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■ Back health ■ Back products ■ Back care
iPhone app wins award page 5 Cushioning the impact page 7 Pain in focus page 13 Pain Alliance Europe page 17
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We’re back!
Contacts
Inside this issue
Welcome Back to Talkback and the re-launch issue of our winter edition. BackCare’s full colour magazine is tailored towards our members or for individuals who have a personal or professional interest in back and neck pain. We hope you will appreciate the level of news items and features that we have gathered and would appreciate any contributions from budding writers who may wish to contribute towards future editions. In this issue, we’ve taken the opportunity to bring you up to date with BackCare’s various campaigns to improve quality of life for people living with back pain. As founder members of the Can You Feel My Pain? campaign, we recently took over an area behind Liverpool Street station in London to publicise new research. Did you know that 62% of the entire adult population now report living with back pain? Incredibly, that includes over half of adults in the 18-34 range. We also explore how new technology can potentially help tens of thousands of people suffering from back conditions. We also review different methods of treatment to strengthen core muscles to ease your back pain including discussions on the merits of Pilates and The Alexander Technique. Meanwhile, we’d love to know what you think of our re-launched magazine and if you are keen to review any of publications please feel free to contact us. It’s time to Talk Back!
BackCare 16 Elmtree Road, Teddington Middlesex TW11 8ST Tel: +44 (0)20 8977 5474 Fax: (0)20 8943 5318 Email: info@backcare.org.uk Helpline: +44 (0) 845 130 2704 Website: www.backcare.org.uk
BackCare news
Registered as the National Back Pain Association charity number 256751 Editor: Schula Byrne Designed and produced by Pages Creative, Stirling House, College Road, Cheltenham GL53 7HY.
Tearing up the Thames
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Cushioning the impact
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Publication reviews
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The Alexander Technique
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Loosen up with Pilates
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Can you feel my pain?
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Spring back to life
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From our correspondent
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Moving through the pain
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Influencing EU policy
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Advertise in Talkback
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Printed by Severnprint of Gloucester on FSC Essential Silk
Schula Byrne Editor of Talkback
Articles written by freelance contributors do not necessarily represent the views of BackCare. We welcome articles from readers for consideration for publication and reserve the right to edit all submissions. Paid advertisements do not necessarily represent the views of BackCare, neither does BackCare necessarily recommend produces and services advertised in Talkback. We request that you exercise your own judgement as to whether an item or service advertised is likely to help you personally and, where appropriate, take professional advice from your doctor before purchasing. Any complaints regarding advertised services or products should be addressed to the marketing manager at BackCare. The information in this magazine was believed to be correct at time of going to press; BackCare cannot be responsible for any errors or omissions. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means without permission of the copyright holder, BackCare © BackCare
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TV Doc backs‘Can you feel my pain?’campaign TV’S DR HILARY JONES has been working closely with BackCare in recent months. As part of the ‘Can You Feel My Pain?’ campaign (see page 13), he has spoken about BackCare in press and radio outlets such as the Sunday Express, Good Housekeeping and Radio 5 Live. In addition, he has written the foreword to two new packs produced for Back Care Awareness Week. In the first pack, aimed at the general workforce, Dr Jones notes that more than four million working days are lost each year due to back pain, at an annual cost to the economy of more than £12 billion. In the second pack, aimed at teachers and students, he congratulates BackCare on its work to improve working conditions for teachers. “I was shocked when BackCare shared new research with me that showed just how prevalent back pain is within the profession; 98% of primary school
Dr Hilary Jones
teachers have hurt their backs at work. Sadly, just under half visited their GP, and only 8% told their boss.” He also points out that “helping people to look after their backs at school could translate into significantly improved
quality of life later on”. This reflects new research showing that more than half of young adults (18-34) now suffer with back pain (see page 13). The two resource packs, which have been funded by Pfizer, offer advice to help delay, reduce, manage and recover from back pain. The corporate pack has sold in large quantities, with one company requesting a customised version that can then be sent to its 10,000 employees. Both packs include advice on issues as varied as setting up your workstation, driving and cycling to work and how to exercise to protect your back. The education pack also contains a board game for primary school children, and posters that Dr Jones says are “remarkably effective at communicating the importance of good posture.” Both packs are available now from BackCare, priced at £18.99.
Legal costs move on injury claims ‘flawed’ Charities representing victims of catastrophic injuries and terminal occupational diseases have condemned the Legal Aid, Sentencing and Prosecution of Offenders Bill, which had its third reading in Parliament in October. They claim that the Bill could require claimants to pay up to 25% of their damages for pain and suffering in legal costs. As this will inevitably lead to a reduction in claims, it has been estimated that the new legislation could save the insurance industry up to £1 billion a year. Rather than passing more of the financial burden on to people who are faced with occupationally related terminal illnesses, or who are distressed and suffering the consequences of a serious road accident, opponents have
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called for further regulation of the claims management industry. Presently, people who have been involved in accidents can be cold-called
by companies offering no-win, no-fee arrangements for prosecution. In many cases, people are then advised to buy expensive insurance policies as the arrangement does not usually cover costs incurred by the defendant if they are awarded against the claimant. Earlier this year, BackCare trustee Sean McDougall sustained whiplash when a driver crashed into his car from behind. Speaking in a personal capacity he said: “Compensation is there to make good damage caused by the negligence of a third party. While there are legitimate concerns about people clogging up the courts and making false claims, reducing the number of claims should be achieved through better screening rather than pushing up the cost of claiming.”
NBE makes BackCare editor honorary member Jacqui Smith, editor of the highly successful 5th and 6th editions of BackCare gold standard series The Handling of People, was awarded Honorary Membership of National Back Exchange (NBE) at its recent annual dinner and conference. Julia Love, NBE’s newly elected chairman, said: “I was thrilled when I discovered that my first official task as the new Chair was to present this Honorary Membership Award. An award nominated by members who feel a person has contributed in a way that is ‘above and beyond’, and it has to be supported by a number of testimonials”. Those who nominated Jacqui spoke warmly of her integrity, expertise and the many years’ service she offered as editor of Column, a role Jacqui will be stepping down from. On receiving her award, Jacqui said: “I am overwhelmed by the nominations and the content of the testimonials. There is no greater praise than that of one’s peers and I have truly valued their support and friendship over the years.” She wished Pam Rose, her successor as editor of Column, all the very best for the future. BackCare has worked closely with NBE over the last several years and is grateful for its significant contributions by authors, peer reviewers and the editorial team in the production of the HOP series.
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iPhone app wins technology award BackCare an inspiration to other charities… BACkCARE SECuRED the ‘Best use of Technology Award’ at the Charity Times Awards ceremony at the London Hilton Park Lane. The annual ceremony, which accredits a number of top quality charities for their efforts, awarded BackCare for the creation of its highly successful iPhone app, which was also selected by The Sunday Times last year as one of the top 10 health apps in the world. The judges congratulated BackCare on raising the bar and described the app as “a great example which organisations from
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all sectors should aspire to. The winner has used this new channel to make its content relevant and appealing to a wider audience”. Dr Brian Hammond, Executive Chairman of BackCare, who attended the event with Marketing Manager Schula Byrne, said: “It’s a great achievement for the charity to learn that we are a technical inspiration to other charities”. BackCare has now commissioned a new version of the app for Android phones, which will extend its reach to around three-quarters of uk mobile phone users.
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BackCare wins the award for Best Use of Technology
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Tearing up the Thames Top comedian David Walliams tore a disc in his back while swimming the entire length of the Thames for charity. The Little Britain star, who is married to supermodel Lara Stone, raised over ÂŁ1,000,000 for Sport Relief while covering the 140-mile course. Over eight days, he burned 66,000 calories as he powered through 107,062 strokes. Following overnight treatment in hospital he undertook a course of physiotherapy, but was reported to be still in pain over two weeks later. The injury also forced him to cancel several public appearances, including an interview on the Jonathan Ross show and an event with the Gorbachev Foundation.
David Walliams stands on the bank of the River Thames in Lechlade, Gloucestershire, before setting off on his attempt to swim the entire length of the river to raise money for Sport Relief
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Photo: PA Wire/Press Association Images
star ‘s back injury
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medical technology
new technology developed by multinational firm medtronic could help tens of thousands of people suffering from back conditions such as arthritis, degenerative disc disease, retrolitheses and facet joint pain…
Cushioning the impact MedICAl teChnology company Medtronic has launched a device for Inter-vertebral assisted motion (dIAM) – a polyester-coated cushion that can be inserted between vertebrae to replace worn out cartilage. By providing a shock absorber effect, it can dramatically reduce pain caused when joints rub against each other. the dIAM was featured in the Daily Mail last August, in an article produced in collaboration with BackCare. the article recounted the personal experience of teri honeyfield, 72, a retired teacher from Somerset. In March 2008, teri experienced “a sudden, excruciating pain in the middle of my spine.” later, she was diagnosed with spinal arthritis – a very painful condition, mostly affecting the over-55s, in which cartilage wears away, leaving little or no cushioning between the vertebrae. teri’s experience with her gP was less
than satisfactory: “the gP explained that it was just part of getting older and I would just have to learn to live with it. All he could suggest was painkillers. I felt as though I’d been picked up and put in the dustbin. “over the next two months, the pain spread to my hips, then all the way down my legs to my ankles. I started hobbling along hunched over and couldn’t walk for more than five minutes without a rest. I became depressed and irritable. It changed my whole personality within a couple of months.” teri set off on a familiar journey, visiting various specialists over an 18-month period and investing a lot of her own money in private treatment. eventually, she was given a course of steroid injections by Mr Ian harding, a consultant at Weston general hospital. these “worked wonders” but the relief from pain was temporary. In January, Mr harding told her about
a new surgical procedure that might offer longer term benefits. Medical technology company Medtronic had developed a cushion that could be inserted between the affected vertebrae and act as a shock absorber. In effect, it would replace the worn cartilage. Mr harding warned that the operation might not work and that there was a risk of infection. After thinking about it, teri opted to go ahead. teri had the operation in June. It took 45 minutes and she was able to return home the same day. the difference for her has been profound. “now it’s like before my problems began. I can garden, do more with my grandchildren and I’m bustling around the house. I’ve joined a skittle team and can’t wait to start tap dancing again.” the operation, which has been approved by nICe, is now available at most major nhS hospitals.
Article prompts a large response to helpline Sarah tetlow, head of Information Services, said: “More than 500 people contacted our helpline to discuss this article, a seven-fold increase in the number of calls we would normally receive. “on its own, that demonstrates that there are huge numbers of people suffering every day in the same way as teri. It’s fantastic that so many people will have been alerted to the new treatment and that gPs now have an additional treatment option to consider.” however, it’s not all good news.
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Mr harding was right to point out that the cushion can sometimes become displaced and that there is always a risk of infection with surgery. We always caution people to think very carefully before proceeding, despite the fact that the alternative might be to continue living in pain. desperation can sometimes result in a worse situation. happily, this did not happen to teri and, as Mr harding says, “the results in all cases so far have been really encouraging in the majority of patients.” As BackCare raises its profile in the
national media, we are planning a fundraising drive to recruit more helpline volunteers, offer refresher courses to our existing volunteers, and create a forum so that people suffering with back pain can access information at times when the helpline is closed or overwhelmed. Medtronic has already offered its own support. With the help of others, we can transform the quality of service we provide to people suffering from constant, severe back pain. Please get in touch if you would like to help.
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Publication reviews publication reviews
Lower Back Pain & Sciatica: A Personalised Treatment Approach AuTHOR PAUL BoxCER • ISBN 978-09562931-0-7 • PRICE £27.00 (READERS CAN SAVE 10% BY ORDERING FROM BACkCARE) This book has a friendly and engaging approach. Although it is aimed directly at sufferers of low back pain (LBP) and sciatica, I feel it has lessons for these people and health professionals alike. As somebody living with LBP and sciatica for many years and having developed reasonable strategies balancing this with work and leisure life, I initially wondered if I could gain any new ideas or tips to help me. After reading the book, I feel the techniques presented add value to both long term and new sufferers. Paul Boxcer is an experienced physiotherapist. His methods are clearly explained using jargon-free language. It is stated in the foreword that the advice and guidance is in line with the current national guidelines for the management of LBP, as reported by the National Institute for Health and Clinical Excellence (2009).
The book is divided into Seven Steps, Learning Zones and Practical Advice sections. Accessing GP and A&E intervention is highlighted by detailing Red Flags in Step One. All the exercise sections have clear diagrams and instructions. A self-support theme is presented via the theme of listening to your body, detailing what this means and how to put this into practice. It is a practical tool presented with a supportive approach. The author really cares about the reader achieving success with their abilities to improve their LBP and sciatica. This is a great book; having read it from cover to cover, I now dip into the various sections when I need to. Because I travel frequently for work the only addition I would like to have is a ‘pull-out’ exercise section! susan Wilder
A Carer’s Guide to Safer Moving and Handling of People – Third Edition BACkCARE 2010 • PRICE £4.95 • AVAILABLE FROM ThE BACk ShoP www.BACkCARE.oRg.Uk – OR BY CALLING 020 8977 5474 People who care for others without payment make an enormous contribution to society. Many of these carers have to lift or assist others in moving and, in doing so, regularly put themselves at risk of injury which could jeopardise their own health and ability to provide care. This booklet, which aims to reduce carers’ risk of injury, is packed with guidance for all situations involving the moving and handling of people. Back pain or injury may result from a single episode of moving or lifting, or from repeated stress on the back; a
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useful checklist will help you to assess your own level of risk. Detailed guidance is provided on helping people to move in bed, to move from sitting to standing, to transfer (e.g. from bed to chair) and to walk and there is advice on helping people to get in and out of cars, handling wheelchairs, dealing with falls and lifting and assisting children. There is a room-by-room guide to help you to optimise your home environment and helpful guidance on where to get professional advice and choosing and using mobility equipment.
I found this booklet extremely accessible, with clear, practical advice accompanied by easy-to-follow illustrations. There is a strong emphasis on planning the best way to help people, the importance of communication and using equipment whenever possible. A welcome emphasis on encouraging independence is accompanied by important reminders to carers to look after themselves and get help when necessary. A list of useful contacts is provided. Highly recommended. Ann v salvage
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ar rking days are lost each ye More than four million wo nt any given day, one per ce as a result of back pain. On in. sick leave due to back pa on is ion lat pu po ng rki of the wo shed healthier backs, has publi BackCare, the charity for ich offer advice on how to a number of booklets wh lude: reduce back pain. These inc g ic Guide to Manual Handlin om on Erg An – rk Wo at re Back Ca h e lid on Better Back Healt th g tin Lif – rk Wo at re Ca Back in the Community Safer Handling of People le* ving and Handling of Peop A Carer’s Guide – Safer Mo Project Group * In partnership with Fife
ily Carers
Moving & Handling for Fam
backcare.org.uk 77 5474 or email info@ 89 0 02 : ne ho lep te n For more informatio .org.uk Website: www.backcare g.uk/forum Forum: www.backcare.or 130 2704 BackCare helpline: 0845 iTunes iPod Touch available on d, iPa e, on iPh r fo p: ap BackCare
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alexander technique
the Alexander technique approach to back pain written by the scientific research committee of the society of teachers of the alexander technique (stat) It IS often said that back pain will affect most people at some point during their life, and that modern sedentary lifestyles make the problem worse. how much do postural habits contribute to this problem? If people choose to improve their habitual ways of sitting, standing and moving, does that have a beneficial effect on their wellbeing – and, if so, how much? the Alexander technique is a taught method of self-care and self-change that helps people become more aware of their actions, improve their postural muscle tone and reduce postural imbalances. through gentle hands-on
contact and spoken advice, Alexander technique teachers help people attend to head poise and lengthening of the spine, to release unwanted muscular tension and avoid ways of reacting and standing, sitting and moving that increase pain and involve unnecessary effort. greater awareness of such unwanted habits enables people to profit more from learning and using the Alexander technique. there is good clinical research evidence showing that taking Alexander technique lessons can lead to pain reduction and an increasing range of activity
for chronic low back pain patients. the benefits were shown to be long-lasting; people were actively engaged in the process of their own change during the lessons and were taught how to continue the process afterward. the Alexander technique is mainly taught one-to-one; introductory group classes are also available. the investment
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of time and attention can lead to wide-ranging and unexpected positive changes as people apply what they have learned to their daily life. â– you can find a teacher near you by contacting the Society of teachers of the Alexander technique (StAt) on: tel: 020 7482 5135 or www.stat.org.uk
Hands on: self-care methods like the Alexander Technique can help reduce postural imbalances
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BackCare discusses how pilates can help back pain sufferers
loosen up with Pilates In My exPerIenCe working with people with back conditions isn’t simply a case of “strengthening their core muscles”. this is important, of course, but in many cases, weeks, months, even years of pain or the anticipation of pain causes deep rooted tension and poor movement habits that must be addressed. Pilates helps you to increase your body awareness and so identify, then release, tension. We start with basic steps – most importantly breathing. Simply learning effective breathing and tension release techniques can make a huge
difference to your wellbeing. We learn to stand, lie, kneel and sit in an aligned (neutral) position, reducing load and imbalance in the joints and soft tissue. from here we can add movement to challenge particular muscle groups. this teaches new or improved body movement patterns. finally, we can work on muscle strength. People can often see or feel a difference in their body after the first or second session of Pilates. Poor postural alignment places a strain on the joints, ligaments and muscles and ultimately causes pain (or
more pain!). regular practice of Pilates will teach you good alignment, improve your posture, develop good movement patterns and ultimately help to alleviate, even eliminate, pain. Quite simply, Pilates puts you back in control of your body; enabling you to improve and build your skills at your own pace. Whether you join a class, have oneto-one sessions or practise on your own, it is important to learn the basics from a reputable teacher who can recommend an exercise plan appropriate for you.
7 Steps to Ease Back Pain AVAILABLE FROM ThE BACk ShoP www.BACkCARE.oRg.Uk – OR BY CALLING 020 8977 5474 SPECIAL OFFER TO NEW BACkCARE MEMBERS Around 30 million people in the uk suffer from back pain every year and there is no miracle cure. Added to that, four out of five people will experience it at some point in their lives. A new book by top exercise and nutrition guru Yinka Thomas, explains how to manage back pain in seven easy steps. Published in collaboration with the Back2 Shop, this new book is an easy read, providing a practical guide to dealing with all forms of back pain. unlike other books on the subject, it also includes valuable information on nutrition, hydration and ergonomics. Who knew that drinking lots of water helped the
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invertebral discs in your spine to rehydrate overnight? Or that a description of a mattress as orthopaedic can often be a gimmick as there are no strict controls over these claims? “The section on nutrition is one of the most informative I have seen,” said Dr Brian Hammond, Executive Chairman of BackCare. until the end of February, we will be including a copy of 7 Steps to Ease Back Pain to anyone wishing to join BackCare for the first time. Just go to www.backcare.org. uk to find out how you can take advantage of this offer or telephone 020 8977 5474 to find out more.
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Campaign helps make back pain visible A telePhone Survey involving more than 2,400 people has led BackCare to take to the streets in support of young people and anyone suffering with neuropathic back pain. In September, BackCare fronted a day of action in the City as a leading member of the new ‘Can you feel My Pain?’ campaign, which is funded by Pfizer. Working with a team of actors and a fake film crew, BackCare’s acting Ceo Sean Mcdougall and office Manager helen horton took over a piazza behind liverpool Street Station in the City to highlight the issue of back pain. Actors wearing suits with burnt out backs mingled with commuters as they made their way to work. In the middle of the piazza, another actor sat on a bench that appeared to have caught fire when he pressed his back against it. A tv crew, apparently filming a sporting piece, was repeatedly distracted by the much bigger news story as the actors walked by. Passers-by who stopped to talk with the actors were told that the event was being organised to highlight the findings of the telephone survey. this had established that gPs treating 60% of people with neuropathic back pain had never mentioned the condition. Just as important, the survey had established that there has been a rapid rise in the number of young people suffering with back pain: 52% of men and 48% of women, all aged 18-34, had reported living with it. A quarter said that it affected their ability to work. Speaking at the event, Sean said: “this survey backs up what our members are telling us about the difficulty in obtaining timely and adequate treatment for all types of back pain. But the real shock is the increase in incidence of back pain in young people. the ‘sit still’ culture of schools and the workplace, combined with lack of exercise, is
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A new ‘bill of rights’ for pain What is the Can You Feel My Pain? campaign about? It is a suite of online social media tools, a series of street level events and a driver for collaboration for charities dealing with different aspects of pain. At its heart is an online petition – the bill of rights – which the public is being encouraged to sign. You can do so, too, by visiting our website. The bill contains five key demands which are shared by all the member charities, including (in the UK) Arthritis Care, Action on Pain and Pain Concern: ■ The right to be understood ■ The right of access to information ■ The right to professional support ■ The right to early intervention and optimal pain management ■ The right of pain relief as a fundamental human right To promote the bill, member charities have also posted a suite of online tools on to their websites. From any starting point, it is possible to post photos illustrating how pain affects you as a person, to describe your own experience in words and sign the bill of rights. There is also a Twitter feed – @cyfmp.
If you have a picture that captures the meaning of pain, why not send it in? We’ll publish the best one in the next issue of Talkback. creating a healthcare time bomb. unfortunately, the cost of implementing change is not being set against the likely cost savings. Consequently, millions of people aged 18-34 are destined to spend the next 60 years living with back pain.” the quote was widely picked up by the media, with prominent features appearing in the national press, radio 5 live, various websites and newspapers as far away as hungary. Sean said: “By wearing suits with burnt out backs, the actors achieved three key goals. first, they were able to highlight the burning sensation that can be an indicator of neuropathic back pain. Second, they established the fact that back pain affects people of all ages. finally, they helped to bring visibility to a hidden pain. BackCare would like to thank Pfizer for helping to get the City talking about back pain. “
Burning issue: one of the actors in London drawing attention to back pain
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Tom hart-Shea’s back problems began in his teenage years. now retired, he cycles, swims and does pilates – thanks to an frp course…
Spring back to life the ChAnCeS of a persistent back pain sufferer making a full recovery fall drastically after six months of unsuccessful outpatient treatment. So what can people do if they’ve suffered decades of pain? Well, functional restoration programmes – exercise therapy combined with behavioural therapy – can help many. frP isn’t a new invention, but it is increasingly seen as the way forward by healthcare professionals.
tom hart-Shea, a 64-year-old retired headmaster, completed Spring rehabilitation’s three-week frP course in September. his problems started as a teenager with a spinal fracture caused by a steelworks accident, followed by a motorbike accident in his 20s which meant he had to learn to adapt to daily pain. Abdominal surgery in his 30s rendered
tom’s muscles less able to support his back. unfortunately, occasional sessions of physio via his gP never offered him much respite. At Spring, tom was seen by a consultant in rehabilitation medicine who reviewed his case and made recommendations to the therapy team there, who tailored exercises to mobilise and strengthen him. ttom said: “Before Spring, I thought the gym was not the right place for me, but now I’m far stronger and more supple, and can walk more freely because I learnt how to move correctly. “Seeing my improvements and being in a group setting spurred me on. one chap, a badly injured ex-soldier, threw away his stick at the end of the course! Since leaving Spring, I cycle, swim and do Pilates weekly. I’ve even found a local gym which doesn’t play loud music! I got sound advice on avoiding depression or isolation after leaving, and I know I can contact Spring whenever I need guidance.” Spring can be contacted on 01428 788376 or via www.springrehab.co.uk Spring rehabilitation, Branksome Place, hindhead road, haslemere, Surrey gu27 3Pn.
Tom with his granddaughter
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local groups
from our own correspondent north WAleS
Service users deserve to be heard IT IS NOW more than four years since the launch of the Assembly of Wales Government Commissioning Directives and still there is little evidence of meaningful long term involvement of service users/ support organisations in the planning, development and evaluation of service delivery. I am involved with the North Wales Arthritis and Musculoskeletal Alliance (ARMA) Local Network Group as BackCare’s representative. I have just given notice to cease as convenor and chairperson but will continue as an ordinary member as long as BackCare requires me to. I must admit it has been stressful at times over the last four years. However, empowerment always comes at a price! We cannot expect other people to undertake roles if we are not willing to learn and develop ourselves and importantly give them, by example, the encouragement and skills to develop. I would not have missed the opportunity and would encourage members to give it a go and become
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empowered! I have gained much from the experience and I believe, considering the lack of resources, that we have achieved solid results. Presently, few of the north Wales supporters opt to receive electronic information such as minutes, agendas and yearly reports. I hope more people will contact me so I can ask their views on matters. I appreciate that due to the nature of our back conditions and the chronic pain we endure that many people wish to maintain their privacy. The geographical area served by the group has expanded to a north Wales one. We received feedback from Directors of Education in North Wales to ascertain how the primary schools have been implementing an exercise initiative called ‘The Class Moves’. As reported in the last update, this is a programme which enables primary school children and teachers to discover the pleasures and benefits of movement and relaxation. Developed in
Holland over several years by a physiotherapist working with health and education professionals, it has been adapted for use in Welsh schools. More information is available on http://wales.gov.uk/topics/health/ improvement/children/schools/exercise/?lang=en Sadly, as this initiative is not mandatory, many schools are not actively engaged in this excellent scheme. How can children respect adults who completely ignore their moral right to the same health and safety protection for their backs in their place of learning as adults demand, and are importantly provided by legislation, in their workplace? I hope this update has been informative. I appreciate it is not easy living with back pain or caring for someone with it. Some days are a real struggle! However, it would be really good to have a few more members with whom to discuss issues in North Wales. Christopher Sweetnam
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research findings
research suggests that those who battle through their pain and stay active fare better than those who ‘take it easy’…
Moving on through the pain Move If you have back pain, this is the advice of a researcher at the Sahlgrenska Academy, university of gothenburg. Patients with acute low back pain who were advised to stay active despite the pain fared better than those who were told to adjust their activity in line with their pain. the thesis looked at 109 patients with acute severe low back pain. they were randomly advised in one of two ways: “stay active even though it hurts” or “adjust your activity to the pain”. they were also asked to keep a diary for seven days and to note how many steps they took each day, to what extent they could carry out their day-to-day activities and how they felt physically. they also completed a form to show whether they felt depressed or not. In spite of having more pain, the group that was advised to be as active as possible recovered more quickly and did not feel depressed at the end of the follow-up. “the other category who had been advised from the very start to adjust their activity to their pain, were less mobile and felt slightly depressed compared
to the patients who were active,” says olaya-Contreras, a researcher at the Sahlgrenska Academy’s department of orthopaedics. She believes that this could be because some people who are depressed and in pain experience the pain more acutely. Another explanation could be that the more acute the pain is perceived to be, the less a person wants or is able to move. this, according to olaya-Contreras, is in line with previous research. “I think that if you’re suffering with acute low back pain you should try to remain as active as possible and go about your daily business as well as you can. If you don’t keep moving, it’s easy to get locked into a downward spiral, as inactivity combined with pain can, in a worst case scenario, turn into long-term disability and an inability to work that, in turn, can lead to depressed mood and more pain.” olaya-Contreras therefore feels that the health service should introduce a routine investigation to determine the underlying psycho-social causes of patients’ back problems. this could measure the degree of perceived
depression as well as anxiety and fear of movement. “the results of the investigation and associated discussion could lead to patients taking a more active role and taking responsibility for their treatment,” says olaya-Contreras. “I also believe that it can help patients to focus more on the positive resources they themselves have to handle the pain and master various physical movements even though it hurts.” Brian hammond, Chair of BackCare, says: “the days of wearing neck braces and lying on hard beds for days on end are long gone. don’t back away from back pain. In most cases, the less you move, the more likely it is that you will find yourself sitting still all day with nothing to think about but your pain. “By contrast, people who set themselves small targets, such as going to the shops or walking round the block, often find that they are able to regain lost capacity and maintain contact with their friends. While their pain may never go away completely, it is something that many people learn to manage as part of a relatively full and happy life.”
don’t ignore nerves as a likely cause neuropathetic (nerve) back pain is experienced by nearly 40% of back pain sufferers. however, a survey of nearly 3,000 people revealed a worrying lack of awareness of the condition. the online survey, conducted last summer, questioned respondents on their experience of back pain (if any) and their awareness of neuropathetic pain. over 60% of people interviewed said they suffered from back pain. of those, 94% said they had suffered for more than
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three months, while half said they had suffered back pain for more than five years. nearly 84% of those with chronic pain said that their doctor had never mentioned neuropathic pain to them, while 63% had never even heard of neuropathetic pain. the results highlight the importance of better information and advice to back pain sufferers and encouraging gPs to remind patients of the course of treatments that are available for back pain.
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Norbert van Rooij (Grunenthal – funder); Marian Harkin MEP (host), Joop van Griensven (President, Pain Alliance Europe) and Sean McDougall (BackCare) at the PAE launch event in Brussels
Influencing policy in europe AS We Went to press, BackCare was helping to launch Pain Alliance europe, an initiative to ensure that policy decisions made at european level have full regard for the needs of people living in pain. Pain is fast rising up the european agenda. In September, the european Parliament passed its first ever motion on chronic pain, recognising that demographic change is putting healthcare systems under ever greater pressure. With all pain-relieving drugs now licensed at eu level, the need for strong representation in Brussels has never been greater. every day, almost 100 million eu citizens wake up in pain, with only half receiving effective treatment. over 20 million find themselves unable to work, while 61% say it affects their ability to do their jobs properly. the cost of treating chronic pain across europe is now estimated at €300 billion a year.
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Welcoming the alliance, hans georg Kress, european President of the International Association for the Study of Pain, said: “Pain relief is a human right, as recognised by the World health organisation and human rights Watch. I welcome Pain Alliance europe as an important step towards our aim of public recognition of chronic pain – not only as a true challenge to patients and physicians, but also to the healthcare systems, the politicians and strategic decision makers throughout europe.” Speaking for BackCare, Sean Mcdougall said: “Basically, half of the pain management strategy of most chronic pain sufferers is decided in Brussels, while the other half is decided in the uK. ensuring that British citizens receive optimal pain management support therefore requires a presence at eu level. BackCare is delighted to have helped bring the new alliance into being and we are looking forward to working with, and
learning from, our colleagues in countries such as finland, romania and Austria.” Pain Alliance europe’s first campaign will be focused on a seven-point roadmap for action: ■ Acknowledgement that pain is an important factor limiting quality of life ■ fuller involvement of patients, their families, relatives and caregivers in pain diagnosis and management through better access to information ■ raised awareness of the medical, financial and social impact of chronic pain ■ education programmes for professionals to support prevention, diagnosis and management of pain ■ Increased funding for research into the societal impact of pain ■ establishment of an eu platform for the exchange, comparison and benchmarking of best practice ■ Provision of guidelines to improve the quality of life of eu citizens.
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Advertise in Talkback Reach out to your target audience TALkBACk magazine caters for the increasing number of people who are affected by back pain, nearly 50% of the uk population. Produced quarterly, Talkback includes some of the following sections; ■ Interview with back pain sufferers ■ Back product testing and the latest gadgets ■ Exercises and tips on preventing back pain
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■ Patient-centred approaches to treatment ■ Research news ■ BackCare Professionals Section If you would like to find out more about advertising within the next edition of Talkback, please contact us at info@backcare.org.uk. Alternatively, if you would like to discuss advertising on our website, please telephone us on 020 8977 5474.
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breathworks
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Caption: sd kj sd jz vzkxj vz lkxjcv lzkxj cvlzk xj cvzx clvj zisu vaiusdf vaiu sdvi isu
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Natasha Doran shares her experience of a mindfulnessbased self-management pain management programme
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Half-page ad 186 x 134mm
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