Spinal pain – when is it less about the spine and more about the person?

SPECIALIST TALK // Kieran O’Sullivan, PhD, Sports Spine Centre at Aspetar Sports Medicine and Orthopedic Hospital, Doha

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Clinicians will be assisted in determining, when therapy should be more – or less – focused on treatment of local spinal tissues.

Spinal pain is a major cause of disability and healthcare utilization. Decades of chasing various pain ‘sources’ through ever-more sophisticated imaging modalities, investigative procedures and interventions has yielded little progress in clinical outcomes. A considerable body of scientific research helps explain, why this has been relatively unsuccessful. Pain is not very well correlated with tissue ‘damage’ and researchers, educators and clinicians are gradually spreading this message.

Two considerable challenges remain:

  1. Trying to identify with confidence, when spinal pain is mostly related to local ‘issues in the tissues’, and when it is more closely connected with an altered sensitivity of the person, and
  2. What is a “physical” therapist to do about contributing factors that might be less “physical” in nature while respecting professional boundaries, training and expertise?

Kieran O'Sullivan seeks to help clinicians identify the key barriers to pain among their patients, and how physiotherapists can play a role in either addressing these factors directly, or counselling patients to seek appropriate support elsewhere as needed.

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