PhD defence (Zhaochen) Zhu

Below is brief summary of the dissertation:

Lower back pain (LBP) is the leading cause of disability worldwide, yet finding effective treatments remains a significant challenge. This research explores how we can improve care for three specific groups: those with sciatica, older adults, and patients with both hip and back pain.
Review of 90 clinical trials found that while certain injections, exercises, and anti-inflammatories provide short-term relief, the overall evidence is surprisingly weak. For chronic sciatica, combining exercise with nerve-stretching techniques showed the most promise, but higher-quality research is needed before these can be fully recommended.
Older Adults & Medication: In a study of 675 adults over 55, those using painkillers—especially opioids—actually reported worse pain and disability over time than those who didn't. Interestingly, patients who stopped or reduced their medication saw the greatest improvements, suggesting a need for caution when prescribing long-term analgesics.
The Hip-Back Link: Data from over 5,000 patients showed that 61% of people with hip osteoarthritis also suffer from LBP. Surprisingly, a hip-focused exercise and education program led to a 20% reduction in back pain. This "spillover effect" suggests that treating the hip can directly benefit the back.
Conclusion: Managing back pain requires a shift away from long-term medication toward movement-based therapies and a more holistic view of how different joints affect one another.