Dr. Kieran O´Sullivan & Brian Sørensen on Spinal Health management through the big lens

01/12/23 • 59 min

In this episode i ́m joined by my irish colleague Dr. Kieran O ́Sullivan.
Kieran has 23 years of experience as a physiotherapist. He ́s known for his research within the field musculoskeletal pain and especially in persistent spinal pain. He has published more than 240 publications including one from 2022 we did together and which i ́m gratefull for helping me with. Kieran is also involved in free online resources such as the www.pain-ed.com with other clinicians and researcher. An online ressource which I ́ve found quite usefull when trying to help people in pain.
Kieran and I talk about spinal health management through the big lens. Since Kieran has researched the field so extensively I thought he would be an excellent person to discuss this subject with.
We cover subjects such as;
Chronic low back pain management and Why there is an increasing burden. Both nationally in Denmark and internationally spinal pain is increasing and one of the top reason for seeking care.
The Biopscyhosocial model - what happened to the bio.
Some would argue that we ́ve made little progress over the last 25-30 years . Another reason for that is a perspective that i personnally do support to some degree when you see the lack of research papers on biological reseacrh compared other parts of the BPS model. We discuss if there could be a point in getting a better understanding of the bio?
Overmedicalization what it is and what it is not – over-rx and over investigation in one sense, but also neglect/underfunding of chronic conditions/multimorbidity – easier to get access to nsaids, mri, injection than to access supervised exercise rehab, support & advice for sleep, mood, diet etc . But also why we most likely need to do a physical evaluation in order to get a got start to our partnership with the human being seeking our help.
Changes in spinal health. Kieran gives some of his takes on what need to change but also the challenges that comes with it.

The future of Spinal health management.
What does the future of lbp hold (prevention, diagnosis, treatment) – Kieran gives us both his pessimistic and optimistic takes on this.
As always thanks for listening. Please like, subscribe, share to stay updated for future episodes of The FysioAalborg Pod.
Brian

Previous Episode

Børn og unge med rygsmerter med Christian Straszek

Min gæst denne gang er min kollega Christian Straszek.
Christian Straszek arbejder som underviser på Fysioterapeutuddannelsen i Aalborg mens han forsker og laver sin PhD.
Christian og jeg taler bla. om følgende;
Hvad er målgruppen børn og unge . Hvad karakteriserer gruppen vi taler om.
Kan man se nogle forhold som er ens for børn og unge og de voksne som oplever rygsmerter.
Ved vi hvorfor den omtalte målgruppe får ondt og ved vi også hvad det sandsynligvis ikke skyldes. Betyder holdning og fysisk aktivitet noget for udviklingen af rygsmerter.
Hvordan opelver børn og unge det at have rygsmerter og hvorledes oplever de forløbet i sundhedssektoren. Hvilken rolle har den sundhedsfaglige og hvilken rolle har forældre, idrætstræner og skolelæren.
Mere om Christian
https://www.linkedin.com/in/cstraszek/
https://www.ucn.dk/om-ucn/presse/presse/find-en-ekspert/christian-lund-straszek

Next Episode

Professor Mark Hancock & Brian Sørensen talks back pain and pathoanatomy

Mark has been so kind to share his thought regarding diagnosis and treatment of spinal pain. Especially the subject of pathoanatomy or what is often referred to as the bio part of the biopsychosocial model.
This was a very objective and good chat where we go in deep on the following subjects;
We start out by taking a look at Marks recent paper ( Reconsidering non-specific low back pain: Where to from here?) and highlight that little attention / research into pathoanatomic diagnosis has been made. And combines this we an earlier paper from 2011 (Discussion paper: what happened to the ‘bio’ in the bio-psycho-social model of low back pain?).
We then jump into some very used papers or at least one of them cause the other one seems neglected or for some reason less interesting and those are the papers by Brinjikji et al 2015, Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. and MRI Findings of Disc Degeneration are More Prevalent in Adults with Low Back Pain than in Asymptomatic Controls: A Systematic Review and Meta-Analysis. These papers are excellent for clinicians and researchers however it is my understanding that they to some extent mainly is used for telling people that their imaging findings are normal which, but I believe there is more to be said from those papers.
Then we discuss the ability (reliability and validity) to use pathoanaomic diagnosis in the clinic. A practice that the current literature suggest is not posiible , however depsite that some people in the health industry seem to neglect that which I believe has several limitations and might even be harmfull. Marks paper from 2007 looks into this matter on abillity to make a pathoanatomic diagnosis (Hancock, M., Maher, C., Latimer, J. et al. Systematic review of tests to identify the disc, SIJ or facet joint as the source of low back pain. Eur Spine J 16, 1539–1550 (2007). https://doi.org/10.1007/s00586-007-0391-1)
As always thanks for listening
Brian