Profile 1
- Reassure the patient
- Explain that aspecific low back pain is not a serious condition, often resolves spontaneously, but may recur
- Advise your patient not to have bed rest and if bed rest is inevitable, the maximum number of days in bed should be 2
- Recommend a physically active lifestyle and explain that activity will not cause any damage to the back
- Advise your patient to slowly increase exercise and activity levels and to resume work as soon as possible as those measures promote healing
N.B. Maximal number of treatment sessions should be 3!
Profile 2
- Same education and advice like in profile 1
- Prescribe exercise therapy
- If you suspect that the physical strain from work is impeding the recovery, an option is to contact the company’s GP if applicable
- If you suspect that impairments in body functions lead to the persistence of pain and limitations, manual therapy techniques like mobilizations and manipulations can be used
- If there is increased muscle tone, the guideline recommends limited use of passive treatment modalities like thermotherapy and massage (be careful as passive therapy shifts the patient’s locus of control to external)
N.B. If treatment does not have an effect after 3 weeks of treatment, the patient’s GP should be contacted!
Profile 3
- Same approach like profile 1+2, but more emphasis on information/advice and on behavioral principles during the exercise program
- There might be the need for a multidisciplinary consultation and collaboration
- Design a graded activity program for the resumption or gradual extension of activities based on load rather than on the patient’s perceived pain level
- If the patient is on sick leave, the exercise should ideally resemble the targets for work resumption
- Explain the negative influence of psychosocial factors on your patient’s recovery
N.B. If treatment does not have an effect after 3-6weeks, the patient’s GP should be contacted!
| Study | |||||
| KNGF (2013) |
