title: Pain education to prevent chronic low back pain: a study protocol for a randomised controlled trial.
abstract: BACKGROUND
  Low back pain (LBP) is the leading cause of disability worldwide. Of those patients who present to primary care with acute LBP, 40% continue to report symptoms 3 months later and develop chronic LBP. Although it is possible to identify these patients early, effective interventions to improve their outcomes are not available. This double-blind (participant/outcome assessor) randomised controlled trial will investigate the efficacy of a brief educational approach to prevent chronic LBP in 'at-risk' individuals.
  
  
  METHODS
  Participants will be recruited from primary care practices in the Sydney metropolitan area. To be eligible for inclusion participants will be aged 18-75 years, with acute LBP (<4 weeks' duration) preceded by at least a 1 month pain-free period and at-risk of developing chronic LBP. Potential participants with chronic spinal pain and those with suspected serious spinal pathology will be excluded. Eligible participants who agree to take part will be randomly allocated to receive 2×1 h sessions of pain biology education or 2×1 h sessions of sham education from a specially trained study physiotherapist. The study requires 101 participants per group to detect a 1-point difference in pain intensity 3 months after pain onset. Secondary outcomes include the incidence of chronic LBP, disability, pain intensity, depression, healthcare utilisation, pain attitudes and beliefs, global recovery and recurrence and are measured at 1 week post-intervention, and at 3, 6 and 12 months post LBP onset.
  Ethical approval was obtained from the University of New South Wales Human Ethics Committee in June 2013 (ref number HC12664). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conference meetings.
  
  
  BACKGROUND
  https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12612001180808.
authors.affiliation: School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia Neuroscience Research Australia, Sydney, New South Wales, Australia.
authors.forename: Adrian C
authors.initials: AC
authors.lastname: Traeger
authors.affiliation: Neuroscience Research Australia, Sydney, New South Wales, Australia Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia.
authors.forename: G Lorimer
authors.initials: GL
authors.lastname: Moseley
authors.affiliation: Neuroscience Research Australia, Sydney, New South Wales, Australia.
authors.forename: Markus
authors.initials: M
authors.lastname: Hübscher
authors.affiliation: School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia Neuroscience Research Australia, Sydney, New South Wales, Australia.
authors.forename: Hopin
authors.initials: H
authors.lastname: Lee
authors.affiliation: School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia Neuroscience Research Australia, Sydney, New South Wales, Australia.
authors.forename: Ian W
authors.initials: IW
authors.lastname: Skinner
authors.affiliation: Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Nicholas
authors.affiliation: Institute of Public Health, University of Heidelberg, Heidelberg, Germany.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Henschke
authors.affiliation: Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Refshauge
authors.affiliation: Centre for Education and Research on Ageing, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Blyth
authors.affiliation: Arthritis Care UK National Primary Care Centre, Keele University, North Staffordshire, UK.
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Main
authors.affiliation: Department of Health Professions, Macquarie University, Sydney, New South Wales, Australia.
authors.forename: Julia M
authors.initials: JM
authors.lastname: Hush
authors.affiliation: Department of Rehabilitation Medicine, Greenwich Hospital, Sydney, New South Wales, Australia.
authors.forename: Garry
authors.initials: G
authors.lastname: Pearce
authors.affiliation: School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia Neuroscience Research Australia, Sydney, New South Wales, Australia.
authors.forename: James H
authors.initials: JH
authors.lastname: McAuley
mesh_terms: D004311:Double-Blind Method; D006801:Humans; D017116:Low Back Pain / Q000517:prevention & control*; D010353:Patient Education as Topic; D011320:Primary Health Care; D012107:Research Design
keywords: Pain Management; Preventive Medicine; Primary Care