Study: Self-Management Program Helps Patients With Lower Back Pain

Helping patients manage their acute low back pain with classes, leaflets and follow-up phone calls can improve their ability to function, according to a study reported in the November 24 issue of the Archives of Internal Medicine.

Led by Teresa Damush, of Indiana University at Indianapolis, the researchers developed a self-management program for poor, urban, primary care patients with acute low back pain that encouraged them to incorporate proven ways to improve low back pain into their daily routine.

The researchers conducted a trial comparing their self-management program with usual care among 211 patients who visited a physician for acute low back pain. Patients were enrolled at university-affiliated neighborhood health centers and an emergency department of an inner-city public hospital.

Patients in the self-management program attended three group sessions that emphasized treatment recommendations, behavioral changes, increased confidence and reducing negative thoughts and behaviors.

The patients also received handouts outlining exercise regimens and periodic follow-up phone calls after the first class to reinforce what they learned in group sessions, check their progress and address any issues or concerns.

Patients in the usual care group did not receive these interventions.

The researchers assessed the patients' back pain, health status, confidence and time spent in physical activity at the beginning of the study and 12 months later.

The researchers found that patients in the self-management group scored significantly better on a questionnaire assessing disability than those in the usual care group. In addition to better mental functioning, these patients also were better able to manage their back pain, were more physically active and were less fearful of reinjuring their backs.

Other sources: Archives of Internal Medicine 2003;163:2632-2638