I've been looking at data from probably over a thousand people with back pain in last 4 years since I changed tack with tackling this problem (cross-sectional, clinic data, monitoring, interventions etc) and a few things have jumped out (I’m getting onto publishing) @GregLehman

1. we CAN fix this, people do get better , 2. Catastrophizing isn’t a consistent ‘mediator’ for changes in disability, it’s certainly linked to pain, but seems influenced by what patients choose to do

3. there’s something going on with treatment that is messing around with the beliefs of a lot of patients, 4. there are lots of clinicians with ‘repeat service business’ models, who don’t really help, 5. Exercise by itself isn’t the answer 6. Neither is anything else ,

7. I’m always surprised how many people with LBP take pain medication, 8. The words patients use to describe their backs are so important!! I STRONGLY caution my students with regards to the words they are using to justify exercise prescription so as not to unduly influence this,

9. Doing ‘more’ isn’t always the answer for these patients, 10. Just b/c we say it should be so (more cognitive approaches) doesn’t make it so in practice (the lag is real)

11. Where is the ‘fun’ in your patient’s lives coming from? Are you asking what they do for fun and helping that happen more?

Anyway, those are my thoughts as I start to take stock of the last few years, & the nearly 20 I've been researching this area

@threadreaderapp unroll please