Non-specific chronic low back pain is a common and multifactorial condition among office workers in primary care, and non-pharmacological approaches such as mindfulness-based therapies remain underexplored in this population.The primary objective of this study was to investigate the effects of mindfulness-based therapies on pain severity in office workers with non-specific chronic low back pain. We hypothesized that mindfulness-based interventions would reduce pain severity and improve psychological and functional outcomes compared to standard care.This parallel-group, open-label, randomized controlled trial was conducted among employees of Dokuz Eylül University. A total of 104 office workers diagnosed with non-specific chronic low back pain were randomly assigned in a 1:1 ratio to either a mindfulness-based therapy intervention or a standard care control group. The intervention consisted of a structured mindfulness-based therapy program, while the control group received usual care. Pain severity, assessed using the Visual Analogue Scale (VAS), was defined as the primary outcome. Secondary outcomes included functional disability (Roland Morris Disability Questionnaire), physical activity levels (International Physical Activity Questionnaire), anxiety (Beck Anxiety Inventory), quality of life (SF-36 Health Survey), and mindfulness levels (Five Facet Mindfulness Questionnaire). Outcome measures were collected at baseline, immediately after the intervention, and at a 3-month follow-up.The intervention group showed a statistically significant reduction in pain severity compared to the control group (VAS, p<0.05), which was maintained immediately post-intervention and at the 3-month follow-up. Functional disability improved initially but was not sustained, while significant improvements were observed in anxiety, quality of life, and mindfulness levels in the intervention group.These findings suggest that mindfulness-based therapies may reduce pain severity in office workers with chronic low back pain, likely through psychological and cognitive mechanisms reflected by improvements in anxiety, quality of life, and mindfulness rather than sustained functional changes.Mindfulness-based therapies may represent a promising non-pharmacological approach for the management of non-specific chronic low back pain, with beneficial effects on pain severity, anxiety, quality of life, and mindfulness. Their low-cost, feasible, and adaptable nature supports their potential integration into primary care and workplace-based health programs to enhance accessibility in chronic pain management.

Patients experiencing serious accidental injuries are at risk of developing long‑term opioid use. Many are discharged without a clear opioid-management or follow-up plan. General practitioners (GPs) frequently report poor communication from hospitals about post-discharge opioid tapering and expected pain trajectories. These gaps in information and coordination may contribute to prolonged opioid prescribing.To evaluate whether a Pain and Coordination Plan (PAC-plan) for patients after accidental injury reduces opioid use and improves health-related quality of life (HRQoL), pain, and other patient-reported outcomes six weeks post-discharge.This pragmatic unblinded randomised controlled trial enrolled 270 patients from the Division of Orthopaedic Surgery, XXX University Hospital, XXX between September 2023 and April 2025. The trial was prospectively registered on ClinicalTrials.gov (NCTXXX). Adults (≥18 years) undergoing acute orthopaedic surgery after accidental injury and discharged home with opioid medication, were eligible. Participants were assigned 1:1 to PAC‑plan or usual care by randomising at the GP (cluster) level. The PAC‑plan comprised (a) an opioid management plan at discharge, (b) a scheduled GP visit, with the consultation to occur within 2–4 weeks after discharge, and (c) facilitated GP–hospital collaboration. The primary outcome was self‑reported oral morphine equivalent (OMEQ) consumption at six weeks post‑discharge; secondary outcomes at six weeks included HRQoL, pain, sleep, mood and other patient‑reported measures. The primary analysis will compare mean OMEQ at six weeks between groups using a linear mixed model with a random effect for GP (cluster) and adjustment for prespecified baseline covariates.Data collection is complete and statistical analyses are currently in progress. Final results will be presented at the conference.If proven effective, there is potential for the implementation of the PAC-plan in clinical practice, which could reduce problematic opioid use within society and improve patient-reported outcomes.Final conclusions regarding the effectiveness of the PAC‑plan will be presented at the conference. Keywords: Opioid Analgesics, Physical Trauma, Continuity of Care

Chronic pain is a major global health issue and one of the leading causes of disability worldwide. Despite increasing recognition of its biopsychosocial nature, management in primary care remains challenging. Psychosocial skills (PSS) are defined by the World Health Organization as cognitive, emotional, and social capacities enabling adaptive and effective responses to life challenges. They may play a key role in how individuals perceive and manage pain. However, the relationship between PSS and chronic pain outcomes remains an insufficiently explored area.This systematic review aims to (i) examine associations between PSS and chronic pain outcomes, including pain intensity, disability, and quality of life; (ii) identify the most frequently studied skills; and (iii) describe the tools used to assess them.Following PRISMA 2020 guidelines, a systematic search was conducted in PubMed, Embase, and PsycINFO for studies published between January 2015 and March 2025 from North America, Europe, or Australia.  Eligible studies included original quantitative research on adults aged over 18 years old suffering from chronic non-cancer pain for more than 3 months.Of the 6,899 articles initially identified, 67 studies were included. The most frequently examined skills predominantly involved cognitive and emotional domains, particularly self-efficacy, coping, psychological flexibility, resilience, and self-esteem. Higher levels of these skills were consistently associated with reduced pain intensity, lower pain interference, and better quality of life. Coping emerged as a central psychosocial skill, encompassing cognitive, emotional, and social components essential to chronic pain adaptation. Social skills, which are less frequently studied, appeared to contribute to overall well-being and social participation.Despite heterogeneity, all studies converge in showing psychosocial skills modulate pain impact through emotional and cognitive pathways.Psychosocial skills emerge as key determinants of disability, pain interference, and quality of life in chronic pain. These findings support a biopsychosocial perspective and highlight the importance, for general practitioners, of integrating psychosocial assessment and skills-based interventions such as cognitive-behavioral approaches into routine care. Strengthening these skills may offer a promising and sustainable approach to improving outcomes for individuals living with chronic pain.

Aspirin is the oldest analgesic treatment. Today, its use for pain relief has been largely supplanted by non-steroidal anti-inflammatory drugs (NSAIDs) in the management of osteoarthritis-related pain. Nevertheless, aspirin remains widely used, particularly for self-medication, facilitated by its over-the-counter availability. The benefit–risk balance of aspirin for this indication remains unclear.The primary objective of this study was to analyse the efficacy data of aspirin in the treatment of shoulder, hip, and knee osteoarthritis pain.A systematic review of randomised controlled trials (RCTs) comparing aspirin with placebo or other NSAIDs was conducted in major databases (Cochrane, PubMed, Embase), following PRISMA criteria. The primary outcome was pain relief. Risk of bias was assessed using the ROB2 (Risk of Bias 2) tool. Level of evidence was graded using the REB (Rebuild the Evidence Base) method.Among 2,990 identified citations, eight studies met the inclusion criteria, all rated as having a high risk of bias. According to the REB method, there is an lack of evidence supporting the efficacy of aspirin for osteoarthritis pain. Five included studies reported that aspirin was significantly more effective than placebo. No statistically significant difference was observed between NSAIDs and aspirin, except for a single study reporting superiority of etodolac.This review’s main strength lies in its comprehensive, librarian-assisted search strategy and its use of the REB method to focus on clinically relevant outcomes. However, the evidence base is outdated and of poor quality, consistent with recent literature.Mainly due to the age of available trials, the overall quality of the evidence is insufficient to attribute a satisfactory level of evidence regarding the analgesic effect of aspirin in shoulder, hip, and knee osteoarthritis pain.

Acute low back pain (LBP) is one of the most frequent reasons for consultation in primary care and a major contributor to disability worldwide. Although most episodes are non-specific and self-limiting, a small proportion may reflect serious underlying pathology. Early differentiation between benign and high-risk presentations relies on the clinical skills of the primary care physician. A structured approach, centred on focused history taking, thorough physical examination, and systematic identification of red flags, is essential to ensure patient safety while avoiding unnecessary investigations.This review aimed to summarise best practices for assessing acute LBP in primary care, with emphasis on key components of the physical examination and the recognition of red flags that may indicate serious conditions. A secondary objective was to clarify which clinical findings should trigger imaging, additional investigation, or urgent referral.A narrative literature review was undertaken using current evidence-based guidelines and major scientific sources on acute LBP in primary care. The synthesis focused on effective physical examination strategies, diagnostic accuracy of red-flag indicators, and established decision-making algorithms guiding investigation and referral.The evidence shows that routine imaging in acute LBP offers minimal clinical value and may lead to overdiagnosis. A comprehensive physical examination should include inspection, palpation, spinal mobility assessment, neurological testing of the lower limbs, straight-leg-raise testing, and gait evaluation. Red flags requiring urgent consideration include age >50 or <20 years, trauma, history of cancer, unexplained weight loss, immunosuppression, fever, intravenous drug use, night pain, progressive neurological deficit, saddle anaesthesia, and bowel or bladder dysfunction. These findings may indicate vertebral fracture, malignancy, infection, cauda equina syndrome, or significant neurological compromise, and warrant prompt investigation.A structured clinical assessment improves diagnostic accuracy and reduces unnecessary imaging. Red flags should not be interpreted in isolation; their combined presence increases the likelihood of serious disease and strengthens clinical decision-making.Primary care clinicians should prioritise thorough physical examination and consistent screening for red flags in acute LBP. This approach enhances patient safety, reduces inappropriate investigations, and supports evidence-based management. Keywords (MeSH Terms): Low Back Pain; Primary Health Care; Physical Examination; Red Flags; Spine.

Low back pain is a common health problem that affects physical and psychological well-being. Understanding the relationship between depressive symptoms and treatment methods may help improve patient outcomes.This study aims to compare the pharmacological and nonpharmacological treatment methods used by patients presenting with low back pain and to investigate the relationship between depressive symptoms and the effectiveness of treatments.This is a prospective, cross-sectional, and descriptive study. The study included 233 individuals aged 18-65 with low back pain who visited the Family Medicine or Traditional and Complementary Medicine (TCM) outpatient clinics at XXX Hospital. The researchers administered a questionnaire form containing sociodemographic characteristics, visual analog scale scores, and treatments applied for back pain to the patients through face-to-face interviews. The emotional state of the patients was evaluated with Beck depression inventory. The data collected throughout the research were analyzed using IBM SPSS 25.0 with a significance level set at p<0.05.A total of 233 individuals participated in the study, comprising 143 women (61.4%) and 90 men (38.6%), with a mean age of 46.16±13.99 years. For the treatment of low back pain, 45.1% (n=105) of patients reported receiving pharmacological treatment, 32.6% (n=76) reported receiving TCM treatment, and 21% (n=49) reported receiving physical therapy. 51.9% of the patients (n=121) had symptoms of depression. No significant association was found between depression symptoms and TCM treatments (p=0,83), exercise (p=0,27), massage (p=0,56), heat application (p=0,78), balneotherapy (p=0,32), kinesiology tape (p=0,67), and physical therapy (p=0,10), while a significant difference was found with the use of pharmacological treatment in the last 3 months (p=0,006).In our study, the rate of depression among those using pharmacological treatment for low back pain was observed to be elevated, consistent with findings from recent studies. Therefore, depression should be considered in patients with excessive drug use related to back pain.Assessing depressive symptoms in patients with low back pain may help clinicians develop more personalized and effective treatment strategies. It is recommended to screen for depression and initiate treatment if necessary, especially in patients experiencing severe low back pain and receiving drug therapy.

In France, back pain accounts for approximately 6 million consultations each year and represents a major public health issue due to the functional disability it causes. Systemic corticosteroids are frequently used in routine practice for the treatment of back pain. Their therapeutic impact has been evaluated by several clinical trials and meta-analyses, without demonstrating a clear benefit.Our work aims to perform a meta-analysis using recent literature and the latest bias assessment tools (RoB2) to evaluate the interest of systemic corticosteroids in back pain, with or without radiculopathy, according to the REB (Rebuild Evidence-Based Medicine) method.A literature review was conducted to identify published trials up to 04/01/2024. The risk of bias in the trials was assessed using the RoB2 tool. The criteria for judgment include: reduction of pain in the short and medium term, disappearance of pain in the short and medium term, improvement in function, adverse effects, and use of analgesics. The overall level of evidence was graded according to the REB method.A total of 14 randomized clinical trials involving 1,099 patients were included. According to the REB method, our study concludes that there is a “lack of evidence” for all judgment criteria, except for the improvement in function, which shows a “signal.”This study shows a lack of solid evidence for the effectiveness of systemic corticosteroids in back pain or radiculalgia for almost all evaluated judgment criteria.The “signal” regarding functional improvement does not constitute sufficient justification for routine use but may encourage further research.