Abstract
BackgroundAlthough most patients with low back pain (LBP) recover within a few weeks a significant proportion has recurrent episodes or will develop chronic low back pain. Several mainly psychosocial risk factors for developing chronic LBP have been identified. However, effects of preventive interventions aiming at behavioural risk factors and unfavourable cognitions have yielded inconsistent results. Risk tailored interventions may provide a cost efficient and effective means to take systematic account of the individual risk factors but evidence is lacking.Methods/DesignThis study will be a cluster-randomised controlled trial comparing screening and a subsequent risk tailored intervention for patients with low back pain to prevent chronic low back pain compared to treatment as usual in primary care. A total of 600 patients from 20 practices in each study arm will be recruited in Berlin and Goettingen. The intervention comprises the following elements: Patients will be assigned to one of four risk groups based on a screening questionnaire. Subsequently they receive an educational intervention including information and counselling tailored to the risk group. A telephone/email consulting service for back pain related problems are offered independent of risk group assignment. The primary outcomes will be functional capacity and sick leave.DiscussionThis trial will evaluate the effectiveness of screening for risk factors for chronic low back pain followed by a risk tailored intervention to prevent chronic low back pain. This trial will contribute new evidence regarding the flexible use of individual physical and psychosocial risk factors in general practice.Trial registrationISRCTN 68205910
Highlights
Most patients with low back pain (LBP) recover within a few weeks a significant proportion has recurrent episodes or will develop chronic low back pain
This trial will evaluate the effectiveness of screening for risk factors for chronic low back pain followed by a risk tailored intervention to prevent chronic low back pain
The aim of this study is to assess the effectiveness of a brief risk factor screening followed by a risk tailored intervention for patients consulting for acute to subacute low back pain in primary care
Summary
Most patients with low back pain (LBP) recover within a few weeks a significant proportion has recurrent episodes or will develop chronic low back pain. Several mainly psychosocial risk factors for developing chronic LBP have been identified. It is expected that patients seen in primary care will recover within a few weeks a substantial proportion continues to suffer from LBP [6,7]. It is of high relevance to recognize patient characteristics predictive of a chronic or recurrent course of low back pain at an early stage [8]. Two sets of risk factors have demonstrated a particular importance in predicting the course of low back pain. Previous pain episodes [10,11,12], and psychosocial risk factors such as depression, and fear-avoidance beliefs [13,14]
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