Study summary

Coached self-management beat standard medical care for back pain

PACBACK trial · Randomized trial · Published June 2026, JAMA Internal Medicine

64% vs 55%had their pain impact cut by half or more, self-management vs medical care

What was tested

A personalized self-management program delivered by physical therapists and chiropractors, compared with medical care and with spinal manipulation, in people at risk of long-term back pain.

What they found

64% of the self-management group had at least a 50% drop in pain impact over 10 to 12 months, against 55% with medical care.
Spinal manipulation did no better than medical care.
Adding manipulation to self-management gave no extra benefit.

What it means

Supports teaching people to manage back pain themselves, with coaching, over passive treatments.

University of Pittsburgh ↗ ← Back to the outlook

Last reviewed 2026-11-14 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.