By John Salak –
Low back pain is a global problem with far-reaching physical, mental health and economic consequences. In fact, close to 620 million people suffer from it worldwide, which includes more than 30 percent of American adults. Not surprisingly, those 65 and older are at particular risk.
As the world’s leading cause of disability, low back pain in the U.S. alone leads to more than 80 million work days lost and tens of billions of dollars in related health care costs.
Treatments, which include physical therapies, medical procedures and pharmaceuticals, can ease the discomfort but often fail to provide long-term relief. Researchers from the University of Sydney now report, however, that incorporating lifestyle support and changes into back pain care could reduce disability and enhance quality of life.
The Australian team came to its conclusions after conducting a randomized controlled trial that included 346 participants, all of whom had chronic low back pain and at least one lifestyle risk factor, such as obesity, poor diet, sedentary habits or smoking. Participants were randomly assigned to one of two groups. These included the “Healthy Lifestyle Program (HeLP)” or standard guideline-based physiotherapy care for managing low back pain.
The HeLP participants received support from physiotherapists, dietitians and telephone health coaches to identify which lifestyle habits might be influencing their back pain, such as weight, inactivity, poor diet, poor sleep, smoking or excessive alcohol use. They were then provided evidence-based advice over a six-month period to help address the lifestyle challenge.
The approach yielded several benefits compared to standard care. These gains included reduced disability and improved weight loss and weight management.
“Resolving back pain needs to focus on more than the back. Our bodies are not like machines, we are more like ecosystems where lots of factors interact and determine how we work and feel. Back pain is no different,” explained Chief Investigator Associate Professor Chris Williams. “So, when someone has back pain that doesn’t get better, they should expect to get comprehensive care about a range of health factors, not just a focus on what’s happening in their spine. We should shout this message from rooftops.”
A growing number of studies underscore the fact pathologies like bulging discs and joint degeneration are rarely the cause of long-term back pain.
“The problem is that few people are told this, and even fewer are given support to focus on the things that influence long-term pain and disability. Too many people are referred for surgery or prescribed medications that don’t help—and may even lead to more harm,” Williams added.
The study’s results underline the need to shift treatment of back pain away from pills and procedures and towards addressing the lifestyle factors that can make a sustained difference.
“Many people with long-term back pain tell us they feel abandoned, often being referred for high cost and ineffective treatments without being offered recommended treatments that promote self-management,” noted Senior Research Officer Dr. Emma Mudd, the study’s lead author. “By shifting the focus to include lifestyle changes and providing simple, supportive interventions, patients feel empowered to take control of their pain. This approach not only improves their symptoms but also enhances their overall quality of life.”
The researchers stressed that lifestyle-integrated care, like the HeLP program, could have far-reaching benefits that go beyond pain management for patients. These programs could potentially reduce the risk of other chronic diseases.
“Our research could influence future updates to back pain guidelines,” Mud said. “Patients valued the holistic support, and the outcomes speak for themselves.”
