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Newsletter of the European Chiropractors’ Union
General news
More action needed to implement
The Lancet papers’ recommendations
FOLLOWING THE seminal
papers of 2018, The Lancet
recently published a call for
action to improve treatment and
eliminate waste associated with
care for low back pain.
The main messages are that low
back pain is still the number-one
cause of disability in the world,
many patients with low back pain
are still receiving the wrong care,
much of the money spent on
low back pain care is wasted and
better policy solutions are needed;
to maintain the momentum of
improvement, ten actions are
recommended:
1 Health care funders should
stop paying for ineffective and
harmful tests and treatments,
and commission research on
those that are unproven.
2 New tests and treatments
should not be marketed,
introduced into practice, or
publicly reimbursed, before
they have been adequately
tested for safety, efficacy, costeffectiveness.
3 Health and social services
should work with employers to
provide support that stimulates
early return to work, and work
conditions that are adapted to
employee capacity.
4 Patients should be taught to selfmanage
low back pain and seek
care only when really needed.
5 Widespread and inaccurate
beliefs about low back pain
in the population and among
health professionals should be
challenged, and the focus put
on reducing the impact of low
back pain on people's lives
rather than seeking medical
treatment for a cure.
6 Clinical pathways, care plans,
and other standardised tools
managing low back pain should
be redesigned to integrate
health and occupational care,
but only after establishing their
comparative effectiveness and
cost-effectiveness.
7 Payment systems and legislation
should be changed to encourage
delivery of the right care.
8 The World Health Organisation
should support new public
policies and urgent political
action to ensure strategies are put
in place to reduce global disability
from low back pain as a priority.
9 Research and funding bodies
should invest in an intensified
research effort to address gaps in
the understanding of low back
pain, as well as implementation
research to determine how best
to put existing knowledge and
evidence to use.
10 Journals and the media should
have greater editorial and
peer-review oversight to ensure
that trial results are accurately
portrayed and do not reflect
unwarranted belief in the
efficacy of new or established
but unproven therapies.
Covid-19
Covid-19 and sports chiropractic
Ulrik Sandstrøm reflects on the past few months
WE HAVE all struggled with
our professional identity
during whichever lockdown our
government chose to impose on
us. It is amazing what happens to
your psyche, when your ability to
practise your vocation gets taken
away from you, and you realise how
much you define yourself by what
you do. As sports chiropractors, we
have felt this too. Most of our clubs
shut their doors, seasons were being
cancelled or postponed and players
were sent home with ‘work-ons’
from the medical team to keep
them in some sort of shape during
lockdown. Apart from the buzz of
dealing with your athletes and your
friends in the medical teams, we
also had to deal with no sports on
TV. Except for re-runs of the 2012
Olympic games (in the UK!) and
more Tours de France than I care to
remember. There was no challenge
of ‘who can we get fit for Saturday’
or keeping an eye on your team’s or
athlete’s results over the weekend.
And, of course, the postponement
of the Tokyo 2020 Olympic Games
was the final blow.
Some of us kept in touch with
athletes over video link as clubs
were returning to training in small
clusters and some clubs were testing
all staff twice per week. Some
sports chiropractors are back in full
swing, whilst some are still waiting
on the sidelines. My rugby club
has returned a minimum number
of medical staff and with as little
hands-on as physically possible
which means that I am not yet
involved as I write this piece.
My personal tele-health
triumph has a little sports flavour
to it, although the mode of injury
was lifting a sofa rather than being
tackled by a large prop. Patient
presented on my Zoom screen
with his arm stuck in 30 degree
abduction explaining that this
happened three weeks ago, the
doctor had diagnosed a ‘rotary
cuff’ (!) and it was going to be
six weeks before he could have it
scanned. After a brief exam via
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