Articles: low-back-pain.
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Antidepressants are commonly used to treat low back pain (LBP), but little is known about patterns of antidepressant use in this population. This study aimed to identify patterns of antidepressant dispensing and switching in Australian workers with an accepted workers' compensation claim for LBP, and to investigate factors associated with dispensing and switching. ⋯ Antidepressants were dispensed to one in seven people with low back pain, most commonly amitriptyline followed by duloxetine. Antidepressants were typically dispensed after 6 months and after other medicines such as opioids, gabapentinoids and diazepam had been dispensed. Due to the administrative nature of the data, the study cannot infer whether antidepressants were dispensed to treat pain or other health problems, such as a mental health condition.
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Pain medicine is an advanced medical subspecialty incorporating trainees from diverse primary disciplines. A curriculum that does not assess or promote the trainees' differential expertise developed from their primary specialties may silo instead of promoting collaborative learning in a multidisciplinary subspecialty. ⋯ We created a novel note-taking and knowledge-sharing platform, anchored by a well-established case-based educational strategy, to improve the learning environment and knowledge retention for multidisciplinary trainees with heterogeneous baseline knowledge.
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Culturally and linguistically diverse (CALD) individuals are underrepresented in pain research, including studies of psychologically informed physical therapy (PIPT) for musculoskeletal pain. This perspective describes a conceptual framework for PIPT management of chronic musculoskeletal pain that identifies essential elements that can be culturally tailored to meet the needs of different CALD populations. Essential interventions, determinants of behavior change, and clinical outcomes were identified from studies of existing PIPT interventions for chronic pain. ⋯ A literature review of sociocultural influences on the pain experience of Latino persons was conducted, and essential elements of the model were operationalized to ensure that therapeutic goals, language, content, and processes were compatible with Latino cultural beliefs, values, and behaviors. Future research using the proposed model to adapt and test PIPT interventions for other CALD populations may help identify shared and divergent mechanisms of treatment response for culturally tailored pain management programs. PERSPECTIVE: A novel conceptual framework may help inform the cultural tailoring of PIPT management approaches for chronic musculoskeletal pain by maintaining fidelity to essential treatment elements while also leveraging the unique sociocultural context of different CALD communities to improve health outcomes.
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Low back pain is one of the main causes of medical consultation worldwide, with heterogeneous management in the request for complementary methods. This study sought to determine the frequency and clinical and imaging characteristics of patients with low back pain in a tertiary hospital, considering the presence or absence of red flags. ⋯ The first consultation for low back pain represented 1.8% of consultations, with acute low back pain being more frequent. Obesity was the most common comorbidity. About half of the patients had red flags according to AHCPR and 21% according to ACR.