Physiotherapists in Harrogate treat many different conditions including the issues profiled below.

Low back pain treatment - short, cheap, effective?

A recent article reported in The Lancet has reported a good effect on low back pain without significant input in terms of money or time. Six sessions of cognitive behavioural therapy were offered to 400 back pain sufferers whilst a further group of 200 did not get the therapy. Both groups received the standard care from their general practitioners. The intervention aimed at helping self management by challenging beliefs about physical activity and back pain which could be seen to be unhelpful. Patients were encouraged to discuss their underlying beliefs about what was going on and to challenge negative thinking about the pain and the functional difficulties it presents.

Recognising and countering fear avoidance and managing and recovering from flare ups in the pain were also covered. After a year the intervention group had significantly higher scores on questionnaires intended to measure disability and pain. Overall the intervention was cheap and easy to apply, especially when its effectiveness is taken into account, an uncommon effect with treatments for low back pain. Short term effects are much more common after treatments but they rarely last more than a few weeks. The treatments effects in this case did last and so may reflect patients. ability to better self manage.

Pacing to Avoid Overdoing Activities in Chronic Pain

Patients with chronic pain very commonly push themselves hard to get things done, to complete the day to day activities they feel they must continue to perform. Unfortunately this almost always leads to a severe worsening of their pain, forcing them to rest in high levels of pain for several days. This pattern is commonly repeated again and again with the consequence that the person.s abilities tend to reduce over time as they become able to do less and less. This is known as the overdoing and under doing cycle, or activity cycling. It is a counterproductive cycle for pain sufferers, who can learn pacing their activities to their advantage.

Pacing changes the way activities are performed from a pain dependent state, where the person does the activity until pain stops them, to a time dependent state. This means they do an activity for a previously specified length of time then stop, not overdoing it at any one time. The person does the activity until they feel their pain worsen, records that time and then takes 20% off that time to give their quota. They are not allowed to go over their quota initially, to gain control of the activity.