For years, Martin Underwood and his colleagues were confronted with people who suffered from low back pain, the cause of which was not immediately known. Logical, as their research shows, because in the vast majority of cases there is no direct cause. One possible cause of the pain can be the lifestyle of the patient. This includes an inactive life, too little exercise or being overweight. Pain can also occur due to psychological, economic or social factors. In other words, things that do not immediately require medical intervention.
Yet patients – all too often due to financial motives – are advised by doctors and hospitals to undergo surgery or to consider injections. This is not only expensive but the current research also shows that operations can make the problem worse. In some cases, vertebrae are fused to each other or an artificial disc is added. The researchers discovered that this can be completely useless and can cause unnecessary harm to patients.
Prescribing medicines such as opioids is also the wrong approach because they can be very addictive and are not the most effective painkillers. As a result, patients will have to take more of them and the risk of addiction increases.
Underwood and his colleagues are sounding the alarm: it is high time that low back pain is dealt with in a proper way. “Useless treatments are far too often prescribed for chronic back pain,” says Judith Turner, a clinical psychologist at the University of Washington. And treatments that do work are under-utilized. These include:
- staying active
- following cognitive therapy
- learning to breathe well
- having enough exercise
Useless treatments are far too often prescribed for chronic back pain.
Redefining spine care.
Since the 80’s, DAVID has evolved in offering medical exercise devices specifically designed for people with spine-related complaints. The David concept is based on exercise therapy that promotes the functioning of muscles and joints. The DAVID Solution fits well with the recommendations made in the research published in The Lancet. The devices have been developed in such a way that within three treatment sessions patients know how to use the devices without the help of the physical therapist. The software that is equipped on each device ensures a balanced training. It also motivates the patients to continue training using proper technique.
The EVE software provides an adequate graded activity program that enables the physical therapist to compose an optimal training program for the patient. Testing and measuring patients at the beginning and at the end of the treatment cycle provide a clear picture of the mobility and strength of the muscles around the spine. The biofeedback system and the preset program rules automatically control the program where it is deemed necessary. The most commonly heard feedback from patients is that they feel very comfortable and safe by training with the DAVID devices.
Regular physical therapy.
In regular physical therapy, we see a variety of treatments that are successful and others which are not. It is often impossible to estimate in advance which treatment is the most suitable for which patient. For example, one patient may benefit from manual therapy and another patient may benefit from dry-needling therapy. What we do know is that the degree of motivation and the time factor, are important elements in the success or failure of treatment.
The patient who uses DAVID.
The DAVID Solution fits perfectly with existing treatments that can create conditions for acute patients to do exercises. For chronic patients, exercise therapy within safe settings is always recommended according to the new insights. The advantages of using DAVID equipment in exercise therapy can be described as follows:
- The patient feels safe and the movement anxiety is prevented or reduced
- The training program is comfortable and customized
- The weights are automatically adjusted according to the feedback system
- The patient is in control of the treatment
- The software motivates patients to continue training
Advantages for the physical therapist.
- The physical therapist does not have to worry about the settings of the equipment and the correctness of the exercise
- Physical therapists can motivate and inform the patient during the exercises
- Employees can treat more patients at the same time
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Jonathan C Hill, David GT Whitehurst, Martyn Lewis, Stirling Bryan, Kate M Dunn, Nadine E Foster, Kika Konstantinou, Chris J Main, Elizabeth Mason, Simon Somerville, Gail Sowden, Kanchan Vohora, Elaine M Hay. Comparison of stratified primary care management for low back pain with current best practice (STarT Back): a randomised controlled trial. The Lancet, 2011; 378 (9802): 1560 DOI: 10.1016/S0140-6736(11)60937-9