Journal of Rehabilitation and Pain Medicine最新文献

{"title":"Opioid Induced Adrenal Insufficiency Complicated by Adrenal Crisis-A Case Report","authors":"William J Naber II","doi":"10.37191/mapsci-jrpm-1(2)-011","DOIUrl":"https://doi.org/10.37191/mapsci-jrpm-1(2)-011","url":null,"abstract":"Introduction: 1 in 5 people experience chronic pain that limits their ability to carry out activities of daily living. Opioid analgesics are one of the pharmaceutical interventions utilized to treat chronic pain. In fact, chronic pain is one of the most common reasons opioids are prescribed. Although many of the secondary effects of opioids are well known, a lesser-known side effect is opioid induced adrenal insufficiency (OIAI). OIAI can cause significant morbidity and has the potential to result in adrenal crisis, profound hypotension, and potential cardiovascular collapse, resulting in death. With sparse literature on OIAI, we present a case of OIAI complicated by adrenal crisis to expand awareness and discussion on the topic. Methods: The patient was a 65-year-old female on chronic opioid therapy for back pain who presented to the emergency room for syncope. On presentation, patient was hypotensive, bradycardic, and had an inadequate fluid response requiring pressors. Traditional etiologies of shock were ruled out, but interestingly morning cortisol and adrenocorticotropic hormone (ACTH) levels were low. Additionally, the cosyntropin stimulation test was suboptimal. Results suggested central hypothalamic pituitary axis suppression, which after discussion with Endocrinology indicated OIAI given the patient’s history. Results: Shortly after steroid regimen initiation the patient was weaned off pressors, and after multiple taper trials was successfully sent home on a steroid taper with Endocrinology follow up. Conclusion: Long term opioid use to treat chronic pain can decrease cortisol production via HPA axis suppression resulting in OIAI. To date, there is limited investigation into OIAI despite its increased prevalence and widespread use of opioids. The case adds to the available literature on OIAI, and sheds light on adrenal crisis as its initial presentation.","PeriodicalId":355292,"journal":{"name":"Journal of Rehabilitation and Pain Medicine","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140521062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pneumatic Compression Massage Decreases Effects of Delayed Onset Muscle Soreness in Active Females","authors":"Kate McLellan","doi":"10.37191/mapsci-jrpm-1(2)-012","DOIUrl":"https://doi.org/10.37191/mapsci-jrpm-1(2)-012","url":null,"abstract":"Background: Eccentric exercise often results in Delayed Onset Muscle Soreness (DOMS) which causes decreases in muscle strength and power with accompanying prolonged pain. Objectives: The study examined the effectiveness of Pneumatic Compression Massage (PCM) on changes in leg power following DOMS-inducing eccentric hamstring exercises. Pain levels and perceived efficacy of PCM as a recovery method for exercise-induced DOMS was also examined. Methods: Twenty-one active college-aged female volunteers were randomly assigned to PCM or control groups after performing 4-rounds of eccentric Nordic hamstring exercises to failure after which control subjects sat quietly for 10 minutes while the PCM-assigned subjects wore pneumatic compression massage (PCM) leggings for 10 minutes. All variables were evaluated at baseline and at 1-, 24-, 48-, and 72-hours after the exercise sets. Results: Movement economy was significantly greater as PCM had significantly faster ground contact time (GCT) at 24-hrs (p=0.01), 48-hrs (p=0.04), and 72-hrs (p=0.03) compared to control subjects. Leg muscle power output was significantly higher in PCM at 24-hrs (p=0.04), 48-hrs (p=0.05), and 72-hrs (p=0.01), while control subjects had significantly more pain at 72-hrs (p=0.02). Conclusion: PCM applied for 10-minutes every 24-hours following DOMS-inducing eccentric exercise resulted in greater improvements in movement economy, reaction time, jump height, lower limb power, pain, and other DOMS-related symptoms.","PeriodicalId":355292,"journal":{"name":"Journal of Rehabilitation and Pain Medicine","volume":"41 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140517245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bipolar Radiofrequency Ablation for Neuropathic Pain in a Patient with a Morton Neuroma of Atypical Location","authors":"Akhil Chhatre","doi":"10.37191/mapsci-jrpm-1(2)-013","DOIUrl":"https://doi.org/10.37191/mapsci-jrpm-1(2)-013","url":null,"abstract":"Introduction: Morton's Neuroma is a common cause of forefoot pain, often resulting from excessive force and compressive footwear, especially in highly active patients. The treatment typically begins with physical therapy and modifications in activity or footwear, progresses to corticosteroid and alcohol injections, and ultimately may involve surgical management. Bipolar radiofrequency ablation (RFA) is an emerging treatment that might delay or prevent surgery and may be more effective than its monopolar counterpart. The aim of this case report is to highlight bipolar radiofrequency ablation as a potential treatment option for Morton's neuroma (MN). Case Presentation: The author’s present a 70-year-old male with a clinical diagnosis of Morton's neuroma in an unusual location who underwent bipolar RFA on the medial side of the left great toe after conservative therapy proved unsuccessful. Following the procedure, the patient showed substantial improvement both functionally and symptomatically, with a notable reduction in pain by 70% at his 3-week check-up. Conclusion: Radiofrequency ablation is increasingly being recognized as a valuable option in the pain management toolkit for Morton's Neuroma. The benefits of delaying or avoiding surgery are particularly significant for athletes and dancers. Compared to monopolar RFA, bipolar RFA may provide a more effective treatment.","PeriodicalId":355292,"journal":{"name":"Journal of Rehabilitation and Pain Medicine","volume":"75 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140520236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intercepting Intracept: A Case Report of Idiopathic Arachnoiditis","authors":"Akhil Chhatre","doi":"10.37191/mapsci-jrpm-1(3)-018","DOIUrl":"https://doi.org/10.37191/mapsci-jrpm-1(3)-018","url":null,"abstract":"Introduction: Determining the exact diagnoses for low back is challenging due to the myriad of causative factors. Consequently, rare diagnoses like arachnoiditis are often overlooked, causing patients with this condition to be ineffectively treated. Arachnoiditis involves inflammation of the arachnoid membrane enveloping the spinal cord, can is caused by diverse etiological factors, including infections, trauma, spinal cord contamination, tumors, and genetic predispositions. Case: In this case report, the author describe a 43-year-old female with a past medical history of anxiety and depression who presented with chronic back pain. The patient had previously undergone trials of various neuropathic and nociceptive modulating medications as well as transforaminal and caudal epidural corticosteroid injections, yielding minimal relief. On the evaluation, the patient’s lumbar spine MRI revealed findings suggestive arachnoiditis, a diagnosis that had also been missed on a previous MRI a year prior. Given this, the patient was advised to not undergo the Intercept procedure which had been previously recommended by another provider. Discussion: Given its resemblance to other neurologic conditions, the diagnosis of arachnoiditis involves a comprehensive approach with history, physical examination, and imaging modalities such as MRI or CT myelography serving as critical components. In this case, the patient did not have any history of infection or trauma, making the diagnosis more elusive, and requiring the team to pay more heed to the imaging finding. Although her imaging served supportive evidence or arachnoiditis, it is important to recognize its correlation with clinical findings and the severity of symptoms is not always consistent. Management of arachnoiditis requires a multi-faceted approach with steroids, neuropathic modulating medications, muscle relaxants, cognitive behavioral therapy, and physical therapy. Conclusion: This case report underscores the diagnostic challenges and clinical intricacies associated with spinal arachnoiditis. The presented patient's atypical symptoms and protracted diagnostic journey highlight the importance of ongoing vigilance and comprehensive evaluation in chronic pain management. Further research should investigate effective treatment modalities for this chronic and debilitating condition that is overlooked, given its similarity to other diagnoses and rare prevalence.","PeriodicalId":355292,"journal":{"name":"Journal of Rehabilitation and Pain Medicine","volume":"25 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140521319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pinealoma Masquerading as Post-Epidural Spinal Injection Dural Tear/Side Effect in a Patient with Chronic Back Pain","authors":"Akhil Chhatre","doi":"10.37191/mapsci-jrpm-1(3)-015","DOIUrl":"https://doi.org/10.37191/mapsci-jrpm-1(3)-015","url":null,"abstract":"Introduction: Pineal gland neoplasms are uncommon, accounting for less than 1% of adult brain tumors. The variable morphology, radiological characteristics, and symptomatic manifestations further complicate the prompt diagnosis and management [1]. Symptoms commonly arise from the tumor’s mass effect with compression of surrounding structures (e.g., headaches, nausea, vomiting, blurry vision, vertigo, fatigue) and may further induce obstructive hydrocephalus and Parinaud’s syndrome [2]. However, with Non-Specific or atypical pinealoma presentation, overlapping medical history suggestive of alternative etiologies may obscure the underlying diagnosis and delay appropriate workup and treatment. Case Presentation: We present a 41-year-old man with a history of chronic lower back pain and lumbar disc herniation presenting with worsening fatigue, cognitive lapses, and gait issues for three to four weeks, as well as nausea, vomiting, and blurry vision for the last three days. One month ago, the patient underwent bilateral L5-S1 transforaminal epidural steroid injection for lumbar radiculopathy and discogenic pain, which resolved the pain. Presentation appeared consistent with dural tear secondary to recent epidural injection. Brain imaging was obtained in the setting of altered mental status and neurologic symptoms. MRI showed a 17mm enhancing pineal mass with associated supratentorial obstructive hydrocephalus, with grade 1 papilledema found on ophthalmologic exam. CT chest/abdomen/pelvis was negative for primary lesions. Six days after initial presentation, the patient underwent an endoscopic third ventriculostomy for pineal tumor biopsy, and CSF collection for hydrocephalus treatment. The patient tolerated the procedure well without complications, was deemed medically and neurologically stable, and was discharged two days post-operatively. He continued to have lapses in judgment, fatigue, and double vision, and underwent a full craniotomy three weeks after discharge, which revealed a vermis lesion. Pathological report revealed a high-grade glioma. Conclusion: Unintentional dural tears occur in 1-3% of epidural spinal injections, commonly presenting as headaches, nausea, vomiting, and dizziness/ataxia [3]. However, this case highlights the need for clinical suspicion of alternative causes for similar presentation and the utility of further workup.","PeriodicalId":355292,"journal":{"name":"Journal of Rehabilitation and Pain Medicine","volume":"30 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140516190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiofrequency Ablation of Palmar Digital Branches of Ulnar Nerve in a Patient with Ulnar Neuropathy","authors":"Akhil Chhatre","doi":"10.37191/mapsci-jrpm-1(3)-016","DOIUrl":"https://doi.org/10.37191/mapsci-jrpm-1(3)-016","url":null,"abstract":"Ulnar Tunnel Syndrome (UTS) is ulnar neuropathy at the wrist or hand typically caused by ganglion cysts, lipomas, wrist or hand compression, carpal bone fractures, carpal tunnel syndrome, or anything else that can impinge on the nerve. The symptoms of UTS can be uncomfortable and debilitating, with numbness and tingling of the 4th and 5th digits being the most common. Weakness of the ulnar portion of the hand can lead to decreased grip strength. UTS is typically managed with conservative treatment including anti-inflammatory oral medications, splinting, physical therapy, activity modification, acupuncture, and stretching. Second line treatment includes corticosteroid injections, although these have shown to have little efficacy. Surgery is also an option but may lead to iatrogenic ramifications. Radiofrequency ablation (RFA) is a treatment modality used for chronic pain, which utilizes heat to target nociceptive fibers. Traditionally, RFA is used in treating cervical and lumbar radiculopathy, but it is less studied in peripheral nerve areas. This case report examines a patient who had clinically significant pain relief after RFA to the palmar digital branches of the ulnar nerve. The patient was 63-year-old male who presented with left ulnar neuropathy that had been ongoing for 3 years. Despite conservative management, his symptoms of pain, paresthesia, and weakness persisted. The patient then elected to have a left cubital tunnel release at the elbow with anterior subcutaneous transposition. The surgery provided relief for three months but then led to worsening contractures and pain in the 4th and 5th digits of the left hand. Due to persistent symptoms after conservative management and surgical intervention, he was referred to interventional pain clinic. A decision was made to trial a digital nerve block of the left medial and lateral digital palmar nerves. Following the nerve block, the patient reported 100% improvement in pain and increased range of motion and function. Four weeks later, the patient returned for a radiofrequency ablation of the same nerves. In the week following the procedure, the patient reported that the pain in the little finger was entirely resolved. While radiofrequency ablation has become increasingly popular for the treatment of chronic back pain, its use in peripheral nerve pain has been limited to case reports and few randomized control trials. This case report highlights the successful use of radiofrequency ablation in the treatment of little finger pain and ulnar neuropathy by targeting the median and lateral branches of the palmar digital nerve.","PeriodicalId":355292,"journal":{"name":"Journal of Rehabilitation and Pain Medicine","volume":"110 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140526212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does a Multidisciplinary Pain Management Treatment Improve Sleep Quality in Patients with Chronic Widespread Pain and Sleep Problems? Results from the AMS-Pain Cohort","authors":"Aleid de Rooij","doi":"10.37191/mapsci-jrpm-1(3)-014","DOIUrl":"https://doi.org/10.37191/mapsci-jrpm-1(3)-014","url":null,"abstract":"Background: Poor sleep quality is a significant concern for patients with chronic widespread pain (CWP), impacting their emotional, cognitive, and physical well-being. While there is little specific attention given to the treatment of sleep in such programs, it is possible that its ingredients, such as cognitive behavioral therapy, improving body awareness, relaxation, having a balanced daily routine, and physical activity, have a positive effect on sleep. The objectives of this study are to examine: 1. whether sleep improves after a multidisciplinary pain management treatment. 2. and to explore predictors of treatment outcome, in patients with chronic widespread pain (CWP) and sleep problems. Methods: Data were used from pre- and post-treatment measurements of 121 patients with CWP and sleep problems, treated with a multidisciplinary pain management treatment (not specifically focusing on sleep). Mean difference in subjective sleep quality and standard outcome of multidisciplinary treatment, as measured with Pittsburg Sleep Quality Index (PSQI) and IMMPACT outcome measures, were analyzed and Cohens d were calculated. Regression models were used to assess whether pretreatment variables predicted poor improvement of subjective sleep quality post treatment. Results: The effect size of improvement in sleep quality was small (Cohen’s d=0.3) and 94% of the patients still experienced poor sleep quality after treatment (PSQI ≥ 6). Moderate effects sizes were found for pain (d=0.6), fatigue (d=0.56) and disability (d=0.53). Pretreatment poorer sleep quality, higher levels of pain related disability, psychological distress and less concern predicted poorer sleep quality post-treatment. Conclusion: The improvement of sleep quality after following a multidisciplinary pain management treatment not specifically focusing on sleep was limited. To improve sleep, specific strategies targeting sleep (e.g., sleep education, sleep hygiene and /or cognitive behavioral therapy for sleep) may need to be included into multidisciplinary treatment. Addressing pain related disability and psychological distress, may also help to improve sleep quality.","PeriodicalId":355292,"journal":{"name":"Journal of Rehabilitation and Pain Medicine","volume":"12 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140520665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive-behavioral Interventions in Occupational Therapy for Chronic Upper Limb Pain - A Qualitative Study","authors":"Alina Aschbacher","doi":"10.37191/mapsci-jrpm-1(3)-017","DOIUrl":"https://doi.org/10.37191/mapsci-jrpm-1(3)-017","url":null,"abstract":"Aim: Within the framework of the Perezoso research group at the Carinthian University of Applied Sciences, which deals with the interdisciplinary treatment of patients with osteoarthritis, it was necessary to focus on the topic of pain. Therefore, the present research work was conducted. But beyond that, it's also essential for the increasing knowledge and awareness in the field of (chronic) pain especially in occupational therapy but also in other health professions. Background: In the treatment of chronic pain, occupational therapists use cognitive-behavioral therapy interventions (CBT) among other methods. The aim is to learn new behaviors and to question and change negative interpretations and constructions. Possible effects of CBT in chronic pain can be a reduction of pain, anxiety, disease activity, psychological effects and disability on the one hand and an increase in self-efficacy, pain control and quality of life on the other hand. Methods: To find out how occupational therapists apply CBT when treating clients with chronic upper limb pain, a systematic literature search was conducted in various databases. Within the framework of a qualitative research approach, five experts were interviewed using semi-structured guided interviews. The transcription was done according to Dresing and Pehl, supplemented by Rädiker and Kuckartz and was analyzed using the deductive-inductive approach by means of qualitative content analysis according to Elo and Kyngäs. Results: The approach is highly individualized, but aims to incorporate both the biological, social and psychological aspects of chronic pain. Everything from individual or group sessions, inpatient or outpatient stays and different emphases are involved. Pain education, awareness and coping measures are applied. Through the orientation to everyday life, a distinction is made between occupational therapy and other professions. The involvement of relatives is sometimes considered useful, but the final decision should be made by the clients. Discussion and Conclusion: Different pain patterns as well as hardly any current studies, especially in which occupational therapists explicitly apply CBT, only lead to a limited comparability. There is a need for more psychological and interdisciplinary interventions in order to be able to optimally treat clients with persistent pain. An advanced knowledge of pain, conversation management or CBT is considered essential.","PeriodicalId":355292,"journal":{"name":"Journal of Rehabilitation and Pain Medicine","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139340741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nanomedicine and Cancer","authors":"A. Hunis","doi":"10.37191/mapsci-jrpm-1(2)-010","DOIUrl":"https://doi.org/10.37191/mapsci-jrpm-1(2)-010","url":null,"abstract":"Nanomedicine is a branch of medicine that uses nanotechnology, science and materials engineering on the nanometer scale (1 nanometer is equal to one billionth of a meter), for the diagnosis, treatment and prevention of diseases. Nanotechnology makes it possible to manipulate and control matter at the molecular level and create materials and devices with unique properties on the nanoscale [1-3].","PeriodicalId":355292,"journal":{"name":"Journal of Rehabilitation and Pain Medicine","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124343407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception Amongst Physiotherapists Regarding the Psycho-Social Risk Factors and the Influence in Chronic Low Back Pain- A Qualitative Study","authors":"Sanika Lagoo","doi":"10.37191/mapsci-jrpm-1(2)-009","DOIUrl":"https://doi.org/10.37191/mapsci-jrpm-1(2)-009","url":null,"abstract":"Aim: To determine the current knowledge and awareness of physiotherapists in India regarding psychosocial factors for managing patients with low back pain. Background: Patients with low back pain are increasing globally. Physical dysfunction and psychosocial factors (often reported as yellow flags) such as stress, anxiety, and fear of movement, play a role in the perpetuation of low back pain. What is not known is the extent to which the yellow flags are screened for and treatment adjusted accordingly by Physiotherapists practicing in India. Design: Semi-structured interviews gathered data from of six physiotherapists. The interviews were conducted online to adhere to COVID restrictions. The data was transcribed and analyzed using thematic analysis. Result: The main findings were that the physiotherapists in India had a limited knowledge regarding psychosocial factors for management of low back pain. Patient were not supportive of adding the yellow flag screening into the routine treatments as patient were not aware of such screening tools Additionally, the physical elements of low back pain had more focus during the treatment rather than psychosocial, by the therapists and the higher authorities. Also, the physiotherapists noted that the high number of patients that patient were expected to treat daily left them with limited time in altering protocols for treatment. Conclusion: There appears to be a lack of information and education delivered to the physiotherapists in India regarding psychosocial factors for managing low back pain. Access to screening protocols would enable them to adjust treatments if permitted by the protocols that patient follow. The addition of these factors in the education and treatment protocols could address these important factors when managing patients with low back pain in India.","PeriodicalId":355292,"journal":{"name":"Journal of Rehabilitation and Pain Medicine","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115662657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}