Optimising conservative management of chronic low back pain: study protocol for a randomised controlled trial

Area of Science:

• Biomedical science
• Clinical research
• Rehabilitation medicine

Background:

• Lower back pain is a widespread global health issue, impacting approximately 80% of individuals.
• While exercise is generally beneficial, pain alone is an insufficient measure for evaluating chronic low back pain interventions.
• Physical deficits associated with low back pain necessitate objective outcome measures beyond subjective pain reporting.

Purpose of the Study:

• To compare the impact of motor control and manual therapy versus general strength and conditioning on physical deficits in chronic low back pain.
• To investigate objective measures, including magnetic resonance imaging (MRI) outcomes, to evaluate exercise protocol effectiveness.
• To inform clinical practice guidelines for managing chronic low back pain by considering outcomes beyond pain reduction.

Main Methods:

• A randomized controlled trial involving 40 participants (25-45 years) with chronic low back pain.
• Intervention groups: motor control/manual therapy (n=20) and general strength and conditioning (n=20) over 6 months.
• Primary outcomes measured by MRI: lumbar spine intervertebral disc T2 relaxation time and transversus abdominis muscle thickness; secondary outcomes include various MRI, DXA, functional, and neurophysiological measures.

Main Results:

• This section is not available in the provided abstract.

Conclusions:

• Chronic low back pain is a leading cause of disability, particularly in Australia.
• Study findings will guide clinical decision-making for adults with chronic low back pain.
• The research aims to provide evidence for interventions that address functional deficits alongside pain.