Developing and Testing New Treatments For Low Back Pain

Pain provides a warning of threat to body tissue. This protective mechanism is critical for survival as it motivates defensive actions to remove the source of the threat. Unfortunately for many people, pain can become ‘stuck’, persisting long past the time when it has served any useful purpose of warning of harm. These people have chronic pain, a disabling and highly distressing condition.

Dr James McAuley’s research is focused on low back pain, the most common chronic pain and the leading cause of disability. Four million Australians have low back pain and around 40% of these will develop chronic low back pain. There are no effective treatments for people who have a new episode of low back pain, and treatments for people who have chronic low back pain lead to only small improvements in pain and disability.

Dr McAuley’s research program aims to develop and test new treatment approaches to prevent people from developing chronic low back pain and to more effectively help those who suffer from it. His research has led to the development a five-item prognostic tool, called MYBACK, which can be used to identify the risk of developing chronic low back pain. Early, accurate information on the risk of developing chronic low back pain provides the opportunity for clinicians to advise their patients on whether or not further treatments are necessary.

This brief, easy-to-use online risk calculator has been made freely available to healthcare practitioners and researchers at myback.neura.edu.au. MYBACK can be used to target interventions for those most in need -those who are at high risk of developing chronic low back pain.

Dr McAuley’s research program is testing this approach in two randomised controlled trials. Firstly, in PREVENT he is testing whether a structured pain education program can reassure patients with a new episode of low back pain and reduce the risk of developing chronic pain. In ZTOP Dr McAuley is testing whether improving sleep quality can lead to reductions in pain intensity and the risk of developing chronic low back pain.

Chronic low back pain is the most problematic type of chronic pain. Most of the $8 billion per year spent on treatments for low back pain is spent on trying to manage chronic low back pain. Unfortunately, the effects of most treatments are only modestly effective. The new treatment program, RESOLVE, combines two promising treatments – a pain education program and sensorimotor retraining. RESOLVE is being testing in a blind, randomised controlled trial to determine whether these promising interventions, either alone or in combination, can reduce pain intensity and disability.

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