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A Back Pain Study

A Model for Integrative Transformation: A Back Pain Group Appointment Program

The following study was published in Alternative Therapies Health Med.


A back pain treatment program was developed for the outpatient, primary care clinic setting. In this pilot study, measured functional status scores improved in a cohort of patients enrolled in the program. The program consists of a series of 5 monthly group appointments and follows a sequential curriculum involving multiple therapeutic modalities. These modalities include exercise, social interaction, motivation/raison d’être, holistic counselling, music, and behavioral modelling. The program provides a forum for the discussion and implementation of complementary and alternative approaches, alongside mainstream approaches, and represents a model of integrative medical practice.

About the Back Pain Group Series

The Back Pain Group Appointment Series program at our institution was developed to address chronic back pain holistically, using exercise, social interaction, motivation/ raison d’être, music, lifestyle coaching, and behavioral modelling, while de-emphasizing medications and surgery. A measure of physical daily function, the RMDQ, was monitored throughout the 5-month series for a group of patients and showed progressive improvement. These results are consistent with other published reports showing improved function with structured exercise interventions.*

Motivation is considered to be a central component of the program. Rather than focusing only on improving health, patients are encouraged to visualize achieving their own personal goals, embodied in the French phrase raison d’être. This motivational concept is outlined as follows: Methods -----> Health ----> Raison d’être

A Sample Assessment

A 56-year-old male came to the low back pain group where he participated in all activities, doing the floor version of exercise routine level 1.

Patient Active Problem List Diagnosis:

  • Knee pain
  • Chronic low back pain
  • Folliculitis
  • Vitamin D deficiency

Physical Exam:

BP, 128/83 mm Hg | Pulse, 74 | Temp (Src), 36.8°C (98.3°F) (oral) | Respiratory, 17 | Height, 1.651 m (5’ 5”) | Weight, 78.382 kg (172 lb, 12.8 oz) | BMI, 28.76 kg/m2 | SpO2, 100%


  • Alert and oriented, no apparent distress.


  • Normal gait, moving all extremities. Psych: Normal affect.

Assessments and Plans:

Low back pain: Patient participated in group discussion, learned standard back exercise regimen, and was assisted with personalizing the regimen to suit individual needs, avoiding any positions causing pain. The regimen was practiced during the appointment. Gentle aerobic exercises and healthy diet were discussed.

Follow-up: As needed or as scheduled previously. He was educated about the diagnosis and treatment plan. Medications were reconciled and he was given a summary of the visit.

In Summary

The program can work for patients suffering from back pain.

Learn more by reading our flyer.

Read the entire study.

*Pahor M. Effect of structured physical activity on prevention of major mobility disability in older adults: The LIFE Study randomized clinical trial. JAMA. 2015;311(23):2387-2396.