Wrapping up Stratified Care for Low Back Pain with Mark Hancock

Mark Hancock, BAppSci(Phty), MAppSc, PhD trained at Sydney University. He later completed his research masters on ankle pain. He finished his PhD in 2007 and is currently a faculty researcher at Macquarie University in Sydney.

We recently chatted to Mark about LBP and how all the stratified care approaches fit together.  Mark points out that we still have a long way to go regarding low back research but feels that we are making progress. 85-95% of patients have non-specific low back pain which makes it more difficult to treat. Stratifying low back pain or classifying low back pain is the most important thing we can do as physiotherapists to help guide clinical treatment.

Mark states that the STaRT Back and Cognitive Behavioral approaches are a step in the right direction. Integrating these models may be an ideal means to treat low back pain and this course has done a great job with covering the most up to date low back classification systems.

The most important knowledge a physiotherapist can keep in mind when treating patients with low back pain is that we are responsible for screening red flags or patients with cancer, fractures that may not be therapy appropriate. Prognosis is also critical and explaining to the patient their potential for rehabilitation. Mark feels that with treating chronic back pain, exercise strategies are the best for long term management.

For preventing acute to chronic low back pain, the STarT back approach helps to identify the patients which are most at risk and we can then direct them to the appropriate treatment category. It also helps to identify those who are more likely to progress to chronic pain and guides us to treat them appropriately. It’s important to keep in mind that the population which becomes chronic is a very small population.

Read more about stratified care for LBP

Some of Mark’s Research