Spinal Manipulation and Patient Self-Management for Preventing Acute to Chronic Back Pain

The long-term objective is to reduce overall low back pain (LBP) burden by testing scalable,
first-line, non-pharmacologic strategies that address the biopsychosocial aspects of
acute/sub-acute LBP and prevent transition to chronic back pain.

The US is in the midst of an unprecedented pain management crisis. LBP is the most common
chronic pain condition in adults and the leading cause of disability worldwide. Guidelines
have recommended non-pharmacologic treatments like spinal manipulation and behavioral
approaches for LBP for nearly a decade, yet uptake and adherence has been poor. Moreover,
little is known about the role of these treatments in the secondary prevention of chronic LBP
(cLBP), especially for patients with biopsychosocial risk factors. With burgeoning costs,
mounting evidence of ineffectiveness, and harms of commonly used drug treatments, including
opioids, there is a critical need for research on non-pharmacological treatments for cLBP
prevention that can be readily translated to practice.