Articles: pain-management-methods.
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Bmc Musculoskel Dis · Jan 2012
Engaging consumers living in remote areas of Western Australia in the self-management of back pain: a prospective cohort study.
In Western Australia (WA), health policy recommends encouraging the use of active self-management strategies as part of the co-care of consumers with persistent low back pain (LBP). As many areas in WA are geographically isolated and health services are limited, implementing this policy into practice is critical if health outcomes for consumers living in geographically-isolated areas are to be improved. ⋯ To sustain improved consumer beliefs regarding LBP and encourage the adoption of more positive health behaviours, additional reinforcement strategies for consumers living in remote areas where service access and skilled workforce are limited are recommended. This study highlights the need for aligning health services and skilled workforce to improve the delivery of co-care for consumers living in geographically isolated areas.
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Several investigators have identified an explosive increase in spinal injection rates in the Veterans Administration and Medicare populations. Furthermore, utilization of spinal injection procedures appears to vary by geographic location, subspecialty, and practice setting. Medicare claims analysis has shown that a small percentage of physicians perform a disproportionately large number of injections. Although Medicare utilization has been well characterized, the utilization patterns for privately insured individuals are not clearly known. ⋯ These findings demonstrate that relatively few providers are responsible for a disproportionately high percentage of interventional spine procedures. This pattern of marked overutilization by a minority of providers is the dominant characteristic of utilization within all specialties.
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To explore the differences in narrative between patients with persistent non-specific low back pain (PLBP) who benefited from a pain management programme, and those who did not benefit. ⋯ Our findings may help to operationalise the restoration of hope in patients with PLBP. Firstly, health care professionals need to identify and resolve any specific fears of movement. Secondly, patients need an acceptable explanatory model that fits their experience and personal narrative. Finally our study confirms the centrality of self concept to recovery.