Acute low back pain (severe pain that comes on suddenly and lasts a relatively short time)
is very common in the United States, and accounts for substantial illness, functional
limitations, pain, and health care costs. This study looks at whether a program designed to
improve self-efficacy (a person's belief in his or her ability to reach a goal, such as
managing one's own disease) and social support improves the health status of people with
acute low back pain.
Acute low back pain (ALBP) is very prevalent in the United States, accounting for
substantial morbidity, functional limitations, pain, and health care costs. Psychosocial
interventions that target improved symptom control and patient functioning have the
potential to improve the outcomes of patients with ALBP. This study evaluates a psychosocial
intervention designed to enhance self-efficacy and social support for patients with ALBP.
In this randomized, controlled trial, we will randomize eligible patients with ALBP to
receive the intervention or usual care. The intervention program consists of: (1) patient
education regarding ALBP; (2) explanations and rationales, in layperson's terms, of
diagnostic and treatment options for ALBP; (3) discussions regarding the management of
negative affect (i.e., depression, anger, fear, hostility, anxiety); (4) methods to involve
social support systems; and (5) strategies to involve the primary care physician to
reinforce patients' behaviors and progress. We will follow patients for 12 months and assess
outcomes at 3 and 12 months.
Primary outcomes are health-related quality of life (i.e., functional status, role function,
back pain symptoms) and patient satisfaction with care. Secondary outcomes include health
care use, direct health care costs, self-efficacy, and social support. We will also estimate
the cost-effectiveness of the intervention.
We will conduct this investigation among socioeconomically vulnerable patients with ALBP, a
group that shoulders a disproportionate burden of disability and morbidity from
musculoskeletal conditions and comorbid medical conditions.
- Acute low back pain
- Chronic back pain (including surgery)
- Disability claim for back pain
- Nursing home resident
- Severe impairment in hearing, vision, or speech
- Unable to speak English
- Severe comorbidity
- Unable to contact by phone
- Excluded by primary care physician