Do you have low back pain?

[Matt Liston]

Hi there,

I'm new to the forum and to Sydney, I moved over from the UK at the end of last year for work to run a research project at the University of Western Sydney into low back pain. I was a pretty keen MTBer in the UK, but my bike is sitting in my house in London waiting to be brought over when i go back to London. Where are the best trails for XC riding around sydney? I work out in Campbelltown but live in Wolli Creek and was wondering where to be going out to when my bike arrives. When are the best times of year to ride?

Also, I am about to do a shameless plug for the study I am running. We need people with low back pain - either a new occurence or a recent flare up in pain. We need 265 people so are spreading our net as far as possible.... and i know mtbers are always going on about their backs Please see the ad below (mods if this is against the rules then please delete, but i couldn't see anything against this).



Have you started experiencing low back pain recently or do you currently suffer with low back pain?

The UPWARD study are currently recruiting people with low back pain into their National Health and Medical Research Council Funded study being carried out by the University of Western Sydney and University of New South Wales (NH&MRC grant number: 1059116, Ethics approval number: H10465).

The UPWARD study is a long-term study that will observe participants over 12 months in order to understand why some individuals get better after hurting their back while others do not. The UPWARD study will investigate the role of brain plasticity, along with biological changes in the spinal cord, hormonal changes and stress, in the development of persistent low back pain. This study is the first longitudinal study of its type to investigate these factors. It is anticipated that findings from the UPWARD study will help clinicians design more appropriately timed and targeted therapies for people with low back pain.

Potential participants will undergo a telephone screening interview with a researcher to determine their eligibility. If eligible you will be asked to attend our research laboratory in the School of Science and Health, University of Western Sydney for an initial testing session lasting approximately 3.5 hours. You will then be asked to attend further lab test sessions 3 and 6 months later. After 9 months you will be asked to complete some online questionnaires and take part in a short telephone call with the research team. This will be repeated again at 12 months.

If you would like further information or would like to participate, please contact Matthew Liston by email (m.liston@uws.edu.au) or visit the study website and complete the contact form at www.upwardbackpainstudy.com


Matt Liston PhD, BSc Hons PT
School of Science and Health, University of Western Sydney
E: m.liston@uws.edu.au
www.upwardbackpainstudy.com
www.facebook.com/upwardbackpainstudy
www.twitter.com/upwardbackpain

 

[pink poodle]

This sounds awesome. Are there any dietary restrictions if I partake? My slam intake is quite high.

 

[johnny]

If I was in Syd I'd take part in this.


[this is a mod-approved thread :yo:]

 

[mtb101]

so you're asking people to participate in a study where they receive no benefits for themselves, no resolution to their problem - so at the end of 12 months they'll receive a letter in the mail, conclusion 'you have lower back pain' thank you for your participation.

why would you expect us to give away our precious time when we receive no benefit? We are not mice.

might be worth considering giving back something to community (participants) it's their money after all.

 

[johnny]

Because research like this is how remedies are found.

How do you think medical/scientific studies usually work?

 

[mtb101]

that's true - may be some distant benefit somewhere into the future in the meantime wouldn't you want some benefit as well - now ? its a government grant (yes your taxes) would have drug company backing so that's where your data would end up.

sounds like your typical elitist spend of our money and no direct community benefit. if people want to participate up to them.

 

[Matt Liston]

This sounds awesome. Are there any dietary restrictions if I partake? My slam intake is quite high.

Hi Pink poodle, no need to change anything and no restrictions on anything. We just want to see how people recover from their back pain. if you're interested drop me an email and we can discuss the project, if you don't have pain now let me know after your next slam!

Matt

 

[Matt Liston]

that's true - may be some distant benefit somewhere into the future in the meantime wouldn't you want some benefit as well - now ? its a government grant (yes your taxes) would have drug company backing so that's where your data would end up.

sounds like your typical elitist spend of our money and no direct community benefit. if people want to participate up to them.

Hi MTB101,
Sorry you feel this way but that’s your prerogative. But I’d just like to put this in context to fight our corner so to speak, but I’m not looking for a row!
We do ask people to volunteer for this study, essentially out of the goodness of their own heart and with the understanding that they are providing a huge amount of useful information to help us get to grips with a problem (the transition from acute to chronic low back pain) which clinicians and scientists do not fully understand. Ask any physio, medic or other health professional why some people don’t recover after injuring their backs whilst others do and they’ll tell you we don’t really know. We know some things that are associated with the development of chronic pain but we don’t understand the mechanism that drives this. Until we know how chronic pain develops we cannot develop effective treatments. You cannot target something that you do not know.
Just to put low back pain in some context for you, so you know what we are dealing with here. Low back pain has the second greatest economic burden in the western world, second only to cancer. Over the course of a lifetime 8 out of 10 people will injure their back and depending on the studies you look at, somewhere between 20 and 40% will still be reporting pain 12 months after injury. This pain, if it does not resolve (i.e. becomes chronic low back pain) can have a dramatic impact on the persons’ life; it can lead to loss of income, loss of role in both family and social life, lead to crippling day and night pain and disability (such as loss of mobility). It can also lead to losses for employers associated with days missed from work and modification of work routines for those with pain. There are obviously direct and indirect costs associated with this, but it is thought that about Aus$1 billion is spent annually on treatments for low back pain in Australia alone (this doesn’t include the cost of visits to the GP or ER). This is subsidised by your tax (Medicare) and by increases in your health insurance premiums. So, would you not prefer us to work out how to prevent people getting chronic low back pain which in turn will reduce the burden on insurers and health services?
You say “why would you expect us to give away our precious time when we receive no benefit? We are not mice.” We don’t expect anyone to do anything, we ask for volunteers that provide their time of their own free will. We cannot pay people to participate (but can reimburse costs) as this is seen as inducement and from our funding stream this is seriously against the rules. The benefit a person would gain would be from helping fellow men (and women). I understand not everyone is altruistic and that is why participating is not compulsory. As for mice, if we could do this study with mice we would…. But humans are very different to mice and chronic pain is not something we can induce in animals. Pain is a very complicated thing and is not purely physical. It is widely accepted that pain is an experience that has sensory, behavioural, psychological and perceptual systems inputting into it – consider phantom limb pain where someone experiences terrific and crippling sensations of pain and cramping in a limb that is no longer there. This pain cannot be managed particularly well with drugs, as the pain is not from a sensory pathway. However, using mirrors to trick the brain that the limb is there can allow people to reduce the sensation of pain as we trick the brain (via visual inputs) that the limb is there and can be moved to reduce the cramps.

Also you say “might be worth considering giving back something to community (participants) it's their money after all” well in actual fact we have a community engagement programme underway. We will be running seminar programmes for people with pain and are also starting a pain education blog. This is written specifically for patients to provide them with cutting edge information that is not commonly accessible to people with pain. There have been a few papers highlighting the lack of useful information on low back pain and its causes. This blog has an editorial group that has people with pain sitting on it to make sure we write stuff that they want to read.
In your next post you say “may be some distant benefit somewhere into the future in the meantime wouldn't you want some benefit as well - now?” what would you want us to do above and beyond providing them with information on how they are doing and providing information? Should we give them free physio? Is that not an inducement to participate as an indirect payment? Would you feel happy that we claimed another chunk of money to fund their treatment on top of our operating costs? Also, the evidence supporting how to treat people with low back pain is limited and not particularly impressive in terms of its effectiveness.
You are correct, this study is funded by a govt grant and we are audited to make sure we spend every last cent appropriately and achieve value for money. Also, I would like to clarify, we have no drug company backing and it would be unethical and very illegal for this data to go any further than the research team. If this were funded by a drug company, it would be a clinical trial to examine effectiveness of the drug they are trying to get registered. Physio is very rarely funded by drug companies (I don’t know anyone that has been funded by Pharma but I don’t know everyone).
“sounds like your typical elitist spend of our money and no direct community benefit”- I really don’t know what you are getting at here. If working towards trying to prevent the development of a terrible and disabling condition, which has a huge economic cost to a number of western cultures and in a large number of cases could be wholly preventable is elitist then so be it.
Sorry for the massively long post, but I wanted to clear some of that up…

Cheers
Matt

 

[pink poodle]

Hi Pink poodle, no need to change anything and no restrictions on anything. We just want to see how people recover from their back pain. if you're interested drop me an email and we can discuss the project, if you don't have pain now let me know after your next slam!

Matt

I see you are not familiar with sarcasm. Apologies in advance as my post includes the word slam, which may have been confusing. That was an autocorrect of spam. I have updated my dictionary now so all should be well into the future. Good luck with your study.

 

[steve jobs' pancreas]

How do you think medical/scientific studies usually work?

Well last time I got some colourful pills and a rectal examination that seemed strangely irrelevant.

 

[johnny]

I munted fuck out of my back picking a cushion up off the lounge.

sciatica like a mofo. I hate everything.

 

[pink poodle]

I munted fuck out of my back picking a cushion up off the lounge.

sciatica like a mofo. I hate everything.

You need to find a new spot to store all those kilos of ice. With the sciatica flare up you'll have trouble retrieving them...were you picking up your "cushion" while standing on your balance board?

 

[Ridenparadise]

Hi MTB101,
Sorry you feel this way but that’s your prerogative. But I’d just like to put this in context to fight our corner so to speak, but I’m not looking for a row!
We do ask people to volunteer for this study, essentially out of the goodness of their own heart and with the understanding that they are providing a huge amount of useful information to help us get to grips with a problem (the transition from acute to chronic low back pain) which clinicians and scientists do not fully understand. Ask any physio, medic or other health professional why some people don’t recover after injuring their backs whilst others do and they’ll tell you we don’t really know. We know some things that are associated with the development of chronic pain but we don’t understand the mechanism that drives this. Until we know how chronic pain develops we cannot develop effective treatments. You cannot target something that you do not know.
Just to put low back pain in some context for you, so you know what we are dealing with here. Low back pain has the second greatest economic burden in the western world, second only to cancer. Over the course of a lifetime 8 out of 10 people will injure their back and depending on the studies you look at, somewhere between 20 and 40% will still be reporting pain 12 months after injury. This pain, if it does not resolve (i.e. becomes chronic low back pain) can have a dramatic impact on the persons’ life; it can lead to loss of income, loss of role in both family and social life, lead to crippling day and night pain and disability (such as loss of mobility). It can also lead to losses for employers associated with days missed from work and modification of work routines for those with pain. There are obviously direct and indirect costs associated with this, but it is thought that about Aus$1 billion is spent annually on treatments for low back pain in Australia alone (this doesn’t include the cost of visits to the GP or ER). This is subsidised by your tax (Medicare) and by increases in your health insurance premiums. So, would you not prefer us to work out how to prevent people getting chronic low back pain which in turn will reduce the burden on insurers and health services?
You say “why would you expect us to give away our precious time when we receive no benefit? We are not mice.” We don’t expect anyone to do anything, we ask for volunteers that provide their time of their own free will. We cannot pay people to participate (but can reimburse costs) as this is seen as inducement and from our funding stream this is seriously against the rules. The benefit a person would gain would be from helping fellow men (and women). I understand not everyone is altruistic and that is why participating is not compulsory. As for mice, if we could do this study with mice we would…. But humans are very different to mice and chronic pain is not something we can induce in animals. Pain is a very complicated thing and is not purely physical. It is widely accepted that pain is an experience that has sensory, behavioural, psychological and perceptual systems inputting into it – consider phantom limb pain where someone experiences terrific and crippling sensations of pain and cramping in a limb that is no longer there. This pain cannot be managed particularly well with drugs, as the pain is not from a sensory pathway. However, using mirrors to trick the brain that the limb is there can allow people to reduce the sensation of pain as we trick the brain (via visual inputs) that the limb is there and can be moved to reduce the cramps.

Also you say “might be worth considering giving back something to community (participants) it's their money after all” well in actual fact we have a community engagement programme underway. We will be running seminar programmes for people with pain and are also starting a pain education blog. This is written specifically for patients to provide them with cutting edge information that is not commonly accessible to people with pain. There have been a few papers highlighting the lack of useful information on low back pain and its causes. This blog has an editorial group that has people with pain sitting on it to make sure we write stuff that they want to read.
In your next post you say “may be some distant benefit somewhere into the future in the meantime wouldn't you want some benefit as well - now?” what would you want us to do above and beyond providing them with information on how they are doing and providing information? Should we give them free physio? Is that not an inducement to participate as an indirect payment? Would you feel happy that we claimed another chunk of money to fund their treatment on top of our operating costs? Also, the evidence supporting how to treat people with low back pain is limited and not particularly impressive in terms of its effectiveness.
You are correct, this study is funded by a govt grant and we are audited to make sure we spend every last cent appropriately and achieve value for money. Also, I would like to clarify, we have no drug company backing and it would be unethical and very illegal for this data to go any further than the research team. If this were funded by a drug company, it would be a clinical trial to examine effectiveness of the drug they are trying to get registered. Physio is very rarely funded by drug companies (I don’t know anyone that has been funded by Pharma but I don’t know everyone).
“sounds like your typical elitist spend of our money and no direct community benefit”- I really don’t know what you are getting at here. If working towards trying to prevent the development of a terrible and disabling condition, which has a huge economic cost to a number of western cultures and in a large number of cases could be wholly preventable is elitist then so be it.
Sorry for the massively long post, but I wanted to clear some of that up…

Cheers
Matt

You need MTB101 in this study. He may be a good example of why some people feel it's their deserved right to be "made" better rather than going with the flow and getting themselves better. Not all CNS plasticity is positive!

 

[Matt Liston]

You need MTB101 in this study. He may be a good example of why some people feel it's their deserved right to be "made" better rather than going with the flow and getting themselves better. Not all CNS plasticity is positive!

Totally agree with you there, plasticity can be a right pain in the back....

 

[Artvandelay]

Research rocks

I cannot think of many greater contributors to the community than research. Any contribution to the pool of available factual information regarding LBP or/ and chronic pain would potentially lead to an improvement in many people's lives. Not to mention the all important money benefits, especially for some, in reduced private health, reduced medicare costs, increased taxation money spent on important community needs apart from LBP (given less people would have it due to improved knowledge from research).