The Confusing World of Low Back Pain Research


  • 8. How can we improve self-care strategies and stimulate people with chronic or recurrent low back pain to become more self-reliant?
  • 9. How do the beliefs and expectations of patients and providers influence the outcomes and reduce the costs of care for low back pain?
  • 10. Can the development and dissemination of guidelines improve outcomes and reduce costs of care for low back pain?

    Lack of real progress in the field of low back pain is not due to lack of study. Back pain has been studied to death. There are currently over 1000 research papers and numerous clinical evidenced-based guidelines out there. But the mysteries of back pain remain unanswered. The Back Letter calls back pain the "nearly universal symptom and financial scourge" that "is arguably the most thoroughly studied non-specific pain condition".

    This area of human health is ripe with opportunity, if only someone could define the who, what, where, when and how of back pain. We chiropractors believe that we have lots of the answers being sought as well as the most effective treatment for back pain. After all, we didn't become the world's second largest healing art for nothing. Our view that the functional state of the spine is more imperative than the structural state has not been seriously regarded. This should be the "new paradigm" of question 7. Most medical research is aimed at locating the structural alterations and pointing there to explain the pain. This, we feel, is faulty logic and Johnny-Come-Lately thinking. Function is altered long before structural changes occur. Structural changes such as degeneration and arthritis are actually just symptoms of altered function. Being fixated on structure only makes the goal of defining and analyzing back pain more elusive than ever as the low back researchers at the Primary Care Forum are finding out.

    The copyright of the article The Confusing World of Low Back Pain Research in Chiropractic Health is owned by Dr. David L. Phillips. Permission to republish The Confusing World of Low Back Pain Research in print or online must be granted by the author in writing.

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