategies is more congruent with the natural history of CLBP than are traditional approaches for PT intervention. This approach may empower patients to undergo lifestyle changes that will favorably influence long-term outcomes; however additional research is needed.

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32 citations in Web of Science
35 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Orthopedics
Rehabilitation
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