This section will evolve as information arises from recent and current research published elsewhere relating to back and neck problems and in particular pain.
Posted: 20th March 2016
NHS Five Year Forward View
Well, there we go – The above was posted 16th February by NHS England, “It sets out a clear vision for health and care services to work in partnership with people and communities to fully realize their value and potential at the heart of health”.
“It makes a specific commitment to do more to support people to manage their own health and care and signals the need to “invest significantly in evidence-based approaches such as group-based education for people with specific conditions and self-management educational courses, as well as encouraging independent peer-to-peer communities to emerge”.
This is the intention of one part of this web site and my professional service as a manual practitioner working within the biopsychosocial domain.
Currently, we are looking at the data collected from a small pilot with one hundred patients receiving Cognitive Reassurance during their initial consultation and clinincal assessment. This occured before they saw there GP. Cognitive reassurance focusses on providing the patient with detailed information about their problem back or neck such that they then have a better understanding of how (and why) to manage in the future. Watch this space!
Posted 11th April 2016
Nevertheless! The pilot referred to on 20th of March is quite clearly showing that while 37% of patients (in the pilot) who can begin the process of self-managing and who have decided themselves to self-manage without starting treatment, there are many more who do need some primary care treatment. 38% need a definitive course of treatment which allows the health provider to reinforce cognitive assurance at each treatment session and hopefully reduce the risk of further episode of pain (and NHS costs).
Posted 25th July 2016
International Forum for Back & Neck Pain Research in Primary Care Buxton Derbyshire. 31st May – 3rd June 2016
This research forum meets every eighteen months somewhere in the world. It was last in England in 1998. I have attended six events over more recent years.
As the forum title implies, it is a gathering of those involved with research for back and neck pain problems – mainly clinicians from a range of disciplines, academics and people like myself who gain further knowledge to enhance the development of existing services or create new clinical pilots - small scale services run to test innovative ideas in a controlled and measured way.
In the ideal world, where pilots demonstrate better treatment outcomes than existing services or parts of existing services, one might expect these to be noted. Particularly by the relevant resources within local NHS commissioning groups or those service providers working exclusively in the private sector? This is rarely the case and opportunities for ever higher quality services are overlooked – to the detriment for the patient. Hence many manual practitioners/therapists remain within their comfort zone providing treatment which does not reflect current thinking. That is not to infer their treatment is “poor” because we know that most patients seeking help from manual treatments are well satisfied. It does raise the question of how good is “good enough” particularly in the NHS sector where high quality at affordable cost is critical.
An example? The biopsychosocial model brought to the UK in the late 1980’s only now is developing to near the point where it is becoming a practical and beneficial tool for many (not all) patients we see every day.
Posted 21st August 2016
Jargon Buster update about pain - acute and long term (chronic). See WHAT YOU DO NOT KNOW AND MAY BE SURPRISED WHEN YOU DO KNOW.
Posted September 8th 2016
In early June this year there was a flurry of mis-information from some of the national press and television news outlets relating to a just published research paper about chronic pain. The inference is that around half the population suffer from “chronic pain”.
Is this true? Not really.
The statistics drawn from the study of many research papers was that overall “approaching half” or 43.5% of the population report long-term pain.
Of these, a smaller group, 10% to 14% report long-term pain which is serious and disabling.
This suggests there are far more people who experience long-term pain but in very many different ways and probably self-manage or putting it another way, just put up with the pain. They remain functional and can go about their daily activities with little need (they feel) to seek treatment.
Nevertheless, there are those in this larger group with “near” self-manageable status who become vulnerable to over-medicalisation, over-prescription and over-treatment. There is evidence from various sources to support this.
To paraphrase a statement made elsewhere in this web site – “inappropriate treatment for long term pain risks leading to more long term pain”! ۞