Recommended standards for clinical low-back pain research hold promise for more consistently designed research and, in the long term, better treatment solutions to support those living with chronic low-back pain. The recommendations from the National Institutes of Health Task Force on Research Standards for Chronic Low-Back Pain were published in several leading back pain journals.

Back pain is costly

The Institute of Medicine has estimated that chronic pain affects approximately 100 million adults in the United States, with an estimated annual cost of up to $635 billion. In the United States, low-back pain is the most common cause of job-related disability and a leading contributor to missed work. Back pain is the second most common neurological ailment in the United States — only headache is more common. Each year, low-back pain is estimated to affect approximately 38 percent of people worldwide.

The research community has faced challenges in finding prevention and treatment strategies to reduce the burden of low-back pain, including difficulties comparing the results of previous studies due to issues such as inconsistent terminology and outcome measures. In 2012, the NIH Pain Consortium recognized these barriers to progress and commissioned a task force of experts to recommend solutions. Led by co-chairs Richard A. Deyo, M.D., M.P.H., of the Oregon Health and Science University and Kaiser Center for Health Research, Portland, and Samuel F. Dworkin, D.D.S., Ph.D., of the University of Washington, Seattle, the task force developed field-specific standards through a three-stage process of gathering research, meetings to examine questions in the field, and deliberation.

Standard questions

At the core of the task force’s recommendations is a standard set of data collection questions, or a uniform minimal dataset, intended to increase consistency among studies. The data collection questions include assessing length of time a patient has been experiencing low-back pain, asking about functional limitations, use of various treatment approaches, and impact on a variety of factors such as mood and sleep. A peer-reviewed article detailing the work of the task force and the resulting recommendations and dataset was published in The Journal of Pain (which led the peer-review process), The Clinical Journal of Pain, European Spine Journal, Journal of Manipulative and Physiological Therapeutics, Pain Medicine, Spine, and The Spine Journal.

“The development of a uniform minimal dataset is a major step to driving strong science around low-back pain,” said Josephine P. Briggs, M.D., director of the National Center for Complementary and Alternative Medicine (NCCAM) and NIH Pain Consortium Executive Committee member. “We are hopeful that these research standards will help ensure that the science can be translated into better clinical care.”

Faster progress

“We encourage all researchers who study low-back pain to utilize these standards in their research efforts,” said Stephen I. Katz, M.D., Ph.D., director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). “With the adoption of a more uniform research approach, we hope to see greater and faster progress for preventing and treating this condition.”

The NIH Pain Consortium convened the Task Force on Research Standards for Chronic Low-Back Pain with 16 invited experts from varied disciplines and from scientific and research institutions outside NIH.  The task force was charged with addressing the challenge of comparing data across different studies.

The work of the task force was facilitated by a 12-member NIH Steering Committee led by Partap Khalsa, D.C., Ph.D., of NCCAM and James Panagis, M.D., M.P.H., of NIAMS. In addition to the journal articles, the task force has released a full report of its activities with its recommendations on standards and the uniform minimal dataset on the NIH Pain Consortium website.

View the full report at: http://painconsortium.nih.gov/NIH_Pain_Programs/Task_Force/cLBP_RTF_FullReport.pdf (PDF - 1.54MB)