Chronic low back pain (CLBP) is highly prevalent and complex to treat, with modest effect sizes and short-term effects for conservative and pharmacological strategies in reducing pain and disability, urging the need for improvement. My successfully completed PhD research showed that pain neuroscience education plus cognition-targeted exercise was superior to usual care to improve pain, symptoms of central sensitization, disability, pain cognitions, mental and physical health (medium to large effect sizes) in patients with CLBP. Yet,
neither this new conservative approach nor current treatments for CLBP address overweight or obesity, an important yet seldom addressed comorbidity.
Overweight and obesity are associated with more severe and debilitating CLBP. Overweight and obesity are not only related to CLBP persistence, but also to higher rates of health care seeking.
Unfortunately, current treatments for CLBP apply a ‘one-size-fits-all’ approach and do not address comorbidities like overweight/obesity. A small-scale uncontrolled proof of concept study found that obese people with CLBP (n=46) not only lost bodyweight but also experienced 48% less pain following a nonsurgical weight loss program.
Therefore, within the current innovative project I propose examining the added value of a behavioral weight reduction program to current best evidence rehabilitation (pain neuroscience education plus cognition-targeted exercise therapy) for CLBP.