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Low back pain (LBP) is a major public health problem. Risk factors for the development and persistence of LBP include physical and psychological factors. However, most research activity has focused on physical solutions including manipulation, exercise training and activity promotion.This randomised controlled trial will establish the clinical and cost-effectiveness of a group programme, based on cognitive behavioural principles, for the management of sub-acute and chronic LBP in primary care. Our primary outcomes are disease specific measures of pain and function. Secondary outcomes include back beliefs, generic health related quality of life and resource use. All outcomes are measured over 12 months. Participants randomised to the intervention arm are invited to attend up to six weekly sessions each of 90 minutes; each group has 6-8 participants. A parallel qualitative study will aid the evaluation of the intervention.In this paper we describe the rationale and design of a randomised evaluation of a group based cognitive behavioural intervention for low back pain.

Original publication




Journal article


Bmc musculoskeletal disorders

Publication Date





Warwick Clinical Trials Unit, Health Sciences Institute, Warwick Medical School, University of Warwick, Coventry, UK.


Back Skills Training Trial (BeST) Team, Humans, Low Back Pain, Pain Measurement, Disability Evaluation, Clinical Protocols, Fear, Cognitive Therapy, Research Design, Patient Selection, Quality of Life, Adolescent, Adult, Aged, Middle Aged, Cost-Benefit Analysis, Primary Health Care, Outcome Assessment (Health Care), Patient Acceptance of Health Care, Female, Male, United Kingdom