Clinician-supported biopsychosocial self-management (SSM) significantly reduced low back disability over 12 months compared to standard medical care.
Spinal manipulation therapy (SMT) alone did not show a statistically significant difference in disability or pain intensity compared to guideline-based medical care.
Combining spinal manipulation with supported self-management did not provide additional benefits over self-management alone.
While disability scores improved in the self-management groups, pain intensity remained largely unchanged across all treatment arms, highlighting a dissociation between functional recovery and pain relief.
Background: The Burden of Low Back Pain and the Chronicity Risk
