Objective:

To evaluate the effectiveness of clinician-supported biopsychosocial self-management compared to guideline-based medical care in patients at risk of chronic low back pain.

Approach:

Key Findings:

• Participants receiving self-management had lower pain impact scores (15.3) compared to those receiving medical care (17.0).
• 64% of the self-management group achieved at least a 50% reduction in pain impact, compared to 55% in the medical care group.
• 34% of self-management participants met the definition of chronic low back pain at 12 months, compared to 54% in the medical care group.
• 15% of self-management patients reported chronic low back pain interfering with daily activities, versus 27% in the medical care group.

Interpretation:

The benefits of self-management were significant, particularly in reducing chronic low back pain risk and improving psychosocial factors related to pain.

Limitations:

• Patients and clinicians were not blinded to treatment assignment.
• The study did not control for differences in treatment time, attention, expectations, or practitioner effects.
• The study population was predominantly White, highly educated, and affluent, limiting generalizability.

Conclusion:

The consistent results suggest that clinician-supported self-management may be clinically relevant for patients at risk of chronic disabling low back pain.

Sources:

• JAMA Internal Medicine
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