Revolutionizing Relief: How Lifestyle Changes Combat Chronic Back Pain Disability

Chronic low back pain is a primary cause of disability globally, and many treatments, including medications, frequently do not provide sustainable relief. Investigators from the University of Sydney’s Centre for Rural Health have discovered a potential remedy. Their research, published in JAMA Network Open, indicated that integrating lifestyle support into back pain treatment could diminish disability and improve quality of life.

The randomized controlled trial involved 346 participants from various regions of Australia, all of whom suffered from chronic low back pain and possessed at least one lifestyle risk element, such as obesity, poor nutritional choices, inactive lifestyles, or smoking. Participants were randomly divided into one of two categories: the “Healthy Lifestyle Program (HeLP)” or standard guideline-based physiotherapy care for managing their low back pain.

The HeLP participants received assistance from physiotherapists, nutritionists, and telephone health advisors who guided them in identifying which lifestyle practices might be impacting their back pain, such as weight, lack of activity, unhealthy eating, inadequate sleep, smoking, or excessive drinking. They were subsequently provided with evidence-based recommendations over a six-month duration to help tackle the lifestyle challenges.

This method demonstrated several advantages compared to standard care, including less disability, with attendees scoring an average of 1.3 points lower on the Roland Morris Disability Questionnaire (where higher scores denote greater disability). Additionally, HeLP participants lost an average of 1.6kg more than those in the control group.

Principal Investigator Associate Professor Chris Williams articulated that the results challenge conventional perceptions of back pain treatment:

“Addressing back pain needs to emphasize more than just the back. Our bodies are not machines; we function more like ecosystems where numerous elements interact and influence how we operate and feel. Back pain is no exception. Thus, when an individual experiences back pain that persists, they should anticipate receiving comprehensive care concerning various health factors, not solely focusing on what is occurring in their spine. This message should be proclaimed from the rooftops.”

Growing numbers of studies have revealed that issues such as bulging discs and joint degeneration seldom account for long-lasting back pain. The issue is that few individuals are informed of this, and even fewer are provided with support to concentrate on the elements that affect long-term pain and disability. An excessive number of patients are referred for surgical interventions or prescribed medications that are ineffective—and may even cause additional harm.”

Associate Professor Chris Williams, University of Sydney

The research emphasizes the necessity for a transition in back pain treatment, moving away from pharmacological solutions and invasive procedures, and focusing more on lifestyle factors that can significantly impact patient outcomes.

Lead author and Senior Research Officer at the University of Sydney, Dr. Emma Mudd, highlighted the real-life implications the program could generate.

“Numerous individuals suffering from chronic back pain express feelings of neglect, often being directed toward high-cost and ineffective interventions without being offered recommended approaches that encourage self-management,” Dr. Mudd stated.

“By redirecting the focus to incorporate lifestyle modifications and delivering simple, supportive measures, patients are empowered to manage their pain actively. This strategy not only alleviates their symptoms but also enhances their overall quality of life.”

The researchers are convinced that lifestyle-integrated care, similar to the HeLP initiative, could benefit individuals beyond just pain management, potentially lowering risks for additional chronic illnesses. Nonetheless, Dr. Mudd pointed out that worldwide guidelines have yet to fully adopt this methodology:

“Our study may affect future revisions to back pain guidelines. Patients appreciated the comprehensive support, and the results speak for themselves.”

“Health professionals treating back pain should reflect on how they incorporate lifestyle support into their daily practice. There doesn’t seem to be a prescribed right or wrong approach to this, as long as the patient feels heard and involved in the decision-making process,” remarked Associate Professor Williams.