|
Seeking ways to prevent disabling effects of back
pain
Many people suffer from back pain and arthritis. Most live productive, active lives. Others find it hard to hold down a job, participate in family life or even enjoy leisure activities. Their physical condition is much the same, so why the radically different responses? Dr. Jaime Guzmán, an Adjunct Scientist at Toronto Rehab, is trying to find out.
"Back pain alone is not necessarily the reason people are disabled. We see that some people with back pain are not disabled while others are. The question is, what factors can we change so more people with back pain can live without disability?"
Research has identified two types of factors which influence how people respond to chronic back pain: personal and environmental. Personal factors include people's beliefs, ways of coping and the severity of their pain. Environmental factors include the kind of work they do and their employers' willingness to accommodate them.
"To take an obvious example, if you have back pain, it's hard to do heavy manual labour," says Dr. Guzmán. "If you can change your work environment - by moving to a desk job, for instance - you might be able to stay in the labour force. Employers' attitudes also play a role. If you are in pain and your supervisor doesn't care, it's going to create problems.
"We can actually do a lot to improve the lives of people with disabilities with relatively small interventions - for instance by talking to employers and persuading them to make small changes in the work environment." |
Dr. Jaime Guzmán |
|
Quick
Biography
|
|
Dr. Guzmán is an Adjunct Scientist at Toronto Rehab, where he specializes in the comprehensive rehabilitation of musculoskeletal injuries and arthritis. He is Scientific and Medical Director, Disability Prevention, for the Occupational Health and Safety Agency for Healthcare in British Columbia and Assistant Clinical Professor of Medicine at the University of British Columbia. He is also an Adjunct Scientist at The Institute for Work and Health. His research interests are the factors that lead to disability in people with back pain and arthritis, and effective ways to prevent it.Dr. Guzmán has published and lectured extensively.
He received his MD and specialties in Internal Medicine and Rheumatology in Mexico, and MSc and specialty in Physical Medicine and Rehabilitation in Canada.
|
|
|
The way people with back pain cope may also be influenced by how society is organized. For instance, back pain and associated disability can be very hard to measure. In a health care system which looks for unambiguous solutions, this can lead health care professionals, insurers and employers to treat people with back problems as malingerers, or, at the other extreme, to view them as completely disabled.
"We need to be sure our health policies are helping to prevent disability and not contributing to it in subtle ways," Dr. Guzmán says. "This is an area that requires further research."
While chronic disabling back pain is often an intractable problem, multidisciplinary interventions can be successful in getting many people with back pain better. In a review of major studies of people with disabling lower back pain, Dr. Guzmán and his colleagues found intensive multidisciplinary rehabilitation can measurably reduce pain and improve function.
Dr. Guzmán has been involved in research in rheumatology (the branch of medicine specializing in disorders of the muscles, joints and tendons) since medical school. "Early in my career, I became aware of the large burden of illness and burden of disability caused by back pain," he says. "It's a huge problem. Many, many people are in need of help in this area."
A busy clinician as well as a researcher, Dr. Guzmán believes practice and research complement each other. "Clinical practice is important for me because it informs my research," he says. "And, asking relevant questions not only focuses research, it helps us find better ways to help our patients."
Links with more information
www.ohsah.bc.ca
|
