Manuela Loureiro Ferreira

The University of Sydney · George Institute for Global Health

Background: Text messages represent a simple and scalable strategy to provide self-management to people with low back pain (LBP), yet their usefulness is unknown. Objective: To assess the usefulness, delivery format, behaviour-change ability and potential for the TEXT4myBACK intervention to be scaled-up. Design: Qualitative study nested within...

Background: There is growing evidence of the anti-inflammatory effect of the anti-diabetic drug metformin and its use to reduce pain. However, we currently lack studies investigating whether metformin is associated with a reduction in chronic back pain prevalence when considering physical activity levels, body mass index (BMI), and age. Objective...

Objectives To determine the feasibility of a patient-education booklet to support patients with low back pain (LBP) to reduce paracetamol intake. Design Single group, repeated measures feasibility study. Setting Community. Participants Adults experiencing LBP of any kind and self-reporting consumption of paracetamol for LBP weekly for at least 1...

Systematic reviews are necessary to synthesize available evidence and inform clinical practice and health policy decisions. There has been an explosion of evidence available in many fields; this makes it challenging to keep evidence syntheses up to date and useful. Comparative effectiveness systematic reviews are informative, however producing thes...

Introduction: The REFORM (REhabilitation FOR Musculoskeletal conditions) trial is a non-inferiority randomised controlled trial (n=210) designed to determine whether a supported home exercise programme is as good or better than a course of face-to-face physiotherapy for the management of some musculoskeletal conditions. The trial is currently bein...

Background The prevalence of low back pain increases with age and has a profound impact on physical and psychosocial health. With increasing age comes increasing comorbidity, and this also has pronounced health consequences. Whilst exercise is beneficial for a range of health conditions, trials of exercise for low back pain management often exclude...

Background and Objective Health coaching aims to empower people to reach their goals and is increasingly used in healthcare settings. Whether health coaching improves pain and disability for people with hip and/or knee osteoarthritis (OA), or low back pain (LBP) is yet unknown. Databases and Data treatment Six databases were searched for randomise...

Background Digital cognitive behavioral therapy for insomnia (CBT-i) in people with low back pain (LBP) may be efficacious in improving both sleep and pain; and twin trial designs provide greater precision of treatment effects by accounting for genetic and early environmental factors. We aimed to determine the feasibility of a trial investigating t...

In 2019, musculoskeletal conditions were estimated to be the leading cause of YLDs in Australia (20.1%). There were 7,219,894.5 (95% UI: 6,847,113–7,616,567) prevalent cases of musculoskeletal conditions and 685,363 (95% UI: 487,722–921,471) YLDs due to musculoskeletal conditions. There were 2,676,192 (95% UI: 2,339,327–3,061,066) prevalent cases o...

Objective: To determine factors associated with hospital admissions from ED presentations for low back pain (LBP). Methods: This was a retrospective analysis of 147 ED centres in New South Wales (NSW), Australia, between 2005 and 2014. Data were accessed from the NSW Emergency Department Data Collection to determine patients who attended ED and...

Background/objective: We aimed to investigate the yearly online public interest for gout, low back pain, neck pain, osteoarthritis, and rheumatoid arthritis, the most popular topics searched for these conditions, and the association between the change in their interest over time and the sociodemographic index of the search location. Methods: We...

Objectives We aimed to investigate age- and sex-specific effects of obesity, metabolic syndrome (MetS) and its components on back pain in middle-aged and older English individuals. Methods We used data from the English Longitudinal Study of Ageing, wave 2 (2004-2005). Body mass index (BMI) expressed the obesity, while MetS was defined according to...

Objective To determine consensus among an international, multidisciplinary group of experts regarding definitions of spinal osteoarthritis for research and for clinical practice. Methods A 15 member, multidisciplinary steering committee generated 117 statements for a three-round Delphi study. Experts in back pain and/or osteoarthritis were identif...

Background We aimed to quantify the association between chronic musculoskeletal pain and all-cause mortality, and to investigate the extent to which this association is mediated by physical activity, smoking status, alcohol consumption, and opioid use. Methods For this population-based cohort study, we used data from UK Biobank, UK between baselin...

Background While reports indicate the association between obesity and back pain, its mechanism is still unclear. Thus, we aimed to investigate the effects of weight and its components on back pain in middle-aged women while considering direct mechanical and indirect effects via inflammatory and metabolic parameters. Methods We used data from the C...

Introduction Musculoskeletal (MSK) conditions constitute the highest burden of disease globally, with healthcare services often utilised inappropriately and overburdened. The aim of this trial is to evaluate the effectiveness of a novel clinical PAthway of CarE programme (PACE programme), where care is provided based on people’s risk of poor outcom...

Background Although working activities are associated with several pregnancy outcomes, there is scarce information regarding the association between working activities and low back pain (LBP) during pregnancy. This study aimed to investigate whether leisure-time and work-related physical activities during pregnancy are associated with LBP. Methods...

The study aimed to determine how much change in neurogenic claudication spinal surgeons expect in patients following lumbar decompression for lumbar spine stenosis (LSS), and radicular leg pain following microdiscectomy. Secondary aims were to identify surgeons’ preferences regarding surgical techniques for lumbar decompression, and their rating of...

Objective: We aimed to study 19-year body mass index (BMI) patterns and their (1) bidirectional relationship with musculoskeletal pain and (2) mortality risk. Study design and setting: We used data from the Chingford study and group-based trajectory modelling to define 19-year BMI patterns. We investigated whether baseline back, hand, hip, and k...

The number of placebo surgical trials on musculoskeletal conditions is increasing, but little is known about the quality of their design and methods. This review aimed to (1) assess the level of placebo fidelity (ie, degree to which the placebo control mimicked the index procedure) in placebo trials of musculoskeletal surgery, (2) describe the tria...

Background Although many people with chronic low back pain (LBP) improve following conservative treatment, one in five will experience worsening symptoms after discharge from treatment and seek health care again. The current LBP clinical care pathway in many health services lacks a well-integrated, systematic approach to support patients to remain...

Importance: Previous studies, using mostly cross-sectional data, provide conflicting evidence of an association between lumbar spine radiographic changes and the severity of back pain-related disability. Such conflicting evidence may be associated with widely unnecessary diagnostic imaging of the lumbar spine. Objective: To examine both cross-se...

Introduction Exercise, support and advice are considered core components of management for most musculoskeletal conditions and are typically provided by physiotherapists through regular face-to-face treatments. However, exercise can be provided remotely as part of a home exercise programme, while support and advice can be provided over the telephon...

Objectives To develop a bank of text messages for a lifestyle-based self-management intervention for people with low back pain (LBP). Design Iterative development process. Setting Community and primary care. Participants Fifteen researchers, clinicians and consumer representatives participated in the ‘Concept and Initial Content Development’ pha...

Background: Although metformin there is growing evidence of metformin's pleiotropic effects, including possible effects on pain, there is a lack of study investigating the association of metformin with the prevalence of musculoskeletal pain among a large type 2 diabetes cohort. Methods: Cross-sectional analyses were conducted with UK Biobank dat...

Objective More than half of pregnant women experience pregnancy-related low back pain (LBP). Pregnancy-related LBP greatly affects activities of daily life, and, although many interventions have been proposed, the optimal treatment for pregnancy-related LBP remains unclear. The purpose of this study was to compare conservative care strategies on th...

Background Low back pain (LBP) and knee osteoarthritis (OA) are major contributors to disability worldwide. These conditions result in a significant burden at both individual and societal levels. Engagement in regular physical activity and exercise programs are known to improve physical function in both chronic LBP and knee OA populations. For peop...

Introduction: The benefits of family-based interventions for patients with musculoskeletal pain have been previously shown in individual randomised controlled trials (RCTs), but no systematic review has summarised their effects. Materials and methods: A systematic review was conducted to assess the effectiveness of family-based interventions on...

OBJECTIVE The aim of the review was to appraise clinical practice guidelines and their recommendations for the treatment of lumbar spinal stenosis. METHODS PubMed, Medline, CINAHL, Embase, and Cochrane Central Register of Controlled Trials were searched up until 25/01/2020 for clinical practice guidelines on the management of lumbar spinal stenosi...

Background: A growing body of research highlights the pervasive harms of adverse childhood experiences (ACEs) on health throughout the life-course. However, findings from prior reviews and recent longitudinal studies investigating the association between types of ACEs and persistent pain have yielded inconsistent findings in the strength and direc...

Introduction: Psychological factors such as fear avoidance beliefs, depression, anxiety, catastrophic thinking and familial and social stress, have been associated with high disability levels in people with chronic low back pain (LBP). Guidelines endorse the integration of psychological interventions in the management of chronic LBP. However, unce...

Study design: Systematic with meta-analysis OBJECTIVES.: To investigate the efficacy and safety of epidural corticosteroid injections compared with placebo injection in reducing leg pain and disability in patients with sciatica. Summary of background data: Conservative treatments, including pharmacological and non-pharmacological treatments, are...

Background and Objective It has been suggested that pelvic floor dysfunction may contribute to the development of lumbopelvic pain as a result of changes in trunk muscle control. However, there is limited evidence that pelvic floor muscle training (PFMT) can improve clinical outcomes in women with lumbopelvic pain. Databases and Data Treatment Six...

Purpose Despite the growing evidence that physical activity and familial factors play a role in low back pain (LBP), there is a lack of robust longitudinal studies that (1) investigate the types and dosages of physical activity that are protective or harmful for LBP, (2) employ objective measures of physical activity and (3) conduct appropriate adj...

Musculoskeletal pain is the greatest cause of disability worldwide. Due to its increasing prevalence and burden, the importance of affordable treatments has been highlighted. Text messages interventions are accessible, low-cost and effective in promoting healthy behaviour and managing chronic diseases. However, little is known about their role in m...

OBJECTIVE: We investigated cross-sectional associations and whether type 2 diabetes increases the risk of musculoskeletal pain after adjusting for the presence of important comorbidities. METHODS: The study employed data from the UK Biobank participants: 495,327 in cross-sectional (2006-2010) and 16,875 in longitudinal (2014-2016) analyses. Type 2...

Background: Lumbosacral radicular pain (commonly called sciatica) is a syndrome involving patients who report radiating leg pain. Epidural corticosteroid injections deliver a corticosteroid dose into the epidural space, with the aim of reducing the local inflammatory process and, consequently, relieving the symptoms of lumbosacral radicular pain....

Objective To use data from the Global Burden of Disease Study between 1990 and 2017 to report the rates and trends of point prevalence, annual incidence, and years lived with disability for neck pain in the general population of 195 countries. Design Systematic analysis. Data source Global Burden of Diseases, Injuries, and Risk Factors Study 2017...

Background Low back pain is one of the leading causes of disability worldwide. Exercise therapy is widely recommended to treat persistent non-specific low back pain. While evidence suggests exercise is, on average, moderately effective, there remains uncertainty about which individuals might benefit the most from exercise. Methods In parallel with...

Background: To evaluate the effectiveness and safety of technology-assisted rehabilitation following total hip/knee replacement (THR/TKR). Methods: Six electronic databases were searched without language or time restrictions for relevant studies: MEDLINE, EMBASE, Cochrane Library, CINAHL, SPORTDiscus, Physiotherapy Evidence Database (PEDro); fro...

Background: To investigate whether engagement in leisure-time physical activity before or during pregnancy is associated with low back pain (LBP) outcomes during pregnancy and postpartum prevalence of LBP in women who reported LBP during pregnancy. Methods: Data from the 2015 Pelotas Birth Cohort Study, were used. Demographic, socioeconomic, and...

Background: Regular physical activity participation is known to promote better mobility and coordination. Although previous research has established that lack of physical activity participation may increase the risk of developing low back pain, the role of physical activity as a predictor of recovery among symptomatic individuals remains unclear....

Background Placebo-controlled trials are an important tool when assessing the efficacy of spinal surgical procedures. The most common spinal surgical procedure in older adults is decompression for lumbar spinal stenosis. Before conducting a placebo-surgical trial on decompression surgery, an investigation of patients’ willingness to participate in...

Introduction Surgical and invasive procedures are widely used in adults with degenerative lumbar spinal stenosis when conservative treatments fail. However, little is known about the comparative efficacy and safety of these interventions. To address this, we will perform a network meta-analysis (NMA) and systematic review to compare the efficacy an...

Objective For many, low back pain (LBP) is a lifelong condition with symptoms varying over time. Previous studies have investigated long-term risk factors and triggers for onset of LBP. No study has examined causes for less distinct fluctuations of symptoms, such as “flares,” which individuals with LBP identify as a significant and worrisome part o...

Low back pain (LBP)varies over time. Consumers, clinicians, and researchers use various terms to describe LBP fluctuations, such as episodes, recurrences and flares. Although “flare” is use commonly, there is no consensus on how it is defined. This study aimed to obtain consensus for a LBP flare definition using a mixed-method approach. Step 1 invo...

Background: Paracetamol (acetaminophen) is vastly recommended as the first-line analgesic for osteoarthritis of the hip or knee. However, there has been controversy about this recommendation given recent studies have revealed small effects of paracetamol when compared with placebo. Nonetheless, past studies have not systematically reviewed and app...

Background and objective Approximately half of the population will experience either low back pain or neck pain, at some point in their lives. Previous studies suggest that people with diabetes are more likely to present with chronic somatic pain, including shoulder, knee and spinal pain. This study aimed to systematically review and appraise the l...

A systematic search was conducted in the MEDLINE, CINAHL, EMBASE and Web of Science electronic databases. Articles titles, keywords and abstracts were searched using the following keywords: (DOCX)

Methodological quality assessment of included studies. (DOCX)

PROSPERO review protocol. (PDF)

Preferred reporting items for systematic reviews and meta-analyses—PRISMA 2009 checklist. (DOC)

Funnel plot used to assess the presence of publication bias through visual inspection. (DOCX)

Background Low back pain is one of the most prevalent musculoskeletal conditions and the highest contributor to disability in the world. It is characterized by frequent relapses leading to additional care-seeking. Engagement in leisure physical activity is associated with lower recurrences and better prognosis and potentially reduced care-seeking....

Purpose To investigate associations between anthropometric measures (birthweight, weight gain and current BMI) and back pain; and to determine whether these associations differ between those born with low or full birthweight. Methods The cross-sectional associations between the lifetime prevalence of back pain and anthropometric measures (birthwei...

Background: Low back pain (LBP) is one of the most debilitating conditions among older adults. Unfortunately, existing LBP outcome questionnaires are not adapted for specific circumstances related to old age, which may make these measures less than ideal for evaluating LBP in older adults. Objective: To explore the necessity of developing age-spec...

The Australia and New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network was formed to build capacity and infrastructure for high quality musculoskeletal clinical trials in our region. The purpose of this paper is to describe the steps taken in its formation to help others interested in establishing similar networks. In particular we describ...

Objectives To investigate the influence of parental chronic spinal pain on prognosis of chronic spinal pain in adult offspring, and whether offspring physical activity level and body mass index (BMI) modified this association. Design Prospective cohort study. Setting We used family-linked longitudinal data from the Norwegian HUNT study collected...

Low back pain is a very common symptom. It occurs in high-income, middle-income, and low-income countries and all age groups from children to the elderly population. Globally, years lived with disability caused by low back pain increased by 54% between 1990 and 2015, mainly because of population increase and ageing, with the biggest increase seen i...

Objective: To estimate the extent to which the co-occurrence of poor sleep quality and low back pain is due to the same genetic and/or environmental risk factors or due to a causal association. Methods: Cross-sectional data on sleep quality (Pittsburgh Sleep Quality index) and low back pain were collected in a population-based sample of adult tw...

Background: Despite multiple risk factors for neurodevelopmental vulnerability, few studies have assessed neurodevelopmental performance of Australian Aboriginal children. An important risk factor for neurodevelopmental vulnerability is prenatal alcohol exposure (PAE), which places children at risk for Fetal Alcohol Spectrum Disorder (FASD). Aims...

Older adults are largely under-represented in to LBP research. In light of the ageing population, it is crucial to understand the influence of comorbidities and lifestyle factors on the risk and prognosis of LBP in older adults. The aims of this study were to describe the course of LBP in older men; to investigate if comorbidities/ lifestyle factor...

Background: Telehealth has emerged as a potential alternative to deliver interventions for low back pain (LBP), however its effectiveness has not been investigated. Purpose: The aim of this review was to evaluate whether interventions delivered by telehealth improve pain, disability, function, and quality of life in non-specific LBP. Study desi...

Study design: Population based health record linkage study. Objective: To determine trends in hospital admissions and surgery for lumbar spinal stenosis, as well as complications and resource use in Australia. Summary of background data: In the United States, rates of decompression surgery have declined, whereas those of fusion have increased....

Background context: Pain is commonly associated with symptoms of depression or anxiety, although this relationship is considered bi-directional. There is limited knowledge regarding causal relationships. Purpose: To investigate whether chronic low back pain (LBP) increases the risk of depression or anxiety symptoms, after adjusting for shared fa...

Background While it is now clear that paracetamol is ineffective for spinal pain, there is not consensus on the efficacy of non-steroidal anti-inflammatory drugs (NSAIDs) for this condition. We performed a systematic review with meta-analysis to determine the efficacy and safety of NSAIDs for spinal pain. Methods We searched MEDLINE, EMBASE, CINAH...

Purpose The aim of this study was to assess the clinical course of pain and disability in patients with lumbar spinal stenosis following surgery. Methods Electronic databases were searched to July 2014 and only prospective cohort studies assessing pain or disability following surgery for lumbar spinal stenosis were included. Two independent reviewe...