[On the move-Prevention of chronic pain with physical activity and movement]

[Innovative interventions in pain physiotherapy : Advancing care for people with chronic pain]

BACKGROUND

Chronic pain, with a prevalence of at least 17%, is a costly health problem associated with a high burden of disease. Musculoskeletal chronic pain is particulary common, which in many cases is treated with physiotherapy.

AIM

The aim of this paper is to provide an overview of innovative, promising physiotherapy interventions in pain management, to present their effectiveness and to discuss their implementation in healthcare.

METHODS

A narrative review was conducted. The Cochrane, Medline (via PubMed) and PEDro databases were searched using the search terms chronic pain, physiotherapy, prevention, pain education, behavioural intervention, eHealth, and systematic review as well as chronic pain, guideline and relevant synonyms.

RESULTS

One guideline review, two guidelines and ten systematic reviews were included. Chronic pain prevention, digital health apps, lifestyle interventions and behavioural approaches were identified as promising and effective interventions for people with chronic pain, showing the potential to meaningfully complement pain physiotherapy and improve quality of care.

CONCLUSIONS

Despite the predominantly positive results from systematic reviews, implementation in everyday care is difficult due to conditions of care and the contemporary education system for physiotherapists in Germany. Health services research can play an important role in accelerating the transfer of innovations into practice.

Recommendations for a Pediatric Pain Education Curriculum for Physical and Occupational Therapists: Scoping Review and Survey

Specialization training for physiotherapists, occupational therapists, and sports therapists involved in pediatric pain is scarce and curricula are rarely published. The objectives of this study are twofold: firstly, to perform a scoping review to derive important contents for a pediatric pain education curriculum for specialized pain therapists. Secondly, to conduct a survey on specific contents in curricula currently used by pain experts and to obtain their evaluation regarding the importance of such contents for a specialized curriculum. The review substantiated the importance of a specific curriculum in pediatric pain education, but provided little information on adequate contents. In the survey, 45 experts in pediatric pain education confirmed that specific curricula and specialized contents for pediatric pain education are missing. Their answers give a well-defined picture of the specifics needed in the interaction with a pediatric population. The most important items they classified were e.g., the biopsychosocial framework and the impact of pediatric pain on daily life. Those expert ratings were in line with the recommendations of pediatric pain management guidelines. Further curriculum work in an interdisciplinary, international network is highly recommended.

[Psychosocial factors in the prevention of pain]

The question of pain prevention is becoming increasingly important, both in society and in science. According to the International Society for the Study of Pain, general areas for which pain prevention measures can be recommended have been defined. These approaches are mostly limited to unspecific recommendations with the aim of improving general health behaviour. Common to all of them is that they essentially address psychosocial and psychobehavioral aspects. In contrast to genetic factors or other non-modifiable environmental factors, psychosocial and psychobehavioral aspects are potentially modifiable variables, making them possible starting points for prevention programs. Furthermore, recent studies provide important knowledge about psychological and social risk factors of pain chronification and thus offer new approaches for future pain prevention strategies. At the same time, the efficacy and successful implementation of such programs is so complex that valid statements on effectiveness and benefit can only be made through care-related evaluation. This review addresses psychological and social factors in the prevention of pain. A selective literature search was carried out to this end. Based on selected studies, psychological and social predictors of pain development are presented and their potential for future pain prevention programs discussed. The article concludes with a discussion of possible implications.