New back pain study in North Staffordshire to identify those at most risk of recurrent problems
Researchers at Keele University are aiming to tackle the huge problem of back pain by targeting those people considered to be at the highest risk of long-term pain and offering an intensive course of appropriate treatment.
Up to 800 people with back pain from 15 GP practices in North Staffordshire are to be recruited onto a major new clinical trial starting in January to test the effectiveness of different types of physiotherapy which will be specifically targeted to their particular needs.
Back pain is a major health problem in the UK affecting more than one third of the adult population. Up to 80 per cent of sufferers are still in pain a year after their first visit to the GP, and persistent back pain has a serious impact on the lives of sufferers and their families.
Although it is already known that physiotherapy and exercise are effective in the treatment of back pain, the fundamental question of who will do best with which treatment remains unanswered.
Many people develop back pain throughout their lives, but in certain types of people the risk of it becoming long-term or recurring is much greater. These are the people being singled out for particular attention by a team of rheumatologists, physiotherapists and other experts at the Primary Care Musculoskeletal Research Centre at Keele, in a new £183, 660 two-year clinical trial funded by the Arthritis Research Campaign.
“Everyone gets upset and anxious about having back pain, it’s quite natural, but there is a small group of people of about 20 to 25 per cent, male and female of all ages, who have inappropriate levels of fear and distress,” explained Professor Elaine Hay, Professor Community Rheumatology at Keele, who is leading the study.
“They don’t follow our messages of keeping active because they think it will make their back pain worse; they withdraw from activity and become de-conditioned, and their backs become weaker and more painful.”
This group of people will be identified from a short questionnaire drawn up by the research team and given to patients by GPs and physiotherapists. All community physiotherapists taking part will undergo three days of intensive training before the trial begins in January.
All back pain patients taking part in the active arm of the trial will have half an hour with an experienced physiotherapist, and given simple messages promoting a speedy return normal activity and avoid resting, and told about local gyms and swimming pools, exercise on prescription and self-help groups.
Those in the second group considered at medium risk of recurring back pain will have another six half hourly sessions focussing on how this can be best avoided, plus manual therapy and exercises
The third group considered to be at high risk of long-term back pain will also have extra six physiotherapy sessions but these will be more intensive and concentrate more on psychological ways of coping, including sessions of cognitive behavioural therapy developed by Professor of Psychology at Keele Chris Main.
Those patients in the control arm of the trial (against which the active arm of the trial will be compared) will receive the best currently available non-targeted physiotherapy. All groups will be assessed at four month and 12 months.
