Autonomous management of low back pain: how safe is it without medical supervision and how can telemedicine help?

Low back pain is a common health problem worldwide. According to a study in the journal Spine, around 60-90% of people with low back pain opt for self-management rather than seeking medical care.

Among the most common self-management strategies used by people with low back pain are physical activity, the use of over-the-counter pain relievers, and the application of heat or cold to the affected area.

However, it is important to note that self-management of low back pain without proper medical supervision may have risks and is not always effective in long-term pain management. Patients may exercise or use techniques that are not appropriate for their specific condition, which may worsen their pain or cause further injury. In addition, lack of medical supervision may delay the identification and treatment of underlying conditions that may be causing low back pain. Therefore, although self-management can greatly improve the quality of life for back pain sufferers, it should be supervised by a health professional. As a physiotherapist, you can teach your patients several ways to improve their self-management.

Correct posture is crucial to prevent and relieve back pain. Teach your patients to sit and stand with a straight back and relaxed shoulders, and make sure they have a supportive chair at work or at home. Relaxation techniques, such as deep breathing, meditation and yoga, can help reduce anxiety, stress and muscle tension, which can exacerbate back pain if left unchecked.

It is also important to control weight, as excess weight can increase pressure on the spine and worsen back pain. Encourage your patients to develop a healthy eating plan and maintain a healthy weight.

Exercise is an important part of pain management, as it helps to strengthen back muscles, improve flexibility and reduce inflammation. Patients should exercise according to their level of pain and physical condition. Teach your patients stretching and strengthening exercises specific to their condition, providing manual therapy and other techniques to reduce pain and inflammation.

Several studies have demonstrated the importance of self-management in the treatment of back pain. A 2016 study published in the journal Spine found that therapeutic exercise significantly improved physical function and reduced back pain in patients with chronic back pain. Another study published in the journal BMC Musculoskeletal Disorders in 2018 found that patient education and self-management are central to the treatment of back pain. Other studies have found that cognitive behavioural therapy, patient education and physiotherapy, including exercise, are effective in improving self-management of back pain.

Telerehabilitation can assist in the self-management of low back pain by providing access to medical care and health professionals from the comfort of the home. Through teleconsultation, patients can interact with healthcare professionals remotely, allowing them to receive advice and guidance on exercises and techniques suitable for their condition.
Remote monitoring can also be used to monitor the patient’s progress in self-managing low back pain. Mobile or wearable devices can provide information to healthcare professionals about the patient’s movement and activity, allowing them to assess progress and make adjustments to the treatment plan as needed.

Telerehabilitation can also provide access to personalised online exercise programmes, supervised by healthcare professionals. These exercises can help patients develop skills to manage their pain and improve their quality of life.

In conclusion, self-management of low back pain without medical supervision can have negative consequences, but using telerehabilitation tools can help patients improve their health and also relieve waiting lists in rehabilitation and physiotherapy practices.