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University of Minnesota to lead $14M national NIH study of non-drug therapies to prevent chronic back pain

September 20, 2017

The University of Minnesota will receive $11.2M, with an additional $2.8M awarded to the University of Washington

MINNEAPOLIS/ST. PAUL (September 20, 2017) – The University of Minnesota’s Earl E. Bakken Center for Spirituality & Healing has been awarded the first phase of a cooperative $11.2 million grant from the National Institutes of Health (NIH) to study non-drug approaches to prevent chronic low back pain, which could lead to reduced opioid use.

Funding will support a Clinical Coordinating Center at the University of Minnesota and the University of Pittsburgh for a national multi-site clinical trial examining the effectiveness of spinal manipulation therapies (SMT) and supported self-management (SSM) compared to usual medical care.

An additional $2.8 million was allocated for a Data Coordinating Center (DCC) led by Patrick Heagerty, Ph.D., at the University of Washington's School of Public Health to provide data management and statistical support for the study.

“Identifying effective management and prevention strategies for back pain is a huge challenge,” said Gert Bronfort, D.C., Ph.D., lead investigator and professor in the Center’s Integrative Health and Wellbeing Research Program. “By examining promising, safe and accessible non-drug treatments like spinal manipulation therapies and supported self-management, we hope to prevent acute low back pain from becoming chronic and to reduce over-reliance on medications and unnecessary surgeries,” Bronfort said.

According to the World Health Organization, low back pain is the leading cause of disability worldwide. One study of back pain patients in the Journal of the American Board of Family Medicine found more than half of the patients used opioids to treat pain.

“Back pain is right in the center of the opioid crisis,” said Roni Evans, D.C., Ph.D., a co-investigator on the study and Director of the Integrative Health and Wellbeing Research Program. “We need to take a step back and consider other options which truly address patients’ needs and enable them to safely and effectively manage their pain.”

The study, called Spinal Manipulation and Patient Self-Management for Preventing Acute to Chronic Back Pain Trial (PACBACK), is one of the largest studies funded by the NIH’s National Center for Complementary and Integrative Health focused on back pain.

The researchers will compare SMT and SSM to usual medical care, which includes prescription medications for the care of acute low back pain in adult patients at increased risk of becoming chronic. SSM encompasses self-care strategies that address the biopsychosocial aspects of back pain through the use of behavioral and coping strategies, mind-body approaches, lifestyle advice and pain education.

Bronfort says about one in five cases of new low back pain will become longstanding or chronic. The study aims to explore how strategies like SMT and SSM could be effective to treat new episodes of back pain, intervening before it become a long-term problem.

“An important part of this study is to explore how chiropractors and physical therapists can play a bigger role in preventing chronic low back pain by having them deliver supported self-management alongside their physical treatments,” Bronfort said.

"For more than two decades, the Center has played a pivotal role in improving the health and wellbeing of people, organizations and communities locally, nationally and internationally," said Center Director Mary Jo Kreitzer, Ph.D., R.N. "This study aligns with the Center's focus on teaching people how to proactively take charge of their health and wellbeing."

The study has brought together some of the most experienced researchers in the low back pain field representing medical, osteopathy, psychology, physical therapy and chiropractic professions.

Collaborators include:

  • University of Minnesota: Gert Bronfort, D.C., Ph.D. (principal investigator of the Clinical Coordinating Center); John Connett, Ph.D.; Roni Evans, D.C., Ph.D.; Brent Leininger, D.C., M.S.; Florin Orza, M.D.; Joyce Wahr, M.D.
  • University of Pittsburgh: Anthony Delitto, Ph.D., P.T., (co-principal investigator for the Clinical Coordinating Center); Carol Greco, Ph.D., Natalia Morone, M.D., M.S.; Mike Schneider D.C., Ph.D., (co-principal investigator for the Clinical Coordinating Center); Joel Stevans, D.C., Ph.D.
  • University of Washington: Patrick Heagerty, Ph.D., (principal investigator for the Data Coordinating Center); Dennis Turk, Ph.D.
  • Duke University: Steven George, P.T., Ph.D.
  • Oregon Health and Sciences University: Roger Chou, M.D.
  • University of North Texas: John Licciardone, D.O., M.S., M.B.A. 

A total of 1180 patients will take part in the study, with enrollment beginning spring 2018.

Funding information: Clinical Coordinating Center (1UG3AT008769-01A1) -- Awarded to University of Minnesota with University of Pittsburgh. Principal Investigator, Gert Bronfort, DC, PhD, University of Minnesota; Co-Principal Investigators, Anthony Delitto, PT, PhD, Michael Schneider, DC, PhD, University of Pittsburgh.

Data Coordinating Center (1UG3AT008767-01A1) -- Awarded to the University of Washington. Principal Investigator: Patrick Heagerty.

About the Earl E. Bakken Center for Spirituality & Healing: The University of Minnesota's Earl E. Bakken Center for Spirituality & Healing enriches health and wellbeing by providing exemplary education, conducting rigorous research, advancing integrative models of care, and delivering innovative solutions to organizations and communities. Learn more about the Center at


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