A multidisciplinary group of researchers, including physical therapists (PTs), has identified a core set of 11 clinical practice guideline (CPG) recommendations for treating adult musculoskeletal (MSK) pain, according to a new article in British Journal of Sports Medicine (BJSM). Authors hope the recommendations will assist emergency and primary care clinicians in providing evidence-based care, as well as help consumers make informed health care decisions.
Authors write that while “care that is more concordant with CPG recommendations results in better patient outcomes and lower costs,” providers across disciplines too often do not practice according to guidelines, resulting in overuse of imaging, surgery, and opioids, and a failure to provide patient education and advice. There are many reasons for this, according to authors: CPGs often are not “user-friendly”; they often lack guidance on how to implement recommendations in practice; and different guidelines for a single condition may include conflicting recommendations.
What do dizziness, headaches, jaw pain, and erectile dysfunction all have in common? These might sound like symptoms you experience after a wild night out, but they are actually all symptoms you probably didn’t know could be treated with physical therapy.
One common misconception is that physical therapists treat only musculoskeletal pain—or, in layman’s terms, you’ll only see them when you have an issue with injuries or pain in your bones, muscles, or joints. While that is a huge component of what we do, it is also only one portion of our treatments.
More and more Doctors of Physical Therapy (DPTs) are specializing in treating other systems, including the vestibular (inner ear) system and the male genitourinary system (this includes the male pelvic floor muscles and conditions such as erectile dysfunction). If you are in pain, it is always recommended to see an MD to rule out other problems before beginning physical therapy. But you should know that multiple treatment options probably exist for whatever it is that’s ailing you.
Patients who underwent physical therapy soon after being diagnosed with pain in the shoulder, neck, low back or knee were approximately 7 to 16 percent less likely to use opioids in the subsequent months, according to a new study by researchers at the Stanford University School of Medicine and the Duke University School of Medicine.
For patients with shoulder, back or knee pain who did use opioids, early physical therapy was associated with a 5 to 10 percent reduction in how much of the drug they used, the study found.
Amid national concern about the overuse of opioids and encouragement from the Centers for Disease Control and Prevention and other groups to deploy alternatives when possible, the findings provide evidence that physical therapy can be a useful, nonpharmacologic approach for managing severe musculoskeletal pain.
One of the things that some universities do to help out new researchers is have senior academics look over their grant applications before they are submitted. Recently we had a proposal for a study on back pain in adolescents assessed in this way. One of the comments was that back pain is not a problem for teenagers; it doesn’t happen very often and if it does it goes away by itself quickly anyway. It is worth noting that this feedback came from researchers outside the field of musculoskeletal pain, and seemed to be on the basis of personal experience.
This appears to be a common view, and was reflected in our study looking at how well pain reports from children match up with their parents. The answer; not very well, parents frequently reported that their child did not have pain over the past week when the child reported that they did. To dig a bit further into the issue, we collected all the systematic reviews that addressed prevalence, risk factors, prognosis, and treatment effectiveness relevant to back pain in children and adolescents. Here’s what we found.