A few days ago, a woman posted a message on to a local community Facebook page asking for the following advice; Has anyone had any experience with sciatica nerve pain and useful treatment? Hubby has been in terrible pain for weeks now. Thanks for any thoughts or recommendations. The advice that followed all came from local people and probably represented a fair snapshot of what many people currently think about the management of back pain. I've printed the whole exchange below - it's long enough to be inclusive, but not too long - so that you can draw your own conclusions, but here are a few thoughts that occurred to me reading through it.* All posts bar one were from women. There … [Read more...] about Evidence-based practice will not help us now
The idea that one approach to practice is superior to another is a powerful discourse in physiotherapy today. Last week I was talking with a colleague who thinks of himself as a 'critical thinker', and we were debating the merits of active rehabilitation over passive treatment. So called 'passive' treatments (some forms of massage, manipulation and electrotherapy, for example), in which the patient has treatment done to them rather than taking responsibility and actively engaging, have been the subject of much criticism in the profession for some time now. There is, I was told, indisputable evidence for the benefits of active approaches over passive treatment, and that those who … [Read more...] about Going beyond good and bad practice
In this final 30DoS for 2016, Director of Professional Policy at WCPT - Tracy Bury - writes about the seminal work of David Sackett and how it influenced her critical thinking. The publication of Evidence based medicine: what it is and what it isn’t (Sackett et al) in 1996 was the culmination of a growing discourse on the challenges of integrating research evidence with clinical expertise for the benefit of patients. The authors also referenced EBM’s philosophical origins in mid-19th century Paris whilst describing it as a young discipline. The definition for EBM that was set out is now universally recognised. The importance of clinical experience, competency and judgement were … [Read more...] about Tracy Bury – EBM: What it is and what it isn’t – 30DoS #30
Perhaps the greatest mind in the entire history of the world - well in my estimation anyway - once argued that it is the the things that are the most obvious and seemingly benign that we should focus all of our critical attention upon, because these are the things that are doing the best job of concealing the immense power that allows them to become so seemingly obvious in the first place. (If you hadn't realise already, that man is Michel Foucault). Well of all the seemingly obvious, taken-for-granted and largely unchallenged ideas currently pervading physiotherapy, evidence based practice must surely be one of the most obvious ideas needing critical scrutiny. Fortunately, a few … [Read more...] about Is it time to end the tyranny of evidence based practice?
A very interesting thing has been happening with the CPN blog in recent weeks. After publishing two relatively controversial blogposts - one on Six useless treatments and the other titled There are no new treatments in physiotherapy, we saw a big spike in members and enquiries through our email service. The post There are no new treatments in physiotherapy has been accessed more than 15,000 times on Facebook, and Six useless treatments nearly 13,000 times. These might not be particularly big numbers for Justin Bieber, but they are for most groups in physiotherapy. What is it about these posts that made them so popular? Based on some of the emails we received after they went … [Read more...] about Desperately seeking evidence