The Back Pain Revolution E-Book

Gordon Waddell

Description

Accessible to all health care professionals, this text provides a guide to understanding and managing back pain and is one of the premier examples of a biopsychosocial approach to medicine. The content challenges unsubstantiated beliefs regarding the best way to treat and manage back pain and presents an interdisciplinary debate on the subject. In a society where patients are demanding more effective approaches to their problems, this resource offers a radical rethink, a necessary step to achieving a more effective method of treatment. The unorthodox spirit of this material places this book at the center of the revolution taking place in the back pain area.

• Gordon Waddell is the world authority on the topic of the back pain revolution.
• The content addresses huge problems of concern to many disciplines and governments.
• The unbiased, open-minded view looks at the issues and the evidence and invites the readers to consider, debate, and agree on the best course of action.
• Comprehensive coverage of all aspects of the problem offers both interventionist and conservative approaches to treatment, psychosocial issues, economic factors, patient education, and prevention.

• A new chapter on Occupational Health Guidelines keeps the reader up-to-date.
• New information allows the book to expand on the insights of the previous edition, which was considered a classic text.
• More social and work-related research and material provides information on these important issues.
• Updated guidelines and references make this resource one of the best for current practice.
• The new illustrations, graphs, tables, and education handouts present Waddell's theory in a fresh, new way that aids in the reader's understanding.

Informations

• Publié par: Churchill Livingstone
• Date de parution: 02 août 2018
• Nombre de lectures: 8
• EAN13: 9780702043253
• Langue: English
• Poids de l'ouvrage: 3 Mo

Extrait

The Back Pain Revolution
Second Edition

Gordon Waddell, CBE, DSc, FRCS
Orthopaedic Surgeon, Glasgow
www.elsevierhealth.com
Printed in China
The Publisher’s policy is to use paper manufactured from sustainable forests
Table of Contents
Cover image
Title page
Additional contributors
Foreword
Acknowledgments
Chapter 1: The problem
Chapter 2: Diagnostic triage
Chapter 3: Pain and disability
Chapter 4: Back pain through history
Chapter 5: The epidemiology of back pain
Chapter 6: Risk factors for back pain
Chapter 7: The clinical course of back pain
Chapter 8: Physical impairment
Chapter 9: The physical basis of back pain
Chapter 10: Illness behavior
Chapter 11: Emotions
Chapter 12: Beliefs about back pain
Chapter 13: Social interactions
Chapter 14: The biopsychosocial model
Chapter 15: Clinical guidelines
Chapter 16: Information and advice for patients
Chapter 17: Occupational health guidelines
Chapter 18: Rehabilitation
Chapter 19: UK health care for back pain
Chapter 20: US health care for back pain
Chapter 21: Future health care for back pain
Chapter 22: Epilogue
Index
Additional contributors
David B Allan MB ChB FRCS, Director, National Spinal Injuries Unit, Glasgow, Scotland
A Kim Burton PhD DO, Director, Spinal Research Unit, University of Huddersfield, UK
Chris J Main PhD FBPsS, Professor of Clinical and Occupational Rehabilitation, University of Manchester, UK
Maurits van Tulder PhD, Associate Professor Health Technology Assessment, VU University Medical Centre, Institute for Research in Extramural Medicine (EMGO) Department of Clinical Epidemiology & Biostatistics, Amsterdam, The Netherlands
Paul J Watson PhD MCSP, Senior Lecturer in Pain Management and Rehabilitation, University of Leicester, UK
Foreword
At the beginning of the 21st century the international epidemic of back pain and disability continues to exact a huge toll in terms of suffering and costs.
Scientists are searching far and wide for biomedical solutions to this crisis: new drugs, innovative surgical methods, and space-age technologies. Yet it is unlikely that medical advances alone can solve this terrible problem. The back pain epidemic does not revolve solely around medical issues.
Back pain is and always has been a common feature of human life. There is no evidence that its prevalence has increased over the past 50 years; what has changed is the way individuals, the medical community, and society have responded to back pain. Any solution to the back pain epidemic must address all these domains. Simple solutions, in other words, are unlikely to work.
But what if an innovative approach to low back pain could attack this epidemic at multiple levels: altering attitudes, rebutting fears, fine-tuning medical care, and speeding millions of employees back to work? This is the approach envisioned in The Back Pain Revolution .
The concepts and strategies described in this book have the potential to achieve the unthinkable: put an end to this spiraling problem. Indeed, there is emerging evidence that the back pain crisis may already have peaked in societies that have adopted some of these concepts (see Waddell et al 2002).
Scottish orthopedist Gordon Waddell needs no introduction to anyone familiar with back pain research. He is among the most influential researchers of this generation, with an impressive record of studies, guidelines, reviews, and reports to his credit. He has made major contributions to myriad fields, as evidenced by the scope of this book. He played a central role in deposing the traditional medical approach to low back pain and in creating a more productive alternative (see Waddell 1987).
Yet, for all his achievements, Waddell is not an ivory tower researcher. His main focus has always been the common man and woman with back pain, and the plight they face in the clinic, the workplace, and the social welfare system. In the UK, he was recently honored by the Queen with the title ‘Commander of the British Empire’ (CBE) for his contributions to disability research – for helping those teetering on the far edge of productive life.

A TRUE REVOLUTION
When the word ‘revolution’ appears in the title of a medical textbook, it usually signals hyperbole and exaggeration. But when applied to the back pain arena, ‘revolution’ is a perfectly accurate description.
Over the past quarter century, the traditional medical model of back pain management has been overthrown. In this model back pain was interpreted as a signal of disease or injury, often attributed to the stresses of work. The typical prescription was rest and inactivity until the ‘injury’ resolved and pain abated. This medical model let a common, benign and self-limiting symptom snowball into an avalanche of chronic pain and disability – and exorbitant costs across the industrialized world.
The outmoded medical model has given way to a more flexible and productive approach: the so-called ‘biopsychosocial model’ that forms the basis for modern back care. This label is a nod to the complexity of pain complaints and the rich diversity of factors which influence them.

CHANGING ATTITUDES ABOUT BACK PAIN
The back pain revolution begins with changing perceptions about the nature of back pain and its significance. It involves rebutting the idea that back pain typically stems from a discrete injury or disease – or that activity and work are to be feared.
This model prescribes a careful but streamlined approach to back pain in clinical settings. It allows the efficient identification of those with serious back problems – and encourages the rest to make a quick and confident return to normal life.
It involves using creative psychosocial approaches to identify and overcome barriers to recovery. It recommends a variety of interventions – whatever it takes, really – keep back pain sufferers at work. It also involves tinkering with social welfare and disability systems to ensure that an active life holds greater allure than disability and invalidity.
Prevention is a major thrust of this movement: prevention of back pain’s all too frequent consequences – withdrawal from normal activity, physical deconditioning, work disability, and social dislocation. Early prevention is a key, since medicine has a poor track record of resolving the complex problems that accompany chronic disability.

AN INTENSIVE RESEARCH EFFORT
This revolution is not based on a single algorithm or management protocol. It is a fluid, broad-based movement that is strongly linked to an intensive research process. It will change over time with gains in knowledge.
That the approach described in The Back Pain Revolution can succeed is not really in doubt. There have been tantalizing glimpses of the kinds of progress than even modest interventions can produce. A multimedia information campaign in Victoria, Australia – modeled on many of the concepts that Waddell and colleagues developed – produced lasting changes in the attitudes and behavior of health care professionals and the general public (see Buchbinder et al 2001). The on-going ‘Working Backs’ campaign in Scotland appears to be having a similarly impressive effect (see Burton & Waddell 2004).
The concepts described in The Back Pain Revolution can also have a major impact on the culture of disability. The UK recently reported a 42% reduction in new awards of back pain-related disability benefits since the mid-1990s. In human terms, this is a spectacular achievement (see Waddell et al 2002).

OBSTACLES TO PROGRESS
Though the back pain revolution can succeed, it may not. There are cultural and institutional barriers to success. Important stakeholders – from governments to major industries – are still heavily invested in the back pain injury model and the back pain crisis itself. The back pain ‘market’ is a humming, economic machine that produces billions in revenue annually.
Some segments of the medical establishment have been slow to abandon the old ways. Some health care providers fear needlessly that modern approaches to non-specific back pain might erode their influence or limit their options in treating patients with specific spinal diseases.
The mass media, in terms of editorial content and advertising, may also be an impediment to progress. Patients have been conditioned to expect instant fixes and passive cures.

A BLUEPRINT FOR THE FUTURE
So who would benefit from reading The Back Pain Revolution ? It is essential reading for everyone in the back pain field: medical and non-medical providers, patients, healthcare administrators, economists, lawyers, and leaders of government.
The Back Pain Revolution is a ‘hands-on’ manual for those involved in the provision of clinical back care. But it goes far beyond that; it is also a guide to the major social, economic, and political issues affecting the back pain crisis. It is a call to arms and a blueprint for the future.
Mark L. Schoene, 2004
Editor, The BackLetter
Newbury, Massachusetts, USA

References

Burton, AK, Waddell, G. Information and advice for patients. In: Waddell G, ed. The Back Pain Revolution . Edinburgh: Churchill Livingstone; 2004:331–341.
Buchbinder, R, et al. Population-based intervention to change back pain beliefs and disability: three-part evaluation. British Medical Journal . 2001; 322:1516–1520.
Waddell, G. A new clinical model for the treatment of low-back pain. Spine . 1987; 12(7):632–644.
Waddell, G, Aylward, M, Sawney, PBac