The Therapeutic Alliance and Low Back Pain

The therapeutic relationship has been defined as; “A helping relationship that’s based on mutual trust and respect, the nurturing of faith and hope, being sensitive to self and others, and assisting with the gratification of your patient’s physical, emotional, and spiritual needs through your knowledge and skill” (Pullen and Mathias 2010). All practitioners of the “healing arts” have experienced the importance of this relationship in helping to get the patient to comply with assessment, explain what they feel and want and helping them turn up for follow ups! In recent years more...

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The Low Back Pain Diet

Nutrition   Sleep Track with sleep cycle, try to average 8hrs Less sleep increase sensitivity to painful stimuli and is associated with the onset of chronic pain problems Most people start to move towards a more “pro-inflammatory” state at less than 7hrs sleep Aim for a 1g of protein a day for each kg of healthy body weight. 100g of meat, fish or nuts will give you approx 20g of protein as a rough guide. Look to get this from animal sources where possible. Nuts are an acceptable substitute for 1 portion a day. 3 eggs will provide approx 21grams Ideally you would split this...

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Gratitude and Low Back Pain

Gratitude is frequently stated to be useful to improving health within alternative health circles. However is there any evidence that improving our focus on gratitude can be useful to improving low back pain? There have not been any studies examining the benefits of gratitude interventions on pain. However, gratitude interventions have improved positive affect, inflammatory markers and specifically depression and anxiety. Emmons and McCullough (2003) were the first to examine the effects of focusing on gratitude or hassles on psychological markers. They assigned patients to focus on either gratitude,...

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Psychosocial Symptoms, Chronic Low Back Pain and Inflammation

Highlights   Psychosocial symptoms are important predictors of those that do worse with chronic low back pain. Currently the prevailing view is that psychosocial symptoms drive systemic inflammation. Psychosocial problems increase inflammation, and inflammation increases psychosocial symptoms. Psychosocial treatments decrease inflammation and reducing inflammation improves psychosocial symptoms. The relationship is bidirectional and we should remember this when dealing with patients with psychosocial symptoms. Explaining this relationship to patients may reduce the stigma associated with...

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Mindfulness and Chronic Low Back Pain; Why and How To.

Mindfulness is basically the western term for meditation. The practice has moved from weird hippies only, to being used by CEOs and professional sport, and is now being studied fairly extensively. This blog will focus on the relevance of mindfulness to chronic low back pain. Outlining the benefits and how to start a mindfulness practice. Psychological stress can directly influence the musculoskeletal, endocrine, immune and nervous systems through the limbic system modifying chronic pain (Macphail 2014). Psychosocial risk factors for low back pain (LBP) chronicity are well known to lead to worse...

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