Introduction to Managing Chronic Low Back Pain with Integrative Lifestyle Medicine

Original Editor - Stacy Schiurring based on the course by Ziya Altug
Top Contributors - Stacy Schiurring, Kim Jackson, Rucha Gadgil, Lucinda hampton, Jess Bell, Aminat Abolade and Tarina van der Stockt

Introduction

When practising physiotherapy, there are many correct ways to treat a condition. Clinical expertise in the field comes from knowing when to use one technique over another based on your assessment of the patient in front of you.  It is important for each clinician to use evidenced-based and supported judgement when selecting interventions for an individual.  When doing a literature review, it is also important to use the highest quality of research available.

The aim of this article is to provide an introduction to the treatment of chronic low back pain (LBP) using integrative lifestyle medicine.  

Chronic LBP

Chronic pain is defined as pain that occurs most days or every day over a continuous period of at least 3 months.  According to the American College of Sports Medicine, LBP “is considered a major public health problem with the lifetime prevalence reported as high as 84%.” According to a 2019 article published in The Journal of Pain, 10.6 million people or approximately 4.8% of the adult population in the United States have experienced chronic pain.

As healthcare providers, physiotherapists should learn more about managing LBP.  A 2019 systematic review sites the following burdens and costs of chronic LBP:

1. On individuals: decreased quality of life and ability to participate in activities of daily living and leisure.
2. On employers: increased absenteeism and decreased work productivity.
3. On society: increased demands on an already burdened healthcare system.

Lifestyle Medicine

A 2012 survey by the National Center of Complementary and Integrative Health found that 30% of adult Americans use health care approaches that have origins outside of western conventional medicine. Given this information, it is important for a well-rounded therapist to have many different effective treatment options that take into account a patient’s values and beliefs.

Integrative health attempts to bring the benefits of both conventional and complementary medicine together in a way that provides whole-person care.  It often combines conventional western medicine with lifestyle changes, physical rehabilitation, psychotherapy, and complementary health.

What is whole person health? “Whole person health refers to helping individuals improve and restore their health in multiple interconnected domains—biological, behavioral, social, environmental—rather than just treating disease. Research on whole person health includes expanding the understanding of the connections between these various aspects of health, including connections between organs and body systems.”

Lifestyle Medicine  combines the modern western practice of medicine with evidence-based lifestyle therapeutic approaches to prevent and reverse lifestyle-related chronic illness.  Examples of lifestyle practices include:

• Nutritional: Whole-food and plant-based diet, dietary supplements, probiotics
• Physical: Regular physical activity, acupuncture, massage, adequate sleep
• Psychological: meditation, hypnosis, music therapy, relaxation techniques
• Combination of the above: yoga, tai chi, dance therapy, art therapy.

Lifestyle medicine encourages clinicians and patients to work together to uncover root causes of medical conditions, by treating the root cause of an impairment long-term improvements can be achieved. Source: this lecture

Resources

• bulleted list
• x

or

1. numbered list
2. x