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Utilizing Clinical Practice Guidelines for Treatment of Low Back Pain: Summary
Key Points on Classification Systems • Acute LBP: ○ No evidence directly comparing
• PNE involves:
○ Teaching clients to reshape their perception of pain ○ Helping clients have a better
effectiveness of different classification systems • Chronic LBP: ○ No evidence to support a classification system as more effective than another for reducing pain and disability 4. Client Education Purpose: • Promote client understanding of the spine • Use neuroscience that explains pain perception • Promote overall favorable prognosis of LBP • Use active pain coping strategies to decrease fear and catastrophizing • Promote early resumption of normal and vocational activities (even if pain is present) • Promote importance of improvement of activity levels, not just relief of pain Education should avoid: • Generating fear • Promoting extended bedrest • Being complex in pathoanatomy Acute LBP: • Education and advice: Moderate evidence/B: ○ Use of active education strategies ■ Advice to remain active ■ Self-pacing strategies ■ Back protection techniques ○ Avoidance of passive education strategies: ■ Providing access to educational materials ■ Directing clients to sources through which they may self-educate Chronic LBP: • Pain neuroscience education (PNE): Strong evidence/A: ○ When used alongside other treatments (manual therapy, exercise) and not as stand-alone treatment ■ One-on-one communication ■ Self-management techniques
understanding of their condition ○ Encouraging clients to be active participants in their condition • Education and advice: Moderate evidence/B: ○ Education effective in conjunction with treatment ○ Not recommended as a stand-alone treatment ○ Standard education strategies encouraged: ■ Advice to stay active ■ Advice related to exercise • Use of the following “other active treatments”: Strong evidence/A: ○ Yoga ○ Stretching ○ Pilates ○ Strength training ○ Recommendation: Use of these “other active treatments” rather than education as a stand-alone intervention Postoperative LBP: • Postoperative “general education”: Moderate evidence/B: ○ Safe resumption of physical activity ○ Postsurgical precautions ○ Proper exercise • This recommendation applies specifically to discectomy or decompression surgery only Key Points for Client Education: • Acute LBP : ○ There is evidence that active client education strategies reduce pain and disability • Chronic LBP : ○ Education should not be used as a stand-alone treatment; beneficial when combined with other interventions such as manual and exercise
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