Video: Person-Centered Treatment of Chronic Low Back Pain

Chronic low back pain affects millions of people in America and is one of the most common causes of poor quality of life and limited movement. However, for many of these individuals, current treatment options for their pain are ineffective. Developing effective and safe treatments for chronic low back pain is a top priority of the Helping to End Addiction Long-term^® Initiative, or NIH HEAL Initiative^®, and particularly its Back Pain Consortium (BACPAC) Research Program. But, as Gwendolyn Sowa, M.D., Ph.D., at the University of Pittsburgh explains, that’s not easy. “Historically, we have thought of treatment for low back pain as a one-size-fits-all approach, but that hasn’t worked that well. What we’re learning is that people’s experiences of chronic low back pain are very different.”

Sowa and her team at the University of Pittsburgh Mechanistic Research Center are studying a wide range of factors that may influence how people experience pain. These analyses measure obvious factors that may contribute to low back pain, like how people move as they perform daily activities. But Sowa’s team also looks at less obvious influences, such as lifestyle behaviors (e.g., physical activity), or mental health problems such as depression or anxiety that often occur in people with chronic pain and can affect how a person experiences pain.

Says Sowa, “We’re exploring all aspects of low back pain, and that helps us identify new targets for treatments as well as new ways that we can approach treatment."

Sowa’s study is part of the HEAL-funded Biomarkers for Evaluating Spine Treatments (BEST) clinical trial that aims to learn which type or sequence of back pain treatments are most effective for people based on their individual characteristics. The trial uses a research strategy that can adapt to the responses and needs of the study participant to find the optimal treatment approach for that person.

The BEST trial, and the NIH HEAL Initiative in general, bring together researchers from a variety of institutions and specialties and with widely differing perspectives. For Sowa, this is a huge advantage as it allows researchers to learn from each other as well as from people with lived experience. “We can approach this complicated problem in a much more sophisticated way than we could in our individual silos,” she says. “It’s going to help us uncover new avenues for the development of new treatments. And I am very confident that many of those approaches will find their way into the clinics.”

Watch Sowa’s full video interview.