Self-Management

Welcome back to SpineIQ’s Back Blog! Last month, we discussed tools and outcome measures that are important to consider implementing in your practice. This month, we will focus on how to help increase patient use of self-management strategies for low back pain. There is a strong movement across all healthcare practitioners to empower patients in the decision making process.  Such approaches are consistent with current clinical practice guidelines, which includes encouraging patients to self-manage and help limit future care.¹ Additionally, self-management is a concept that is gaining widespread recognition. For example, a recent systematic review on best care for musculoskeletal pain recommends encouraging self-management for all patients.²

What is self-management?

Patient self-management has recently been defined as “individual’s ability to manage the symptoms, treatment, physical and psychological consequences, and lifestyle changes inherent in living with a chronic condition.”³ Self-management practices are consistent with a growing emphasis on patient-centered care that focuses more patient empowerment and less on ‘one-way clinician to patient’ care.⁴ They are also consistent with the practices of many conservative spine clinicians, who traditionally spend time educating their patients on how to make lifestyle improvements that maximize function.

Our blog throughout the month of August will aim to help clinicians feel more comfortable in the skills needed to help patients take more responsibility in their management of low back pain. While low back pain is very disabling, patients who feel like they can manage their symptoms have a higher likelihood of positive outcomes through increased self-efficacy.⁵ Clinicians augment the use guideline recommended treatments (e.g., exercise, manual therapy, advice, and education) with some of the tips we will summarize throughout this month to support patient self-management. A focus on self-management encourages patients to view you as the expert and your advice on self-management only reinforces your clinical credibility.  With so much confusion in health care advice, sound self-management can be the first step in gaining confidence in you and your approach.

Stay tuned for next week’s blog where we dive right into tips and key points to incorporate in your clinic that will help increase patient’s beliefs in their ability to self-manage their low back pain!

 References:

1. National Guideline Centre (UK). Low Back Pain and Sciatica in Over 16s: Assessment and Management. National Institute for Health and Care Excellence (UK); 2016. Accessed June 11, 2021. http://www.ncbi.nlm.nih.gov/books/NBK401577/
2. Lin I, Wiles L, Waller R, et al. What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review. Br J Sports Med. 2020;54(2):79-86. doi:10.1136/bjsports-2018-099878
3. Barlow J, Wright C, Sheasby J, Turner A, Hainsworth J. Self-management approaches for people with chronic conditions: a review. Patient Educ Couns. 2002;48(2):177-187. doi:10.1016/S0738-3991(02)00032-0
4. Lin I, Wiles L, Waller R, et al. Patient-centred care: the cornerstone for high-value musculoskeletal pain management. Br J Sports Med. 2020;54(21):1240-1242. doi:10.1136/bjsports-2019-101918
5. Jackson T, Wang Y, Wang Y, Fan H. Self-efficacy and chronic pain outcomes: a meta-analytic review. J Pain. 2014;15(8):800-814. doi:10.1016/j.jpain.2014.05.002