A RECENT randomized clinical trial has demonstrated that incorporating healthy lifestyle care into chronic low back pain management can provide small but meaningful improvements in disability, weight loss, and quality of life. The study sheds light on the benefits of integrating lifestyle modifications with current guideline-based physiotherapy care.
Conducted in Australia from 2017 to 2020, the trial involved 346 participants with activity-limiting chronic low back pain and at least one lifestyle risk factor, such as obesity, poor diet, physical inactivity, or smoking. Participants were divided into two groups: one receiving guideline-based care alone and the other undergoing the Healthy Lifestyle Program (HeLP), which combined physiotherapy with lifestyle-focused interventions.
At 26 weeks, patients in the HeLP group showed a statistically significant reduction in disability, with a mean difference of −1.3 points on the Roland Morris Disability Questionnaire (RMDQ) compared to the guideline-only group. Importantly, patients who adhered to the HeLP intervention experienced even larger reductions in disability, with a mean improvement of −5.4 points.
The study also found that the HeLP group achieved modest weight loss (an average of 1.6 kg) and reported improved quality of life, particularly in physical functioning. These results underscore the potential for targeting lifestyle risks as part of a comprehensive approach to managing chronic low back pain.
While the improvements observed were modest, they highlight the feasibility and safety of integrating lifestyle care with traditional treatments. This dual approach not only addresses the underlying causes of chronic pain but also offers an opportunity to mitigate other chronic disease risks, such as obesity and physical inactivity.
For healthcare providers, this research emphasizes the importance of considering lifestyle factors in chronic back pain management. By incorporating dietetic support, exercise counseling, and health coaching, clinicians may help patients achieve better outcomes while promoting overall health and well-being.
This study represents a step forward in bridging lifestyle medicine with evidence-based clinical guidelines, offering a multidimensional solution to a persistent healthcare challenge.
Reference: Mudd E et al. Healthy Lifestyle Care vs Guideline-Based Care for Low Back Pain. JAMA Netw Open. 2025;8(1):e2453807.
Anaya Malik | AMJ
