You’ve visited your physiotherapist or GP looking for advice about managing your low back pain. You have had a few sessions of hands-on treatment and you might have a set of exercises that you do for relief, maybe some strength exercises you do at home or in the gym and you’ve been told to stay as active as you can.
But as days turn into weeks and life carries on, it gets hard to remember exactly what you should be doing for your back. You might go on holiday and fall out of the habit of doing your exercises or maybe life gets busy and when you have the time to focus on yourself again, you can’t remember what advice you were given.
Nearly four million Australians suffer from low back pain at any one time and while most will notice improvement with conservative treatment – such as education about their pain and exercise – one in five will experience persistent aches and pain. If you’re one of those, sticking to the advice you’ve been given can be really challenging.
Why is it so hard to stick to the advice you’ve been given?
We know that people with persistent low back pain who engage in regular, leisure-time physical activity will often have less pain, less disability and a better quality of life than people who fail to maintain adequate levels of physical activity. So why is it so hard to stick to the advice you’ve been given, and why is it so hard to get active and stay active when faced with low back pain?
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People with back pain commonly report they feel overwhelmed by the amount of information given to them when they finish treatment. Some say they lack the confidence to manage their symptoms alone and others say they struggle to stick to exercise programs without the support of their treating therapist. Some people recognise that they have low self-efficacy to maintain new, healthy behaviours and others say their back gets better for a while but by the time it returns, they can’t remember exactly what they were told to do (and end up doing nothing at all).
Research tells us that after an episode of low back pain, one-third of people will experience another episode of pain and half of those will return to care. Lots of people recognise that they feel lost trying to follow the advice they’ve been given, without regular contact with their treating practitioner.
Current evidence highlights that health coaching may be a great way to bridge the gap between back pain management (by a healthcare practitioner) and trying to follow their advice alone. Health coaches can help people with low back pain set realistic goals to increase their physical activity levels, troubleshoot barriers to exercising regularly, and help them stay motivated in the long term.
Get Back to Healthy Study
Researchers at the University of Sydney, Charles Perkins Centre, have partnered with NSW Get Healthy Service® to see if they can help people stick to the advice they’ve been given by their treating therapist.
YourLifeChoices understands just how important this is, not only to help people follow the advice, but also to find ways to support people in the community when they’re managing their back pain alone on a daily basis. YourLifeChoices is joining with the research team to share this information, help find people who might like to be part of the research and follow the team as it strives to find answers to helping people stick to the advice.
The Get Back to Healthy Study is for anyone who might be finding it hard to stick to the treatment plan that has been recommended by their GP, physiotherapist or chiropractor. It is for people who might be interested in joining a back pain support program and for anyone who might like to be part of an exciting study into low back pain care after treatment.
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People who decide to join the Get Back to Healthy Study will be randomly put into one of two groups:
1. Usual care group: Participants will continue with usual care and follow the advice given by their treating healthcare professional. Being involved in the trial and filling out fortnightly diaries might help them to stay motivated and remember to follow their treatment advice.
2. Health coaching group: The same pathway as the usual care group, plus up to 10 phone health coaching sessions to encourage them to increase their physical activity, stay motivated and set realistic health goals.
Head to the Get Back to Healthy Study website for more information. You can fill in a pre-screening form while you’re there, and the research team will contact you to give you the details and help you decide whether you would like to participate.
The results of this clinical trial, which is supported by Western Sydney Local Health District and the National Health and Medical Research Council of Australia (NHMRC), will help to inform healthcare policy and clinical practice in Australia to improve the evidence regarding community-driven solutions to support people with low back pain after they have been discharged from treatment.
Kate Roberts is an experienced physiotherapist and PhD candidate at the University of Sydney. She has a passion for helping older Australians manage their aches and pains.
Are you troubled by recurring low back pain? Why not investigate the finer details of the study? And share your challenges in the comments section below.
I’ve had to cope with lower back pain for 45+ years. Nothing, not exercise, physio, etc will take the pain away.
I have lived with lower back pain since a I suffered a prolapsed disk at 50 and am now 73. The original pain was crippling but over the years it eased and I leaned how not to aggravate it. In recent years the pain fluctuates but is generally at such a low level I can play tennis again and do most things as long as I am careful with my movements, and all without painkillers.
I tried chiropractic last year and after a few months treatment there was a clear benefit as my pain level dropped to almost none at all. I then stopped that treatment and gradually this year some mild pain has returned so am considering getting some more chiro.