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

Back Pain - Yellow Flags for Disability and Work Loss

Low back pain is one of the most common and disabling musculoskeletal conditions prevalent in the population, causing high degrees of work loss, suffering and expense. Back pain sufferers are affected by a variety of physical and psychological issues which affect the severity, duration and outcome of the back pain episode. The ideas of yellow flags, to add to red flags which are an indication of serious spinal pathology, has been formalised by work in New Zealand under the title of .Yellow Flags . Indicators for Work Loss and Disability.. These psychosocial factors are important and they are much stronger predictors of how well the person is going to turn out with their back pain than any of the physical factors.

Physiotherapists ask yellow flag questions to find out what their patients are thinking and thereby to be able to target their interventions more closely to the presenting problems. Typical yellow flag positive indications might be the belief that activity is harmful, the belief that pain means there is damage going on in the back and the idea that work is harmful. These beliefs are important in holding some people back from going back to doing normal activities.

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.