Research Snapshot: New Survey Enables Incorporation of Personal Preferences in Treatment for Chronic Low Back Pain

• Since no single treatment for chronic low back pain is effective for all people living with the condition, current research focuses on developing personalized treatment strategies.
• HEAL-funded researchers have developed a new survey to measure the preferences of people living with chronic low back pain and guide treatment.
• In a recently published study, data from the CAPER TREATMENT survey show that overall, patients are willing to accept certain risks for treatments with the best chances to relieve their pain, lengthen the period of pain relief, and improve physical activity.

Chronic low back pain (cLBP) is a major health problem, affecting almost one in four Americans. No single treatment for cLBP works for every person living with the condition. Rather, some research has shown that giving people with low back pain their preferred treatment—which differs by individual—may significantly reduce pain and disability. As such, clinical research that focuses on personalized treatments is especially important. The CAPER TREATMENT survey—developed with support from the National Institute of Arthritis and Musculoskeletal and Skin Diseases through the NIH HEAL Initiative^®— is designed to be used to personalize treatment options for cLBP based on the preferences related to possible benefits and risks.

The CAPER TREATMENT survey presents people with chronic low back pain with several different non-surgical treatment scenarios. The survey offers two options at a time and individuals continuously select which of the two treatment options they would prefer. Each different treatment option contains specific information on the time commitment, chance of pain relief, length of pain relief, and risk of negative experiences, among other issues. 

Researchers analyzed data from more than 200 participants, most of whom have already tried many different treatment options, to explore what cLBP patients value most when selecting a treatment. Unsurprisingly, they found that overall, the patients preferred treatments that were:

• Most likely to deliver pain relief.
• Expected to relieve pain for a longer period of time.
• Likely to increase their physical activity.

However, the results also showed some differences in treatment preferences based on sex, socioeconomic status, and pain level.  For example, people with lower income selected treatments less often that required a higher time commitment. And females favored treatments that offered more individual support from a provider slightly more than males did.

Future larger and more comprehensive studies are planned that will offer more insight into patient treatment preferences across a more diverse population. Ultimately, the CAPER TREATMENT survey could also be incorporated in clinical decision-making for more personalized treatment for millions of cLBP patients.