Chronic low back pain care is broken

We need a shift in thinking when it comes to chronic low back pain care and pain management programs. We need to move away from the idea that treatments are something administered to patients by external providers. Instead, patients must be empowered with tools that allow them to take control and be in charge of their own pain management. This tectonic shift requires both patients and pain care providers to change how they see their role.

Chronic low back pain is more common than type 2 diabetes

13% of Americans between the ages of 18-65 suffer from chronic low back pain (1). There are many possible causes for low back pain: heavy physical work, awkward static and dynamic working postures, shift work, stress, manual handling and lifting, as well as lifestyle and psychological factors. In very few cases (~1%), low back pain results from a serious condition like fracture, infection, or cancer. Most often, it’s a result of various factors that are not life threatening (2).  

Current treatments are missing the target

Currently, the main goal of low back pain treatment is to control the pain, maintain function and prevent pain flares (3). In other words, their aim is not to cure or reverse the pain. The most common treatments for chronic low back pain are analgesics. Other common treatments are physical therapy and spinal manipulation  – while back surgery is the last option (3). Outcomes from these treatments, including surgery, are often disappointing (4).

To learn more about how chronic low back pain is treated, visit this blog post.

All these treatments have one thing in common: they focus on the biological aspect of pain but do not address the root cause of chronic low back pain.

Recent studies show that chronic pain re-organizes the brain functionally, anatomically, and chemically (5). This should impact how chronic pain is treated. In fact, current recommendations dictate that behavioral and psychosocial aspects should also be considered when treating chronic low back pain (6). However, Aivo Health’s Chief Science Officer and co-founder, Dr. Vania Apkarian, goes one step further. He argues that not only should behavioral and psychosocial aspects be considered, they should be the main focus of chronic pain care (5). Looking at the results from our member survey, this makes perfect sense.

Change the driver – shifting the roles of care provider and patient

Focusing on behavioral and psychosocial aspects of chronic low back pain care requires two attitude shifts in order to be successful and provide better care for patients.

First, you as a patient need to trust that you hold the keys to recovery. Chronic low back pain can be conquered, but it requires effort. When you take the initiative to take control of your pain management, you can make changes in your behavior and mindset for good. These changes can lower your pain.

Second, care providers must understand that the causes underlying chronic low back pain have more to do with re-organization of the brain than with the back. As a consequence, they should adopt a role of empowering and supporting the patient to actively pursue changes in lifestyle and to address emotional and behavioral changes related to chronic low back pain6.

The Aivo pain management program

Aivo Health is one of few companies offering an assisted mobile self-care program. Take the driver’s seat by using the Aivo pain management program to address the root causes of chronic low back pain. The program offers pain education, positive psychology, mindfulness exercises, and a supportive peer group. Each individual’s pain experience is different. This is why in the Aivo Program we use data science to analyze what combination of approaches works best for you. Your professional health coach then helps you untangle the ins and outs of your pain experience and provides personalized feedback to help you understand the what, how, and why of chronic pain management.

Take Control of Your Pain Care

Are you ready to take the driver’s seat in managing your pain? You can now access Aivo's pain management program through our pain app.   For the best possible results we recommend that you use the app daily.

If you are tired of being a passive passenger of your pain journey, Aivo's pain management program is for you. Your commitment to daily engagement is critical, but you do not need to take this journey alone. The Aivo team and your is there to support you. To get started, just click the buttons below.

Sources:

1. Epidemiology of chronic low back pain in US adults: National Health and Nutrition Examination Survey 2009–2010 https://onlinelibrary.wiley.com/doi/full/10.1002/acr.22890 (accessed Oct 5, 2020)
   
2. Prevalence of and screening for serious spinal pathology in patients presenting to primary care settings with acute low back pain (2009) https://onlinelibrary.wiley.com/doi/full/10.1002/art.24853 (accessed Oct 6, 2020)
   
3. Update to Background Paper 6.24 Low back pain (2013) https://www.who.int/medicines/areas/priority_medicines/BP6_24LBP.pdf (accessed Oct 5, 2020)
   
4. Khot A, Bowditch M, Powell J, Sharp D. The use of intradiscal steroid therapy for lumbar spinal discogenic pain: a randomized controlled trial. Spine (Phila Pa 1976). 2004 Apr 15;29(8):833-6; discussion 837.
   
5. Pain perception in relation to emotional learning (2008) https://doi.org/10.1016/j.conb.2008.09.012 (accessed Oct 5, 2020)
   
6. Care for low back pain: can health systems deliver? (2019) https://www.who.int/bulletin/volumes/97/6/18-226050.pdf?ua=1 (accessed Oct 5, 2020) Andersson GB. Epidemiological features of chronic low-back pain. Lancet. 1999 Aug 14;354(9178):581-5.