OIOC

OIOC stands for the Occupational and Industrial Orthopaedic Center and is an affiliate of NYU and the Hospital for Joint Disease. I was fortunate enough to spend a day there over my spring break a few weeks back and would like to share my experiences here.

Firstly, everyone there was very pleasant and helpful. The Acting Associate Clinical Director was kind enough to take an hour out of her day to give me a presentation about the biopsychosocial model for treating low back pain (LBP) which is the main reason I wanted to visit. As a preface to the treatment it is important to know that 60-80% of adults suffer LBP at some point in their life. It is the second leading reason for doctors visits (common cold is 1st). There is a huge fiscal impact of this between medical costs and the cost of lost labor. The basic summary of treatment is as follows:

The main approach being used for a while was the medical model - which looked for pathoanatomy - something was physically wrong and they had to find it. People were generally not getting that much better with this approach. As more research came out they found that almost 85% of LBP is nonspecific (meaning you cant really specify what is causing the problem). As an alternative there was a psychological model that was implemented claiming that the pain was all being caused by your thinking. So if you can change the thinking that would be the solution. Also, didn't work that well.

This brought them to the biopsychosocial model which combines both and adds a sociological perspective to it (Waddell et al., 1984). THis starts with the sensation of the pain itself, moves on to the cognition (how you think about the pain), then your affect (how it translates into your mood), then the illness behavior (i.e. taking a day off work or avoiding certain positions because they hurt), and lastly how the social environment is changed (i.e. problems at work, with family, etc.). At OIOC they are very innovative and on the cutting edge of research. They incorporate numerous sources of evidence including the European and New Zealand Guidelines for treating LBP.

There is a lot more to it, with yellow and blue flags, etc., but this should be hopefully this is enough to get you thinking about back pain and what is involved.

Back to studying, almost done with this semester...