Lizzy Quinn is a Musculoskeletal Physiotherapist with 20 years experience focusing on people with spinal pain. Australian Health Journal spoke with Lizzy on the complexities of persistent lower back pain in women.
Lower back pain in women in their 30s, 40s, and 50s is complex to treat due to the combination of physical and emotional factors, and health professionals need to stay updated on best practices and science to provide the best recovery platform for patients. These women typically have busy lives, pressures, and expectations.
The Australian Institute of Health and Welfare (AIHW) website states, ‘Mental and behavioural conditions commonly co-occur with musculoskeletal conditions. Compared with people without musculoskeletal conditions, for people aged 45 and over with mental and behavioural conditions were 1.9 times as likely in people with back problems, 1.6 times as likely in people with arthritis and 1.5 times as likely in people with osteoporosis’.
Lizzy believes women with persistent lower back pain need treatment that considers their emotional and physical pain due to the complexity of their lives. Women with lower back pain often try various treatments without realising the impact of their emotional state on their symptoms, making long-term recovery difficult.
Changes in the spine as we age are normal, but the language used in MRI reports can make it concerning for patients, without a healthcare professional providing a through explanation of some of the terms.
Lizzy states, “MRI findings generally provide little information on how to recover from lower back pain, and only a small number of people actually need imaging straight away. For the majority, it won’t change their treatment.”
Getting a lower back MRI may lead to unnecessary worry as normal age-related changes are often misinterpreted as serious issues.
As far as the body is concerned, the brain cannot tell the difference between physical pain and emotional pain, making lower back pain complex to treat.
Lower back pain may be driven by tissue sensitivity and hyper-sensitisation in the brain, rather than just joint issues.
Emotional distress can reactivate sensitisation in the brain, that can cause persistent lower back pain, especially when combined with emotional distress. Sensitised pain centres in the brain, can prolong lower back pain even after physical healing.
Educating patients about the complexity of lower back pain is important, but GPs have limited time to do so, making it challenging for them to convey the message to their clients.
Without this awareness, patients will fail to understand the main drivers of lower back pain that are vital for long term recovery.
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Continuity of Care under COVID-19
Series 3, Episode 1
Under the COVID-19 pandemic, the Australian Healthcare system has handled the public health crisis by monitoring and responding to challenges in supply chains, testing & tracing of new infections and stock piling of essential equipment.
The public has largely responded by practising social distancing, understanding how hand hygiene can spread contagion and recently installing the COVIDSafe mobile application. Public health messaging has been largely effective and literacy improve, to combat the dangers of misinformation.
To open up access to medical advice during the pandemic, in March the Australian government issued MBS item codes for telehealth consultations, for advanced practice nurses as well as GPs and other specialists.
According to AMA President Dr Tony Bartone, as of mid-May 2020, around 10 million Medicare-funded telehealth services have been provided, either over the phone or via video, a significant majority of which have been provided by GPs and other specialists since the Medicare telehealth items were introduced in March.
However in recent months, the health system has mounting concerns on:
- a reduction in general practice visits for testing, investigation or immunisation
- lower rates of elective procedures resuming since being halted
- reduction in laboratory testing
- reduction in treatments and diagnosis of chronic and acute conditions
- access to, and continuing to take medications
Those with pre-existing conditions have been urged to keep appointments and routine treatments to maintain their health.
Industry has taken action such as the newly formed Continuity of Care Collaboration (CCC). The 15 health organisations forming CCC are an Australian first national communication collaboration of Peak Bodies, Industry and Healthcare Organisations coming together to stress the importance for people to continue monitoring their health and maintaining their regular care.
This Australian Health Journal episode on the continuity of care was produced with commentary from the following health industry associations and organisations: APNA – Australian Primary Health Care Nurses Association, RACGP, Medical Technology Association of Australia (MTAA), West Cessnock Medical Practice, Consumers Health Forum of Australia, Medicines Australia
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Value-Based Health Care : Dental Health Services Victoria Case Study
Dental Health Services Victoria has implemented a value based health model for oral health, around the patient and the clinician that included both during co-design. This has been possible with a single oral health data system for the state of Victoria and staff keeping in mind the value and outcomes that patients seek.
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Trends report identifies prototyping targets for breakthroughs in digital and hybrid futures
Vishaal Kishore, a Professor of Innovation and Public Policy at RMIT in Melbourne, serves as the Executive Chair of the RMIT-Cisco Health Transformation Lab and RMIT’s Director of Impact. Led by the RMIT-Cisco Health Transformation Lab, the National Industry Innovation Network (NIIN) Health Alliance combines the best minds, technologists, industry capabilities and academic resources to solve pressing industry and social challenges through technology-driven innovation. The NIIN aims to pool insights and expertise to address national health challenges, marking its first vertical focus on health.
