A Portable Wireless Solution for Back Pain Telemonitoring: A 3D-Based, Virtual Reality Approach - Computational Intelligence in Healthcare: Advanced Methodologies - page 428

reliable due to its low specificity. It could, nevertheless, be used as a cost-effective
method prior to CT/MRI scan or discography.
Nuclear scans. Finally, the least commonly used technique is the nuclear scanning,
which includes single-photon emission CT to produce three dimensional spatial im-
ages, valuable for the exclusion of tumor, fracture, and infection. Although it can be
helpful in select cases, in overall it was found not adequate to assess back pain [11].
Besides the imaging techniques just described, others also exist, but since the inten-
tion of this work is not to provide a thorough description of them, only the most
commonly used have been mentioned. In addition, although they are a valuable tool in
the assessment of back pain, currently available imaging techniques also have several
limitations, so they usually provide only partial conclusions in the process. This is the
main reason that imaging tests are recommended only as a supplementary method that
should be used in conjunction with other assessment techniques [11]. Moreover, [52]
in their study argue that it is a fact that imaging testing is frequently used in the as-
sessment of back pain despite recommendations and guidelines on limitation of its
usage. Excessive usage naturally causes increased healthcare costs, in addition to the
theoretical health risk that implies due to the high emission of radiation.
Finally, based on the overall findings from the assessment process, the clinician
then categorizes patients in one of three groups, according to the Agency for Health
Care Policy and Research guidelines (AHCPR): 1) patients with a potentially serious
underlying problem, 2) patients with possible neurological involvement, and 3) pa-
tients with nonspecific back pain [55]. Such categorization of patients into the afore-
mentioned groups is considered to be of high importance for the assessment process,
as eventually, when the potential group has been identified, and if necessary, imaging
tests have been performed, plausible therapeutic protocols that could be used for
treatment planning are determined and finally selected/designed in the following last
phase, always in accordance to the assessment phase findings [27].
2.5 Planning Phase
The final phase of the patient management process involves the design or selection of
an appropriate therapeutic protocol, which the clinician administers to the patient by
continually monitoring and assessing the response to the treatment plan and then
revises the diagnosis and/or treatment plan accordingly, if necessary, until the process
terminates with satisfactory patient recovery [27].The treatment plan is designed or
selected based on the information built up during the previous phases.
However, it should be noted that there is no sure treatment of back pain disorders.
Therefore, the main aim of the treatment plan should be the right pain management by
trying to a) relieve pain , b) to return normal muscle function , and c) to eliminate fac-
tors that could advance pain into a chronic disorder [42]. This could be achieved
using a multidimensional approach to pain management, meaning that sometimes the
use of treatment options from various complementary disciplines might be required.
To this end, when developing a treatment plan, a clinician normally considers any
appropriate treatment option available, which could be characterized as of either a
conventional or alternative nature.