Call it, if you like, “low back pain”. And keep in mind that in this period, also thanks to the stress of resuming activities after the relaxation of the holidays, it can manifest itself more frequently. But above all consider that back pain is tremendously democratic.
“Back pain”, which in 2050 will climb one place: from eighth to seventh place, even preceding a disabling disease such as Alzheimer’s. Back pain will therefore become one of the most important and widespread disabling causes among the world’s population. This was revealed by a forecasting study conducted on 204 countries and published in the Lancet last May, entitled “Burden of disease scenarios for 204 countries and territories 2022-2050”.
For this reason too, we must learning to protect our backThe experts of FNOFI (National Federation of Physiotherapists’ Orders) remind us of this on the occasion of the launch of the campaign “The movement that does not stop”.
How much does back pain weigh?
It forces almost one in three Italians to stay at home every year. But back pain, whether localized in the lower areas of the spine (and we are talking about lumbago) or whether it is a question of cervicalgiathe classic neck pain, is not addressed properly. Also for economic reasons. The Censis-FNOMCeO report of July 2024 recalls that they are at least 4.5 million Italians who give up on treatmentin addition to these, we must also consider those who need physiotherapy and rehabilitation interventions but who give them up for various reasons. All this, in a country that according to Istat data sees more than 8 and a half million people in Italy with motor difficultiesof which 3.4 million have serious difficulties. And with 5.5 million subjects (mostly women), who resort to physiotherapists.
The analysis reported in Lancet confirms even more how back pain, specifically, it is already a disabling pathology and provides a perspective on which prevention is urgently needed: between now and 2050, Italy will fall into that category of countries with the probability of seeing an increase, between 46% and 53%, in pathologies and disorders such as back pain.
Prevention and physiotherapy: FNOFI’s commitment
“As FNOFI, we promised it and we started to act immediately – comments the President of the Federation Piero Ferrante. A categorical imperative to work on prevention of ‘low back pain’ (precisely, back pain), is to reach citizens, also through our new social channels such as Instagram and Facebook, explaining how to best address the issue of back pain and chronic conditions, if they exist, combined with the opportunity of a physiotherapy intervention. As a Federation we are committed to intervening on a situation, namely back pain, which by its nature generally has a favourable outcome, improve accessibility of care for citizens, to ensure that the economic factor is not a barrier to addressing it in the best possible way, thus making the health system more sustainable, also promoting the contribution of value that freelance physiotherapists can give to the NHS”.
The theme of this year’s World Physiotherapy Day is a problem that, as we can see from the data also from the research published in the Lancet, affects practically all citizens: the ‘Lumbago‘. ‘Back pain’, which affects millions of people every year, is undoubtedly a topic in which the Physiotherapist can and must carry out his very important action, both with regards to the preventionboth to help people who suffer from it to receive the best answers – added the FNOFI President”.
Tailor-made treatments to address back pain
According to WHO, there are five classes of approaches for prevention and intervention:
- education, or patient learning and awareness;
- physical therapies (exercises)
- psychological therapies
- multi-component therapies
- the use of drugs.
At the same time, the WHO guidelines also recommend actions not to be done or to be done with caution in routine care interventions:
- traction, ultrasound, transcutaneous electrical nerve stimulation (TENs);
- the use of opioid-based analgesic drugs, antidepressants, anticonvulsants;
- pharmacological weight loss.
There are three innovative areas that are creating an impact on physiotherapy and new treatment methods: two are more historic, already active for a few years, and have to do with robots and hard devices applied in the neurological and musculoskeletal fields. These devices are able to create interaction with the patient and collect data.
The other area is related to the software technology with which they are created sensory stimulations to promote learning.
The first two historical strands are connected to the Remote physiotherapywhich already began during the pandemic, which gave a great boost, precisely because physiotherapists – even for a long time after the pandemic emergency – had to readapt, in many cases, the way they interface with the patient. Physiotherapy, let us remember, is characterized by contact and physical presence. These developments have played a decisive role in allowing more patients to be reached, that is, theExtension of physiotherapy services. Being able to treat the patient at home has improved the scope of the physiotherapist’s work.
From here, they are developing new possibilities for both the patient and the professionalin the field of study: bracelets and sensors that are able to continuously record the patient’s needs.
Can Artificial Intelligence Help?
Finally, AI is being developed to serve the patient. But above all, the physiotherapist. In fact, we are talking about generative artificial intelligence, which changes the path of telerehabilitation because it allows the patient to be aware of the disorder or therapies that he must follow and allows the physiotherapist to have updated data in real time on how to optimize the rehabilitation path.
However, some researchers, including Andrea Turolla, from the Department of Biomedical and Neuromotor Sciences at the University of Bologna and some Italian physiotherapists, have conducted studies on ChatGPT, Gemini and COPILOT to verify the accuracy of the recommendations generated with respect to international clinical practice guidelines and those of the Istituto Superiore di Sanità, highlighting how the‘accuracy of generative AI can make a difference in acquiring information on the rehabilitation path for the patient. If a patient wants to know the guidelines for the disorder that concerns him, based on this study, he can now know and understand how to behave also on back pain, the theme of World Physiotherapy Day.
As the research highlights, “Performance of ChatGPT compared to Clinical Practice Guidelines in Making Informed Decisions for Lumbosacral Radicular Pain: A cross-sectional Study”, the researchers compared these responses from the generative AI, showing that there is only partial accuracy: about 30%. They also tested it on lumbago – the common back pain – and the accuracy result is similar; two out of three recommendations they are not reliable.
This data highlights how the use of Artificial Intelligence alone, separated from the fundamental supervision of the physiotherapist, is potentially harmful for the patient’s health and once again underlines the essential role of the physiotherapist in the construction and management of the patient’s rehabilitation path. The personalization of care and the role of the physiotherapist, in short, remain central to the rehabilitation-physiotherapeutic path.
