Researchers at the University of Limerick are revolutionising the way we understand and treat back pain and other musculoskeletal conditions through a holistic approach which ranges from diagnosis and treatment to impacting public health policy.
Dr Kieran O’Sullivan explains: “It’s all about treating the person, not just the bones or the muscles. Globally there are vast levels of misinformation around conditions like back pain, such as the idea that structures such as bones and discs can go out of place. Not only is this inaccurate, the fear it creates actually adds to disability. What is important is that we identify the impact pain has on people’s lives, understand their personal and unique barriers to recovery and empower them to regain control of their lives.”
The team co-led with the HSE the establishment of a first-of-its kind programme National Musculoskeletal Triage Initiative across 12 HSE hospitals which reduced hospital waiting lists by 22,000 patients.
Back pain accounts for 25% of GP visits in Ireland and is one of the most costly conditions to diagnose and treat.
Dr Norelee Kennedy explains: “Each year, thousands of patients present in our hospitals with back pain and other musculoskeletal conditions which if not treated appropriately will reoccur and put further strain on our health care system. Our ethos is to evaluate the person quickly and to give them the appropriate advice and treatment.”
Dr O’Sullivan explains that attempts in recent decades to treat chronic back pain by only treating the back itself through massage, manipulation, injections and surgery have had only marginal success. The effectiveness of medications to manage symptoms is similarly underwhelming. He explains: “While people with chronic pain may be very stiff and sore in their back, it appears that overall health factors such as stress, sleep, mood, activity levels are very important. In particular, how a person thinks about their back problem is critical. If a person believes their back is vulnerable and could be easily injured, they are more likely to avoid usual activities or move too carefully, which limits the potential for recovery.”
Dr O’Sullivan added: “There’s an opportunity here to embed real change which will have lasting impact on people’s lives. As physiotherapists we can lead the way in building resilience through public health programmes, encouraging activity, understanding pain is not just about bones and muscles and not always looking for a quick fix.”
Ultimately, this research has had a significant impact on public health through reduced hospital waiting lists, surgeries and medications and overall better outcomes for patients.
Dr Norelee Kennedy and Dr Kieran O’Sullivan are Lecturers in Physiotherapy at the Department of Clinical Therapies, University of Limerick. This research is supported by the Health Research Board (HRB), Irish Research Council, EU Social Fund/Department of Social Protection.