Back Skills Training Trial (BEST)

The Back Skills Training Trial (BeST) was a large, pragmatic randomised controlled trial that evaluated a cognitive behavioural intervention for patients with persistent (≥6 weeks) nonspecific low back pain in primary care (n=700). This landmark clinical trial was led by Professor Sallie Lamb at the University of Warwick and was commissioned by the National Institute of Health Research Technology Assessment programme.

BeST was a structured group-based programme that aimed to improve physical activity and function through education and targeted training in important self-management skills, such as pacing and goal setting. We trained a range of NHS health professionals to deliver this treatment programme, including nurses, occupational therapists, physiotherapists and psychologists.

Patients who received the BeST programme significantly reduced their disability and pain at 12 months and beyond. Furthermore, participants reported significantly greater treatment satisfaction and improved quality of life. This evaluation also demonstrated that BeST was cost-effective, and it is still one of the most cost effective treatments available for the management of persistent low back pain to date. The full trial results, published in the Lancet, can be found here.

We have developed a comprehensive online programme (iBeST) to train health professionals to deliver this cognitive behavioural programme for low back pain. All BeST materials are available from the online programme, including a detailed treatment manual, and patient information in the form of a workbook and tablet/mobile app.

The BeST online training is now available online via FutureLearn. More information.