Improving long-term outcomes for chronic low back pain: time for a new paradigm?

These are exciting days for physical therapists who treat people with chronic low back pain (CLBP). Many of the mysteries of this condition are beginning to be uncovered, and it seems as though major breakthroughs are on the way. Advances in neuroimaging, together with increased understanding of the molecular and submolecular events associated with the symptoms of back pain, are helping us reconceptualize the etiologies and mechanisms of this condition. The result of these advances is that physical therapists now have a wide range of potential “treatment packages” that can include patient education, manual therapy, and a wide variety of exercise options for people with CLBP. The question is, “How can long-term, self-management programs become more effective?”