Alfred Cove physiotherapist’s work improving the diagnosis and treatment of lower back pain

Aubrey Monie at his Alfred Cove Precision Physiotherapy clinic.
Aubrey Monie at his Alfred Cove Precision Physiotherapy clinic.

AUBREY Monie has spent nearly five years developing an innovative new testing regime he hopes will improve the accuracy of diagnosing and measuring outcomes in patients with lower back problems.

Dr Monie completed his PhD at the University of Western Australia earlier this year.

His thesis was dedicated to matching movement patterns with common structures causing lower back pain, like disc herniation, facet joint dysfunction and nerve compression.

“We tested the low back movement of 200 pain-free people of both genders and varying age groups and then compared this with patients experiencing low back pain,” he said.

“Our preliminary evidence shows that the lumbar disc, facet joints and nerve compression can result in specific movement patterns.”

Using this knowledge, Dr Monie and his research associates suggest that these patterns can be used alongside a structured assessment to inform diagnosis, treatment and management decisions.

“A lack of accurate diagnoses is an issue when examining patients with musculoskeletal conditions,” he said.

“A lot of people are diagnosed with what we call non-specific lower back pain, which basically means we don’t know what is responsible for their pain.

“Using this new information, we hope to improve clinical assessment and the way we manage lower back pain.”

Dr Monie owns Precision Physiotherapy, which has grown from one clinic in 2000 to five locations south of the river, employing nine clinicians today.

While he is an advocate for new diagnostic techniques, Dr Monie said he did not believe in the machine-based treatment that has become common.

“We don’t use electrical modalities, such as ultrasound and interferential – there is almost no evidence to support their use and what evidence there is shows they might only help for three to five minutes,” he said.

“I continue to hear of, and have personally experienced, therapists giving thoughtless diagnoses and treating two people at once with both patients connected up to machines.

“We have a focus on hands-on manual therapy and prescription exercise.”

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