PCORI has identified the need for large studies that look at real-life questions faced by diverse patients, caregivers, and clinicians. To address this need, PCORI launched the Pragmatic Clinical Studies initiative in 2014. Pragmatic clinical studies allow for larger-scale studies with longer timelines to compare the benefits and harms of two or more approaches known to be effective for preventing, diagnosing, treating, or managing a disease or symptom. They focus on everyday care for a wide range of patients. This research project is one of the studies PCORI awarded as part of this program.
This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
Low back pain is a common problem among adults in the United States. For many adults, low back pain is temporary. For others, the pain may never go away. Constant, long-term pain is called chronic low back pain. It can make everyday life difficult. Adults with chronic low back pain may have trouble with daily activities such as sitting, walking, or climbing stairs. Back pain also can make working difficult.
Researchers are looking at two ways to help doctors treat adults who are at risk for developing chronic low back pain.
Who can this research help?
This research can help patients with current low back pain, doctors, and physical therapists choose how to treat low back pain and keep it from becoming a long-term problem. People in professional organizations that focus on helping people with chronic pain and in the insurance industry can use results from this research when making recommendations for treating low back pain.
What is the research team doing?
Researchers are working with 88 clinics in five regions across the United States. Researchers are dividing the clinics into two groups, by chance.
The first group of clinics provides doctors with information about the risks for adults with current low back to develop chronic low back pain. Doctors use this information to treat high-risk patients based on current medical practices.
In the second group of clinics, doctors get the same information about the risks for developing chronic low back pain. They also work with physical therapists who provide the patients with treatment to help them overcome both physical and emotional barriers to getting better.
Across all of the clinics, researchers are enrolling 3,000 adults who currently have low back pain and who are at risk for chronic pain.
At 6 and 12 months after patients join the study, the researchers are looking at how many patients in both groups had low back pain that became a long-term problem. The researchers are studying how well these patients can do activities such as standing, walking, or lifting. The researchers also are looking at the types of medical tests or treatments the patients have (such as x-rays, magnetic resonance imaging, or surgeries).
For comparison, the researchers are looking at a third group of 9,000 adults who are at low to medium risk for developing chronic low back pain. The researchers want to know how well the adults in this comparison group can do daily activities. Researchers also want to know about the types of medical tests and treatments the adults in this group had.
Patients with low back pain are part of a committee that is overseeing this research. Other people interested in this research, including doctors and policy makers, provided input about the study design.