Two conservative interventions are effective for treating acute and subacute spine pain, new research suggests.
Results from the SPINE CARE randomized controlled trial showed that 6–8 weeks of an individualized postural therapy (IPT) or a multidisciplinary biopsychosocial intervention known as ICE that includes physical therapy were associated with small but statistically significant reductions in pain-related disability at 3 months compared with usual care.
In addition, spine-related healthcare spending did not differ significantly between ICE and usual care. However, IPT significantly increased spending compared with usual care.
“We found that, compared to usual primary care, both interventions reduced pain-related disability at 3 months and that these changes were sustained and clinically meaningful at 12 months ― long after the interventions were over,” lead author Niteesh K. Choudhry, MD, PhD, Brigham and Women’s Hospital and Harvard Medical School in Boston, Massachusetts, told Medscape Medical News.
Spine pain is defined as pain that occurs in the neck or back, the investigators note. It “accounted for more health spending than any other health condition in the US in 2016,” they add.
“Spine pain is an exceptionally common reason for patients to visit their primary care providers,” Choudhry said.
The SPINE CARE trial enrolled 2971 adults (60% women; mean age, 51 years) with back or neck pain that had lasted less than 12 weeks. All were randomly allocated to usual care (no intervention, n = 992) or to the ICE (n = 829) or IPT (n = 1150) interventions.
The “identify, coordinate, and enhance” (ICE) care model stratifies patients on the basis of their risk of progression from acute to chronic pain and addresses biopsychosocial contributors to pain. Low-risk patients received one physical therapy (PT) visit and one coaching call, while higher-risk patients received three PT visits, three coaching calls, and one e-consultation.
The IPT intervention, which was delivered in 8 weekly sessions, focuses on postural realignment. IPT also emphasizes self-efficacy and self-management, including daily exercises to improve postural control, coordination, and muscle balance.