A recent study has revealed that adding lifestyle support to the treatment of chronic back pain can significantly decrease disability and enhance quality of life.
Chronic low back pain is a significant contributor to global disability, yet conventional treatments, especially medications, frequently lack effectiveness for long-term relief. A team of researchers from the Centre for Rural Health at the University of Sydney has identified a potentially more effective approach. Their findings, shared in JAMA Network Open, indicate that incorporating lifestyle support into back pain management could lower disability rates and improve individuals’ quality of life.
The randomized controlled trial involved 346 participants from various parts of Australia, all of whom suffered from chronic low back pain and had at least one associated lifestyle risk factor, such as being overweight, unhealthy eating habits, lack of physical activity, or smoking. Participants were randomly divided into two groups: those enrolled in the “Healthy Lifestyle Program (HeLP)” and those receiving standard physiotherapy care based on established guidelines.
Those in the HeLP group received assistance from a team comprising physiotherapists, dietitians, and telephone health coaches. This team helped participants identify which lifestyle choices might be affecting their back pain, such as weight issues, inactivity, poor nutrition, inadequate sleep, smoking, or excessive alcohol consumption. Over six months, they were given evidence-informed advice to tackle these lifestyle challenges.
Compared to the standard care group, the HeLP approach yielded several positive results, including a decrease in disability. Participants in the HeLP group scored an average of 1.3 points lower on the Roland Morris Disability Questionnaire (with higher scores indicating greater disability). Additionally, HeLP participants lost an average of 1.6kg more than their counterparts in the control group.
Chief Investigator Associate Professor Chris Williams highlighted the implications of these findings for back pain treatment:
“Managing back pain effectively requires looking beyond just the spine. Our bodies function more like ecosystems where various factors interact, influencing our overall health and well-being. Back pain is a perfect example of this. When someone experiences persistent back pain, they should expect thorough care that addresses many health factors, not just a focus on spinal issues. This is a critical message that needs to be widely communicated.”
“An increasing number of studies suggest that issues like bulging discs and joint degeneration are seldom the primary causes of chronic back pain,” Associate Professor Williams stated. “However, many people remain unaware of this, and even fewer receive guidance to focus on factors that contribute to long-term pain and disability. Consequently, numerous patients are directed toward surgeries or medications that prove ineffective and could even cause additional harm.”
This study emphasizes the necessity for a transformation in back pain treatment, shifting away from reliance on medications and procedures and towards addressing lifestyle elements that can lead to significant improvements.
Dr. Emma Mudd, the lead author and Senior Research Officer at the University of Sydney, emphasized the practical benefits that the program may offer.
“Many individuals suffering from chronic back pain report feelings of neglect as they are often referred to high-cost, ineffective treatments without receiving recommended self-management strategies,” Dr. Mudd remarked.
“By redirecting attention towards lifestyle modifications and offering straightforward, supportive measures, patients gain a sense of empowerment over their pain management. This method not only alleviates their symptoms but also enhances their overall quality of life.”
The researchers are optimistic that lifestyle-focused care, such as the HeLP program, could have benefits that extend beyond managing pain, potentially lessening the risk of other chronic health conditions. Nonetheless, Dr. Mudd pointed out that current global guidelines have not yet fully integrated this method:
“Our research has the potential to influence upcoming revisions to back pain treatment guidelines. Patients highly valued the comprehensive support, and the results are compelling.”
“Healthcare providers treating back pain should think about ways to incorporate lifestyle support into their everyday practice. There doesn’t seem to be a singular effective method, but the key is for patients to feel respected and included in the decision-making process,” stated Associate Professor Williams.
