Low back pain is one of the biggest health problems of our time. In 2020, 619 million people worldwide were affected, and this number is expected to rise to 843 million by 2050.
The impact is also substantial in the Netherlands: back pain costs society around €3.5 billion each year, mainly due to productivity losses and recurring complaints. Seven out of ten patients experience back pain again within a year, even after treatment by a physiotherapist.
Something can be done about this. An Australian study showed that a structured preventive approach can significantly reduce the risk of recurrent low back pain and is cost-effective. The intervention combines supervised walking programs, personal health coaching, and targeted education, under the supervision of physiotherapists. As a result, patients remain active for longer, learn to cope better with their complaints, and experience fewer relapses.
Practically applicable prevention program
The research project “Prevention and Education against Chronic Episodes of Low Back Pain” - led by university lecturer in methodology and biostatistics Esther Maas, Professor of Physiotherapy Raymond Ostelo, and postdoctoral researcher in the field of physiotherapy and musculoskeletal complaints Nynke Swart - will adapt and test this successful approach for Dutch healthcare practice. The team will use proven implementation strategies (“Replicating Effective Programs”) and the RE-AIM framework, which examines reach, effectiveness, adoption, implementation, and sustainability. The result will be a practically applicable prevention program, complete with training materials for physiotherapists and accessible information for patients.
Physiotherapy not only helps treat acute back complaints but also clearly adds value in preventing chronic and recurrent pain. By focusing early on physical activity, coaching, and education, long-term complaints and healthcare costs can be reduced. Moreover, this approach increases patients’ participation in work and daily life.
The project therefore provides important answers to questions from the Physiotherapy Knowledge Agenda 2023. It demonstrates which preventive strategies are effective, how evidence-based interventions can be successfully implemented in practice, and what the (cost-)effectiveness of physiotherapy is compared with a wait-and-see approach or other forms of care.
Fewer recurrences of back pain mean less absenteeism, lower healthcare costs, and above all a better quality of life for hundreds of thousands of people in the Netherlands. With this intervention, prevention may gain a permanent place within physiotherapeutic care for low back pain.
The project is funded by ZonMW.