PACBACK Trial Cuts Chronic Back Pain Impact in 64% With Supported Self-Management
Updated
Updated · BIOENGINEER.ORG · Jul 1
PACBACK Trial Cuts Chronic Back Pain Impact in 64% With Supported Self-Management
2 articles · Updated · BIOENGINEER.ORG · Jul 1
Summary
More than 1,000 adults at moderate to high risk of chronic low back pain were tracked for a year, and supported self-management delivered the strongest reduction in pain impact 10 to 12 months after treatment.
The 8-week program paired pain education, tailored exercise, relaxation and cognitive reframing in one-on-one sessions, outperforming guideline-based medical care in pain severity and function.
Spinal manipulation alone matched standard medical care rather than beating it, and adding manipulation to self-management produced no clear extra benefit.
About three-quarters of the treatment effect was tied to higher self-efficacy, lower fear-avoidance and healthier pain beliefs, pointing to psychosocial change as the main driver.
Published in JAMA Internal Medicine, the PACBACK findings support more targeted, biopsychosocial early care to prevent acute or subacute back pain from becoming chronic.