Abstract
Background
A proportion of patients with low back pain fail to respond to conventional medicine, physical therapy or surgery. Neurophysiological changes occur in chronic pain and research shows that Mindfulness and ‘3rd wave’ Cognitive Behavioural Therapy can help patients with long-term musculoskeletal conditions to live more actively, despite pain. This paper describes the development of the three year ‘OsteoMAP’ project (Osteopathy, Mindfulness and Acceptance Programme) to expand the scope of primary care by integrating these psycho-educational interventions into osteopathic practice.
Methods
A before and after design is being used. Patients with disabling pain for more than six months attend a course of six, individual, one hour sessions, integrating mindfulness and acceptance-based exercises with manual therapy. Questionnaire data collected at the course start and after six months, analysed by an independent group, includes pain-related behaviour (Bournemouth Questionnaire), quality of life (EQ5D), self-efficacy (PSEQ) and mindfulness (MAAS).
Results
The project started in June. Follow-up data is not yet available. Qualitative data from a pilot study will be presented. It supports the preliminary hypothesis that touch and osteopathic techniques combined with psycho-education and mindful movement may increase patients' embodied awareness, promote active self-management, and guide more patient-centred manual interventions.
Conclusion
Despite the challenges of balancing practitioner-led manual therapy treatment with more collaborative acceptance-based interventions which aim to empower patients' active self-management capabilities, there appear to be potential benefits in expanding the scope of community-based healthcare for patients with long-term low back pain that is unlikely to be resolved by physical interventions alone.
