Individualised treatment of Low Back Pain: The STOPS Approach
Identifying the key barriers to recovery and then providing individualised and effective treatment for low back pain can be complex. The STOPS Low Back Pain approach is based on high quality randomised trials that showed long term effectiveness (pain and function) as well as cost effectiveness.
The course is presented by Dr Jon Ford (PhD, Musculoskeletal Physiotherapist) who has 25 years experience in the management of recent onset and persistent low back pain within a physiotherapy and multi-disciplinary setting.
Through pre-course online learning modules, a clinically oriented cased based learning approach on the course and PDF resources for use in the clinic your treatment of low back pain will be more effective on Monday morning following the course!
Identifying barriers to recovery – the key to effective treatment
You’ll learn how to tailor a comprehensive initial assessment to your patient and with advanced clinical reasoning arrive at a prioritised list of barriers to recovery based on pain type (nociceptive, neuropathic, nociplastic), hypothesised pathoanatomical diagnosis, impairments and psychosocial factors. Understanding how to individualise treatment targeting the most relevant barriers is the key to effective and efficient treatment
Every patient is different, having a range of barriers to recovery. In the STOPS Low Back Pain course we’ll use case studies provided from patients in your clinic to explore individualised treatment. Consider for example how you would treat:
Case 1 with lumbar and somatic left leg pain (nociceptive dominant) with the lumbar z-joint hypothesised as the source of symptoms with possible contributions from neural mechanosensitivity and a maladaptive long lumbar lordosis in functional tasks
Case 2 with diffuse lumbar and leg symptoms (nociplastic dominant) with marked conflict at work, maladaptive fear avoidance beliefs, very poor sleep and marked deconditioning due to 6 months of minimal activity
During this course you’ll learn how to individualise treatment including manual therapy, motor control retraining (including sub-optimal posture, movement and muscle activation), McKenzie principles, cognitive-behavioural strategies and graded activity/exercise (using a time or pain contingent approach). Individualised treatment applied with clinical reasoning is quick to apply and so can optimise your private practice patient contact time.
Further information on barriers to recovery including an illustrative case study can be seen here.
- Develop understanding of the multi-factorial mechanisms in recent onset-persistent pain and the relevance to clinical decision-making
- Developing an individualised, methodical and comprehensive assessment based on the biopsychosocial approach
- Learn key serious pathologies and clinical patterns not to miss, in particular the subgroups from the Specific Treatment of Problems of the Spine (STOPS) trial (eg z-joint, types of discogenic problems) as well as psychosocial and neurophysiological types (eg neuropathic pain, nociplastic pain)
- Develop skills in narrative reasoning and exploration of the patient’s perspective
- Learn how to develop a prioritised list of barriers to recovery and a patient individualised treatment program
- Learn how to access and implement the best available evidence to assist in planning treatment
- Improve ability to provide patient explanations specific to the barriers to recovery
- Learn how to use the STOPS Patient Info Sheets and Clinical Decision Making Flow Charts in patient scenarios
- Be able to apply a range of treatment methods for simple recent onset back pain to complex persistent pain cases including specific manual therapy, directional preference management and graded activity/exercise in a time and pain contingent manner
- Explore a range of other treatment strategies for multi-factorial persistent pain including medication management, graded activity/exercise programs, acceptance and commitment therapy (ACT), a cognitive behavioural approach, goal setting, pacing, relaxation, sleep management and managing flare ups
- Understand the evidence and clinical application of motor control training in selected patients
- Improve clinical reasoning skills in assessment and treatment
- Improve problem solving for common issues arising during treatment of back pain and adapt the treatment program as required
- Interactive teacher led training (Powerpoint with some text, figures and video) – 30%
- Prepared case studies – 10%
- Participant case studies used in small and large group problem solving exercises – 15%
- Small group role play – 10%
- Workbook for self directed learning using course manual as a resource – 10%
- Whiteboard “requests” for day 2 content including difficult scenarios – 25%
Course manual includes
- Four papers detailing the STOPS treatment protocols in full
- Over 25 Patient Info Sheets
- Clinical decision making flow charts
- Diagnostic and screening questionnaires (with free links for downloading)
- Assessment checklist
- Links to additional resources for further learning and consolidation of course content including online modules to be done before the course
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