Is There a Role for Behavioral Self-Management in Patients with Low Back Pain?

Little is known about the relative efficacy of nonpharmacologic approaches in patients with subacute low back pain (LBP for 2–12 weeks; see Figure 1). To address this gap, researchers randomized 1000 adults with subacute LBP (mean age, 47) to one of four interventions:

• Spinal manipulation

• Clinician-supported behavioral self-management (4–8 60-minute training sessions focused on pain education, physical exercise, cognitive restructuring, and social strategies)

• Both interventions together

• Usual medical care (guideline-concordant medication and physical pain-control modalities)

Nearly all participants reported at least one previous episode of back pain, and 40% reported radiation to a lower extremity. Chiropractors and physical therapists pe…