One in five Australians over the age of 45 experience chronic back pain, with the most common complaint being low back pain. It is estimated that this costs AUD 139 billion annually, including $12 billion in direct healthcare costs. So, what treatments work and which ones don't when it comes to chronic back pain?

The commonly offered treatments for chronic back pain, such as opioids and invasive procedures, often have serious side effects and may not be effective. The World Health Organization recommends that the most crucial approach to addressing back pain and preventing it is through pain education, advice, structured exercise programs, and physical or psychological interventions that target the underlying physical or psychological factors contributing to the ongoing pain.

Two recent Australian trials, RESOLVE and RESTORE, have demonstrated that these guidelines provide a personalised approach to healthcare and are relatively low-cost. The trials implemented pain education and cognitive functional therapy, and they were considered successful.

The interventions examined in these trials involve up to 12 sessions over a period of up to 26 weeks. A single physiotherapy session can cost between $90 and $150, which is unaffordable for many Australians. Moreover, trained clinicians are scarce, particularly in rural areas of Australia. The combination of high cost and limited accessibility makes it difficult for Australians with chronic back pain to avoid turning to opioids and more invasive treatments. These trials emphasise the need to reform Australia's private and public healthcare systems.