Center for Musculoskeletal Research

Johns Hopkins University School of Medicine

Clinical Trials

Optimizing Treatment Sequencing for Patients with Chronic, Nonspecific Low Back Pain

Low back pain (LBP) is a nearly universal human experience. LBP is common and can be very burdensome for impacted individuals. The tremendous burden imposed by LBP on health and well‐being was recently highlighted in the Global Burden of Disease initiative of the World Health Organization. Of 291 conditions studied, LBP ranked first in terms of associated disability and overall burden in detracting from perfect health. LBP results in more disability and overall burden for affected individuals than conditions such as depression, Alzheimer’s disease, substance abuse disorders, or arthritis. The high ranking of LBP reflects the number of people who experience the condition and the amount of pain, functional loss, and overall decrease in quality of life that individuals with LBP experience.

Despite intensive and expensive treatment efforts, the number of individuals with chronic LBP continues to increase. From 2000 ‐ 2007 the prevalence of chronic LBP increased from 4% to 6% of the U.S. adult population. Ineffective LBP management by healthcare systems is also contributing to the crisis of opioid over‐prescribing. Chronic LBP is the most common non‐cancer pain condition for which opioids are prescribed despite a lack of evidence for beneficial effects.

Our goal is to improve the healthcare provided to patients with cLBP by investigating augmented PT or CBT treatment and the sequencing of follow-up options for non-responders. This study is funded by the Patient Centered Outcome Research Institute (PCORI). For more information, please visit our study web-site.



Genetic Disorders