Conceptualizing and Managing Chronic Low Back Pain from a Fit-For-Purpose-Model Perspective

with Aidan Cashin, Ph.D. About: An improved understanding of the biopsychosocial influences that contribute to and maintain pain has prompted the development of new explanatory models and treatment strategies for chronic low back pain. This presentation will introduce the Fit-For-Purpose-Model (FFPM), a contemporary treatment framework to help make sense of the complexity of chronic low back pain, and an associated treatment approach, education and graded sensorimotor retraining, which has demonstrated clinically meaningful effects for people with chronic low back pain in a recent sham-controlled trial. Objectives: Identify and assess biological, psychological, and social contributors to chronic pain through a Fit-For-Purpose-Model perspective. Evaluate graded sensorimotor retraining intervention to address salient contributors to chronic low back pain. Identify the mechanisms through which an education and graded sensorimotor retraining intervention provides clinically meaningful reductions in pain and disability. Examine your ability to conduct and implement contemporary, coherent, biopsychosocially informed management for people with chronic low back pain. Citations: 1. Bagg MK, Wand BM, Cashin AG, et al. Effect of Graded Sensorimotor Retraining on Pain Intensity in Patients With Chronic Low Back Pain: A Randomized Clinical Trial. JAMA. 2022 Aug 2;328(5):430-439. doi: 10.1001/jama.2022.9930. 2. Wand BM, Cashin AG, McAuley JH, et al. The Fit-for-Purpose Model: Conceptualizing and Managing Chronic Nonspecific Low Back Pain as an Information Problem. Phys Ther 2022 Nov 1:pzac151. doi: 10.1093/ptj/pzac151. 3. Cashin AG, Lee H, Wand BM, et al. Mechanisms of education and graded sensorimotor retraining in people with chronic low back pain: a mediation analysis. Pain. Accepted 15th April 2023 4. Rizzo RRN, Wand BM, Leake HB, et al. "My Back is Fit for Movement": A Qualitative Study Alongside a Randomized Controlled Trial for Chronic Low Back Pain. J Pain 2022 Dec 26:S1526-5900(22)00478-3. doi: 10.1016/j.jpain.2022.12.009. Bio: Dr Aidan Cashin is a NHMRC Emerging Leadership Fellow. Aidan worked clinically as an exercise physiologist before completing a PhD in Medicine from the University of New South Wales. He has published his research in leading general medical and speciality journals such as JAMA, BMJ, and Pain and has been recognised for his research including receiving the IASP Ronald Dubner Research Prize and the APS Rising Star Award. Aidan’s current research focuses on investigating the mechanisms of healthcare interventions for optimisation and translation into clinical practice and health policy. Most of his work is applied to the management of chronic musculoskeletal pain conditions. Aidan also conducts methodological work that aims to improve research transparency and openness. He is a full-time Research Fellow at the Centre for Pain IMPACT, Neuroscience Research Australia and an Associate Lecturer at the School of Health Sciences, The University of New South Wales.