Are we making progress?: the tenth international forum for primary care research on low back pain.
METHODS
Synthesis and analysis of presentation and discussion highlights, with a focus on emerging trends and promising new directions in primary care research on low back pain (LBP).


OBJECTIVE
To present a summary of findings, themes, and insights from the Tenth International Forum on Primary Care Research on Low Back Pain, a meeting of researchers designed to share the latest concepts, methods, and results of research on LBP diagnosis, treatment, and disability prevention.


BACKGROUND
Earlier Forum meetings have developed several common themes and general conclusions. These are contrasted with the presentations and discussions at the 10th International Forum.


RESULTS
Major themes included concerns about the epidemic of chronic, disabling LBP, associated treatments, iatrogenesis, and the "LBP medical industrial complex"; the variability and complexity of outcomes and how their importance differed across patients in defining recovery and recurrence; the power of nonspecific effects, expectations, and therapeutic alliance; and the challenges of identifying important therapeutic subgroups. New research addressed early risk factor screening and linked intervention, nonmedical approaches to reframe the LBP problem and avoid unnecessary care, cognitive and behavioral aspects of LBP, and ways to train clinicians to implement these innovations. More appropriate use of longitudinal designs and a greater focus on implementation research was called for.


CONCLUSIONS
Although the field of primary care LBP research often seems to progress slowly, the Forum highlighted several important, promising developments that could substantially improve LBP research and primary care practice.
Center for Disability Research, Liberty Mutual Research Institute for Safety, Hopkinton, MA 01748, USA. glenn.pransky@libertymutual.com
Glenn
G
Pransky
Jeffrey M
JM
Borkan
Amanda E
AE
Young
Daniel C
DC
Cherkin
D035843:Biomedical Research / Q000379:methods* / Q000639:trends; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000628:therapy*; D011320:Primary Health Care / Q000379:methods* / Q000639:trends; D057170:Translational Research, Biomedical / Q000379:methods / Q000639:trends