According to the article, low back pain is highly prevalent in the United States and is extremely costly in terms of health care expenditures, lost wages and disability. Acute low back pain is defined as symptoms lasting less than three months, accounts for more than 90 percent of all back pain and nearly half of the associated cost. A recently conducted national survey indicated that compared to whites, African American men and women in the United States reported losing more workdays for greater lengths of time because of low back pain.

Teresa M. Damush, Ph.D., of Indiana University, Indianapolis, and colleagues developed a self-management program for poor, urban, primary care patients with acute low back pain that focuses on boosting confidence in order to increase the patient's motivation to incorporate suggestions for improving low back pain into their daily activities. According to the authors, programs that emphasize increasing patient confidence are consistently successful at improving and maintaining health outcomes and reducing health care use among patients with various chronic conditions.

The researchers conducted a randomized, controlled trial comparing their self-management program with usual care among 211 patients who visited a physician for acute low back pain. Patients were enrolled at university-affiliated neighborhood health centers and an emergency department of an inner-city public teaching hospital.

Patients in the self-management program attended three group sessions that emphasized treatment recommendations, behavioral changes, increased self-efficacy (confidence), and reducing negati
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Contact: Mary Hardin
317-274-7722
JAMA and Archives Journals
24-Nov-2003