Table 2 Topics to be addressed during therapy in Positive Therapeutic Alliance and Usual Treatment Groups [9,42,48,49,50,51,52,53,, 27, 41–43, 47–54]
Addressed topic | Key issues to be discussed | Example sentences |
|---|---|---|
Regarding low back pain | • Low back pain causes • Low back pain diagnosis • Low back pain classification • Prognosis • Low back pain natural history | “Permanent or severe back damages are rare” “It is really very difficult to damage your back” “Back pain is rarely caused by a serious illness” “Back pain prognosis is favorable” |
Imaging tests | • Imaging findings in asymptomatic people • Normal degenerative signs | “About 60% of the asymptomatic population has some sort of degenerative sign” “There is nothing seriously wrong in your back” |
Physical activity and Rest | • The importance of physical activity • Low back pain behavior | “The sooner you resume your activities the sooner you will get better” “Rest is not good for the back” “You may have some limitations, but the most important thing is to keep moving” |
Pain control | • Medication • Available treatments • Self-care | “There are several steps you can take to help your back pain” “Physicians and physical therapists can help your back pain, but only you are able to take care of yourself” |
Family and work, anxiety and stress-related factors | • The importance of family support • The importance of controlling anxiety and stress • The influence of these factors on back pain | “Gradually return to your social activities and work! The sooner you return, the less future problems you will have” “You really can help yourself!” “People who cope better with the pain return to their activities faster and better” “You will have good and bad days, this is normal!” “Although the natural history is positive, there are some factors that contribute to pain that becomes chronic, we will work on them” |
Concepts of chronic pain | • Current concept of pain • Pain threshold • Central hypersensitivity | “Pain does not mean back injury” “Pain is a response to sensory stimuli, and it is not necessarily related to any tissue damage in the spine” “Pain can just be a misunderstanding of the body” |
Encouragement 51,55 | • Good prognosis: subgroup of low risk of involvement of psychosocial factors • Return to activities | “This information is taken from the best and most current research in the world” “Do not let your back pain take over your life, you are able to get through it” |