Spinal Manipulation and Patient Self-Management for Preventing Acute to Chronic Back Pain (PACBACK)

  • End date
    Sep 21, 2023
  • participants needed
  • sponsor
    University of Minnesota
Updated on 4 October 2022
chronic pain
back pain
secondary prevention
manipulative therapy
pain relieving


The long-term objective is to reduce overall low back pain (LBP) burden by testing scalable, first-line, non-pharmacologic strategies that address the biopsychosocial aspects of acute/sub-acute LBP and prevent transition to chronic back pain.

The US is in the midst of an unprecedented pain management crisis. LBP is the most common chronic pain condition in adults and the leading cause of disability worldwide. Guidelines have recommended non-pharmacologic treatments like spinal manipulation and behavioral approaches for LBP for nearly a decade, yet uptake and adherence has been poor. Moreover, little is known about the role of these treatments in the secondary prevention of chronic LBP (cLBP), especially for patients with biopsychosocial risk factors. With burgeoning costs, mounting evidence of ineffectiveness, and harms of commonly used drug treatments, including opioids, there is a critical need for research on non-pharmacological treatments for cLBP prevention that can be readily translated to practice.

Condition Acute Pain, Low Back Pain, Mechanical
Treatment Standard Medical Care (SMC), Supported-Self Management (SSM), Spinal Manipulation Therapy (SMT), SMT + SSM
Clinical Study IdentifierNCT03581123
SponsorUniversity of Minnesota
Last Modified on4 October 2022


Yes No Not Sure

Inclusion Criteria

At least 18 years of age
Acute or sub-acute low back pain
Average low back pain severity ≥3 on the 0-10 numerical rating scale over 7 days
Medium or high risk for persistent disabling back pain according to the STarT Back screening tool
Ability to read and write fluently in English

Exclusion Criteria

Non-mechanical causes of low back pain
Contraindications to study treatments (e.g,. surgical fusion of lumbar spine)
Active management of current episode of low back pain by another healthcare provider
Serious co-morbid health condition that either requires medical attention or has a risk for general health decline over the next year
Pregnancy, current or planned during study period and nursing mothers
Inability or unwillingness to give written informed consent
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Additional screening procedures may be conducted by the study team before you can be confirmed eligible to participate.

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If you are confirmed eligible after full screening, you will be required to understand and sign the informed consent if you decide to enroll in the study. Once enrolled you may be asked to make scheduled visits over a period of time.

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Complete your scheduled study participation activities and then you are done. You may receive summary of study results if provided by the sponsor.

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