Participation in a self-management program decreases symptoms associated with low back pain and increases confidence in managing low back pain symptoms for inner city patients, according to a recent study funded by the Department of Health and Human Services' National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and the Department of Veteran Affairs.

The study, carried out by Teresa Damush, Ph.D., and others at the Indiana University School of Medicine, initially involved 211 patients with acute low back pain (symptoms lasting less than three months) from inner city neighborhood health centers and the emergency department of a public teaching hospital. Patients were randomly assigned to participate in a self-management program or to receive standard care. The self-management program included three in-person classes, handouts, audiotapes, physician letters of support and telephone follow-up. Classes involving goal setting, problem solving, social support, exercise and back education were also given. The standard care group received medications, back exercise sheets and referrals to health care specialists as needed.

After four months, the 76 patients remaining in the self-management program reported improved emotional functioning (less anxiety and depression), less low back pain, less fear of physical activity and movement, and more confidence in managing back pain symptoms compared with the 87 patients remaining in the standard care group.

Despite the high prevalence of back pain in the United States, research on reducing back pain disability in socioeconomically vulnerable patients has been lacking. Self-management strategies show promise as a tool to improve the quality of life for selected individuals who experience acute low back pain.

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Damush T, Weinberger M, Perkins S, Rao J, Tierney W, Qi R, and Clark D. Randomized trial of a self-management program for primary care patients with acute low back pain: Short-term effects. Arthritis Care & Research 2003;49(2):179-186.