A randomized clinical trial published in JAMA Internal Medicine found that a personalized self-management program — delivered by physical therapists and chiropractors — was more effective at preventing the conversion to high impact chronic low back pain than standard medical care or hands-on spinal manipulation alone.

Almost everyone will deal with back pain at some point in their lives. Most recover quickly
— but for about 20% of people, acute pain becomes a chronic condition that interferes with daily life and keeps them out of the workforce.

Low back pain is one of the leading causes of disability worldwide, and more money is spent managing it in the United States than any other health condition. Despite that, the most effective way to prevent a short-term episode from becoming a long-term problem has not been clear — especially for people who are most at risk.

The trial enrolled 1,000 adults through Pitt and the University of Minnesota. It was one of the largest clinical trials ever to include spinal manipulation as one of its treatment arms.

Importantly, it didn’t recruit just anyone with back pain. Participants had to have acute or subacute low back pain and score at moderate or high risk of developing chronic pain based on a validated screening tool that accounts for physical and psychological risk factors.

“Chronic low back pain prevention is a public health issue,” said Michael Schneider, co-principal investigator of the Pitt arm of the study. “The 20% of patients who turn chronic account for 80% of the costs and the suffering. This paper shows that helping people self-manage their pain through a properly trained physical therapist or chiropractor is a great way to mitigate this public health problem.”

Presented as a service to the community by: Union County Chiropractic Clinic, 110 Skyline Drive, Maynardville, TN (865) 992-7000 www.unioncountychiropractic.com