PainRelief.com: What are the main findings?
Response: The main findings were that those who received supported self-management with and without spinal manipulation had less disability over one year than those receiving medical care.
PainRelief.com: What should readers take away from your report?
Response: Supported self-management delivered by physical therapists and chiropractors should be considered for patients with acute and subacute low back pain as a viable first step instead of medications. This makes it more likely they will gain the tools to better manage their pain themselves, with less reliance on medications over the long term. This is important given the side effects associated with many pain-relieving medications.
PainRelief.com: What recommendations do you have for future research as a result of this study?
Response: Future studies should address the cost effectiveness of these interventions as well as addressing best ways to train physical therapists and chiropractors to effectively deliver self-management interventions congruent with reimbursement models.
Any disclosures: The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Citation: Bronfort G, Meier EN, Leininger B, et al. Spinal Manipulation and Clinician-Supported Biopsychosocial Self-Management for Acute Back Pain: The PACBACK Randomized Clinical Trial. JAMA. Published online December 29, 2025. doi:10.1001/jama.2025.21990
https://jamanetwork.com/journals/jama/article-abstract/2843255
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Last Updated on December 29, 2025 by PainRelief.com