Prevention of recurrent and persistent low back pain
Low back pain is a highly prevalent and costly condition. It is also a recurrent problem in most cases, and persistent (chronic) in some. However, little is known about the fluctuations, the course, over time. Further, a recurrent condition invites the idea of secondary prevention, in order to minimize the episodes of disability and pain. A persistent condition requires tertiary prevention, to stop deterioration and to minimize the effects of the problem.
Background
Very few preventive strategies have been studied. In order to investigate a large number of subjects, a new method of gathering frequent data is used: text messages and mobile phones. Weekly measurements provide a detailed picture of course over time, on an individual and a group level. The method is cheap and user-friendly and yields high response rates and good compliance.
In a randomized controlled trial, the culmination of a strategic and long-term research effort, the Nordic Maintenance Care Program, a preventive manual treatment procedure, Chiropractic maintenance care (MC) has been investigated. In a series of publications, the primary results of the trial have been published and received worldwide attention and recognition. The preventive approach (MC) utilizing a pre-planned treatment strategy seems to be effective for a specific subgroup of patients with high interference, affective distress and low perceived control when compared to a control group receiving care only upon the recurrence/deterioration of LBP symptoms. Total number days with pain were fewer, pain free period between episodes were longer and recurrences were less acute at equal number of treatments compared to the control group. Currently a full economic evaluation is being conducted to access cost effectiveness of the procedure.
Financing
- European Chiropractors' Union
- Swedish Chiroprators' Association
- The Danish Chiropractic Association
Publications
Eklund A, Hagberg J, Jensen I, Leboeuf-Yde C, Kongsted A, L枚vgren P, Jonsson M, Petersen-Klingberg J, Calvert C, Ax茅n I. Chiropr Man Therap. 2020 Apr 21;28(1):19
The Nordic Maintenance Care Program: Does psychological profile modify the treatment effect of a preventive manual therapy intervention? A secondary analysis of a pragmatic randomized controlled trial. , , , , , , , , . PLos One 2019 Oct 10;14(10):e0223349
The Nordic Maintenance Care program: Effectiveness of chiropractic maintenance care versus symptom-guided treatment for recurrent and persistent low back pain鈥擜 pragmatic randomized controlled trial Andreas Eklund, Irene Jensen, Malin Lohela-Karlsson, Jan Hagberg, Charlotte Leboeuf-Yde, Alice Kongsted, Lennart Bodin, Iben Ax茅n PLos One 13(9): e0203029.
Ax茅n I, Bodin L, Kongsted A, Wedderkopp N, Jensen I, Bergstr枚m G
BMC Med Res Methodol 2012 Jul;12():105
Ax茅n I, Bodin L, Bergstr枚m G, Halasz L, Lange F, L枚vgren P, et al
J Clin Epidemiol 2012 Apr;65(4):454-61
Ax茅n I, Bodin L, Bergstr枚m G, Halasz L, Lange F, L枚vgren P, et al
BMC Musculoskelet Disord 2011 May;12():99
Ax茅n I, Jensen I, Eklund A, Halasz L, J酶rgensen K, Lange F, et al
Chiropr Osteopat 2009 Jan;17():1