Medical Evidence
Medical Evidence
SpineOne’s practice and solutions are based on the latest scientific evidence. All interventions, whether simple advice and reassurance to stay active or comprehensive interdisciplinary functional restoration, are founded on the most recent scientific evidence. SpineOne’s primary, secondary and tertiary pathway evidence is summarized below.
Summaries of Evidence
Active Rehabilitation, Exercise and Back and Neck Pain Interdisciplinary Care
1. Swedish Council on Technology Assessment in Health Care. SBU Guidelines. www.sbu.se or SBU Guidelines (500 kb pdf)
- Strong evidence shows that multidisciplinary treatment is effective in pain relief and functional improvement for patients with long-term and severe chronic low back pain.
- Strong evidence shows that back training is effective treatment for chronic low back pain.
2. Philadelphia Panel Evidence-Based Clinical Practice Guidelines on Selected Rehabilitation Interventions for Low Back Pain.
- Therapeutic Exercises for Chronic LBP (greater than 12 Weeks), Level I (RCT), Grade A for Pain and Function (Clinically Important Benefit).
3. Cost B13 Working group on European guidelines for chronic low back pain. www.backpaineurope.org or Euro Guidelines (910 kb pdf)
- Recommendation: Supervised exercise therapy is recommended as a first-line of treatment in the management of chronic low back pain
- Recommendation: We recommend multidisciplinary biopsychosocial rehabilitation with functional restoration for patients with chronic low back pain who have failed monodisciplinary treatment options.
- Recommendation: We recommend cognitive behavioral therapy for patients with chronic low back pain.
4. ACOEM Occupational Medicine Practice Guidelines. Evaluation and Management of Common Health Problems and Functional Recovery in Workers, 2nd Edition.
Throughout chapter six of the ACOEM guidelines, Pain, Suffering, and Restoration of Function, authors discuss and recommend the use of multi-/inter-disciplinary programmatic care, stating:
- “Research suggests that multidisciplinary care is beneficial for most persons with chronic pain, and likely should be considered the treatment of choice for persons who are at risk for, or who have, chronic pain and disability. “ Page 114
- “The treatment of chronic pain requires specialized knowledge, substantial time, and access to multidisciplinary care. Judicious involvement of the other professionals, including psychologists, exercise and physical therapists, and other health care professionals who can offer extra physical or mental therapy while the physician continues to orchestrate the whole therapeutic process can be helpful. Close communication between all participating professionals is mandatory.” Page 109
- “Multidisciplinary treatment was found to be superior to conventional physical therapy alone, had benefits that persisted over time, and was beneficial in improving return to work and decreasing use of health care. While the components and approach of multidisciplinary care often differ, the hallmarks of such programs include: Through, multidisciplinary assessment of the patient; the establishment of a time-limited treatment plan with clear functional goals; frequent assessment of the patient’s progress toward meeting such goals; modification of the treatment plan as appropriate, based on the patient’s progress”
- ”Typically, such programs involve ongoing medical care or supervision, exercise, or specific physical therapy intervention, psychosocial intervention, and occupational therapy or other services related to daily functioning and / or vocational rehabilitation. Specific Multidisciplinary approaches, such as functional restoration, report return to work rates of more than 80% following treatment, with a high percentage of these persons still working after one year. Because not all chronic pain patients may need intensive multidisciplinary interventions, some programs offer comprehensive multidisciplinary evaluations resulting in specific treatment recommendations for the patient.” Page 114
5. North American Spine Society. North American Spine Society phase III clinical guidelines for multidisciplinary spine care specialists. North American Spine Society, LaGrange (IL): North American Spine Society (NASS); 2000. 96 p. [204 references]. Secondary and Tertiary Phase of Specialized Care (Non-Operative Interventions). www.guideline.gov.
6. Schonstein et al. Cochrane Collaboration Review 2002 and 2003. "There is evidence that physical conditioning programs that include a cognitive-behavioral approach can reduce the number of sick days lost at 12 months follow-up by an average of 45 days, when compared to general practitioner usual care or advice, for workers with chronic back pain." 2002.
7. Guzman J, Esmail R, Karjalainen K, Malmivaara A, Irvin E, Bombardier C., Multidisciplinary bio-psycho-social rehabilitation for chronic low back pain. Cochrane Database Syst Rev. 2002;(1): CD000963. “The reviewed trials provide evidence that intensive multidisciplinary bio-psycho-social rehabilitation with a functional restoration approach improves pain and function. Less intensive interventions did not show improvements in clinically relevant outcomes.”
8. Articles on exercise and back pain in Research Exercise (125 kb pdf)
Documentation Based Care (DBC)
Articles published by DBC researchers
McKenzie® Method:
Articles published on the McKenzie Method
For more information on specific articles or guidelines, please contact Dr. Darrell Bruga at 408.264.1021.
