back pain

Internet-Based Low Back Pain Self-Management Program Could Benefit Patients

An internet-based program for patients with low back pain (LBP) which incorporated support for making beneficial behavioral changes could help to improve self-management of LBP, according to the results of a recent study.

Guidelines for the management of LBP in primary care recommend behavioral changes over surgical and pharmacological treatment options. Because of the high prevalence of LBP, “there is a critical need to examine how strategies that promote self-management and physical activity can be effectively implemented,” the researchers explained.

They conducted telephone interviews with participants from a feasibility trial of the SupportBack Internet intervention, a 6-week, self-tailored program which helps patients to self-manage LBP using physical activity as the main strategy. All participants had documented LBP, access to the internet, and were over 18 years of age. Acute, persistent, and recurrent LBP were all included. The participants were randomly assigned to either receive additional support from telephone physiotherapist calls over the course of the study.

Overall, 25% of the participants from the feasibility trial (n = 15) agreed to take part in the interviews. The researchers broke out the interview responses into 6 themes:

  • Perceptions of SupportBack’s design
  • Engaging with the SupportBack intervention
  • Promoting positive thought processes
  • Managing behavior with SupportBack
  • Feeling supported by telephone physiotherapists
  • Severity and comorbidity as barriers

They found that the intervention benefited self-management of LBP in most of the participants, while a small number of participants reported less perceived benefit due to comorbidities, high perceived severity of LBP, or a low relevance due to minor LBP. Telephone appointments with a physiotherapist appeared to add further motivation for behavioral changes.

“This study indicates the feasibility of digital support for the self-management of LBP in primary care with and without telephone support from a physiotherapist. Participants reported being reassured, particularly regarding using physical activity to manage their back pain. Broadly, the intervention appeared to act on key self-regulatory processes likely to impact and support effective self-management,” they concluded.

—Michael Potts

Reference:

Geraghty AWA, Roberts LC, Stanford R, et al. Exploring patients’ experiences of internet-based self-management support for low back pain in primary care. Pain Med. 2020;21(9):1806-1817. https://doi.org/10.1093/pm/pnz312