A MULTIDISCIPLINARY PERSPECTIVE

TABLE 1. THE MULTI-DISCIPLINARY PANEL IN ALPHABETICAL ORDER Speaker

Biography Paul Chek HP, NMT Holistic health practitioner

– Specialist in corrective exercise, high performance conditioning and healthy lifestyle counseling

– Author of five books, including his latest ‘How to Eat, Move and Be Healthy!’ – Director and founder of the CHEK Institute – Creator of the PPS Success Mastery coaching program

Alan Jordan DC, MSc, Phd Chiropractor

Robin Kirk MSc, DO, ND Osteopath/clinician

Diane Lee BSR, MCPA, FCAMT Physiotherapist/clinician

Lynne McTaggart Freelance journalist

Research consultant at the Spine Centre, University of Southern Denmark

– Published extensively in peer-reviewed journals – Primarily interested in evaluation and treatment of noninflammatory spinal conditions

Principle of the London School of Osteopathy

Former Editor of British Osteopathic Journal and Council Member of the British Osteopathic Association

Specialist on pelvic dysfunction

Author of ‘The Pelvic Girdle’ Editorial advisor for the journal Manual Therapy and Journal of Manual and Manipulative Therapy

– Founder and editor of the international newsletter What Doctors Don’t Tell You – Author of ‘The Field’

– Former managing editor of the Chicago Tribune-New York News syndicate – Interested in the practices of conventional and alternative medicine

Anne Moore PhD, GradDipPhys, FCSP, – Fellow of the Manipulation Association of Chartered Physiotherapists Chartered Society of Physiotherapy DipTP, CertEd, FMACP, ILTM (Chair) Physiotherapist

Honorary Fellow at the University of

Kent at Canterbury and Fellow of the Physiotherapy Research Network

Colin Natali

Consultant spinal, trauma and general orthopaedic surgeon

– Senior lecturer at Queen Mary Westfield College, London

– Programme director for Student Selected Components Queen Mary Westfield College – Clinical director of ‘Back2Normal’, a rehabilitation clinic in London

■ Lack of joint stability (muscle weakness and/or structural changes)

■ Excessive muscle contraction (increased disc compression) ■ Maladaptive postures ■ Pregnancy and delivery ■ Prolonged flexion postures ■ Poor control of neutral spine ■ Poor movement awareness ■ Inefficient transfer of load during movement ■ Decreased isometric endurance of the back extensors ■ Heavy lifting (especially when associated with flexion and rotation)

■ Illness and disease ■ Lifestyle factors (poor dietary habits, stress, smoking, obesity) ■ Psychosocial factors (emotional stress. low job satisfaction, poor social network)

■ Heredity (congenital abnormalities)

Although mechanical factors may help practitioners to design effective treatment strategies, it is still necessary to understand why the patient has low back pain. Each patient will invariably have a specific set of symptoms that is not only related to the presenting pathology, but may also be dependent upon their occupation, socio-economic status, and other lifestyle factors. Interventions that solely address the symptoms may not help to

20

re-educate the patient in all areas that may be contributing to their back pain.

WHAT ARE THE KEY FACTORS THAT SHOULD BE RECOMMENDED TO HELP A LOW BACK PAIN SUFFERER? A number of treatment modalities are available that can be effec- tively combined to produce the best possible outcome for indi- viduals with low back pain. The panel agreed that surgery is an option for only the minority of low back pain sufferers, and should be a last resort.

Soft tissue therapy Soft tissue techniques are often used continually throughout the treatment of low back pain by many practitioners. In the first instance soft tissue techniques may prove to be a practical methodology in releasing any tissue restrictions that are limiting the ability to achieve an optimal strategy. Common techniques include mobilisation and manipulation, myofascial release, posi- tional release, dry needling and acupuncture. Many of these tech- niques can be effectively integrated with a number of other strategies within the same treatment session.

Postural and movement re-education Although posture is not an accurate predictor of low back pain in

sportex dynamics 2007:13(Jul):19-22

– Head of the Clinical Research Centre for Health Professions at the University of Brighton

– Chair of The National Council for Osteopathic Research and The National – Editor of Manual Therapy and published extensively in peer-reviewed journals