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...
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...
CLBP is the leading cause of disability worldwide and patients with yellow flags have the worst outcomes and contribute significantly to the societal cost. Clinicians are aware of the importance of yellow flags but feel undertrained to deal with them. Furthermore there is a lack of clarity for clinicians looking at how to specifically manage these patients from guidelines and an incredibly varied set of approaches available to clinicians. The objective of this review was to establish the effectiveness of physiotherapy interventions for chronic low back pain patients with yellow...
Low back pain (LBP) is usually defined as pain localised below the costal margin (ribs) and above the inferior gluteal folds (buttock crease). It is the leading cause of disability worldwide and is becoming increasingly prevalent (Harkness et al. 2005, Hoy et al. 2012, Vos et al. 2012). Chronic low back pain (CLBP) is variously defined as lasting longer than 7-12 weeks, to 3 months (Anderrson 1999, Frymoyer 1988). LBP is typically classified as “specific” or “non-specific”. Specific LBP refers to symptoms caused by specific pathophysiologic causes, such as hernia nucleus, infection,...
C-Reactive Protein (CRP) is best known as an acute phase protein and is typically assessed in most general blood work. High sensitivity CRP (hsCRP) may be a useful clinical marker of chronic inflammatory states in musculoskeletal conditions. It appears that it is raised in inflammatory chronic low back pain (CLBP) and associated with reduced pain thresholds, weakness and reduced function. It is also possible CRP could contribute towards the development and maintenance of CLBP by activating the complement system which increases peripheral nociception. Diet and lifestyle factors can promote...