What do we mean by 'self-management' for chronic low back pain? A narrative review

Eur Spine J. 2023 Dec;32(12):4377-4389. doi: 10.1007/s00586-023-07900-4. Epub 2023 Aug 28.

Abstract

Background: Chronic low back pain (CLBP) is a highly prevalent musculoskeletal condition affecting 60-80% of the general population within their lifetime. Given the large numbers of people affected, self-management approaches have been introduced as a way to manage this condition with endorsement by the national institute for health and care excellence. Interventions are often termed self-management without defining either content or goals. Our study sought to determine the content, characteristics, and evidence for self-management of CLBP.

Methods: This narrative review was conducted using a systematic approach to search journal articles in English that focused on CLBP self-management. MEDLINE, EMBASE, CINAHL, and PsycINFO databases were used to identify publications with terms relating to back pain and self-management from January 2016 until January 2022.

Results: In total, 15 studies were found suitable for inclusion in the review. Core components of self-management strategies include exercise, education, and psychological interventions, but there was a lack of consistency with respect to content. Intervention characteristics were either under-reported or varied. Furthermore, outcome measures used to assess these self-management programmes were diverse, mainly focusing on functional disability and pain intensity.

Conclusions: Inconsistencies in the content of self-management interventions, intervention characteristics, and outcome measures used for assessing self-management programmes were found across the literature. Current self-management approaches do not consider the complex biopsychosocial nature of CLBP. A consensus on the key components of self-management interventions, and how they should be evaluated, will pave the way for research to determine whether self-management can effectively manage CLBP.

Keywords: Chronic low back pain; Component; Evidence; Outcome; Self-management.

Publication types

  • Review

MeSH terms

  • Chronic Pain* / psychology
  • Chronic Pain* / therapy
  • Humans
  • Low Back Pain* / epidemiology
  • Outcome Assessment, Health Care
  • Self-Management* / methods