The ‘Best Practice Guide to Conservative Management of Patellofemoral Pain’: incorporating level 1 evidence with expert clinical reasoning (Barton et al, 2015).
Patellofemoral pain (PFP) is a common cause for knee pain in general practice and sports settings. Pain is aggravated by running, stairs, and squatting. The majority of suffers report an onset of pain in early adolescence and chronic ongoing pain for up to 20 years.
A number of high-quality reviews covering conservative interventions for PFP provide greater guidance for research and clinical practice.
Four key principles to ensure effective management include:
(1) PFP is a multifactorial condition requiring an individually tailored multimodal approach.
(2) Immediate pain relief should be a priority to gain patient trust.
(3) Patient empowerment by emphasising active over passive interventions is important.
(4) Good patient education and activity modification is essential.
Research supports a multimodal treatment approach including:
The ‘Best Practice Guide to Conservative Management of Patellofemoral Pain’ has been based on a combination of contemporary level 1 evidence and the analysis of international experts’ clinical reasoning:
Back pain is a big problem. Everyone gets it. It's the most common thing I treat. About a quarter of the patients I see have back pain. There's a massive disease burden. It's expensive.
And it can seem complicated. Everyone's got different advice about what to do. There's not one thing that fixes it. It can seem a bit out of control. And that can make it worse again. Stupid little things aggravate it. It doesn't seem fair. Stress. Anxiety.
Usually there's not anything magical I can do to give you immediate relief. We work on little gains that you can achieve regularly by yourself throughout the day and it gradually improves. It takes a bit of work.
My main goal when you come in for treatment is to give you control. Once you have a sense of control it doesn't hurt as much. I frame this as a "BACK PAIN MANAGEMENT PLAN"...
- KNOW WHAT AGGRAVATES IT -
For example, this could be:
- KNOW WHAT RELIEVES IT -
This could be:
- KNOW HOW TO PREVENT THE NEXT EPISODE -
This could be:
We need to pick the one or two most important things from each of these lists