A MULTIDISCIPLINARY PERSPECTIVE

■ To reassure and guide the patient based on their history and accurate evaluation

■ To direct treatment based on their existing knowledge.

The future of back care management, and indeed any aspect of human health, should focus on a more multidisciplinary approach that makes use of an integrated model that encompasses an implicit understanding of anatomy, kinesiology, biomechanics, neuroscience, psychology, nutrition and lifestyle management - a truly holistic model. For this to occur, practitioners involved in all areas of back care must firstly gain an understanding of other therapeutic modalities and then begin to work together to combine resources and exchange ideas and information to meet the objectives of the patient.

CONCLUSION Back pain statistics often report that up to 80% of all low back pain is of unknown aetiology and ultimately begs the question, ‘Who Owns Low Back Pain’? Although the question alone lends itself to the supremacy of a single therapy or intervention strategy, the general consensus of the panel certainly refuted this notion. In answering this question, it’s important for practitioners to not only acknowledge the insights that other professions can offer in terms of diagnostic models and treatment modalities, but also consider low back pain from a patient perspective. With this in mind, the treatment of low back pain with a specific diagnosis and a singular therapeutic approach may not prove to be productive in the majority of cases. Optimal low

back rehabilitation undoubtedly requires a multidisciplinary approach that seeks to treat all factors involved and deliver patient focused care. Everyone has a role to play in the treatment of low back pain, as no-one has all the answers.

THE AUTHORS Kesh Patel is an exercise therapist and movement specialist, author and lecturer in clinical sports and exercise therapy. He runs a private clinic in Surrey and is the training director for Origin Health Ltd, an accredited training provider for the Register of Exercise Professionals. For more information on clinical and training services, call 01483 825155 or email kesh@origin-health.co.uk

Dr Suzanne Patel is an experienced health writer and researcher. She currently works as a freelance writer specialising in the area of exercise and health science.

References 1. Atlas SJ and Volinn E. Classics from the spine literature revisited: a ran- domized trial of 2 versus 7 days of recommended bed rest for acute low back pain. Spine 1997; 22(20):2331-2337 2. Butler D, Trafimow JH, Andersson GB, et al. Discs degenerate before facets. Spine 1990; 15(2):111-113 3. Brinckmann P, Biggemann M, and Hilweg D. Prediction of the com- pressive strength of human lumbar vertibrae. Clinical Biomechanics 1989; 4(S2):1-27 4. Manniche C, Hesselsoe G, Bentzen L, et al. Clinical trial of intensive muscle training for chronic low back pain. Lancet 1988; 2(8626- 8627):1473-1476

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