Treatment-Based Classification versus Usual Care for Management of Low Back Pain

PURPOSE The primary purpose of this study was to compare two management strategies forSoldiers with low back pain. Both received self-management education which as termed usualcare and one group received immediate physical therapy. The secondary purpose was to comparedownstream healthcare utilization associated with the two management strategies.DESIGN A randomized controlled trialSCOPE Active duty Soldiers with low back pain 1-year follow-up periodMAJOR FINDINGS Improvements favored the early physical therapy group, but only short term 4weeks. At 1 year, although both groups were significantly better, neither was superior.The influence of the self-management education component may have been underestimated, andlikely better than usual care. In addition, while the Oswestry Disability Index isconsidered the best outcome measures for low back pain, it may not be sensitive enough tocapture meaningful change in military service members. Most service members did not qualifyfor the study as their disability score was too low, despite having disabling back pain.This was a Career Development Grant with dual focus on mentoringdeveloping new scientists.