Managing low back pain

Published Date: 27 Feb 2019

Back Skills Training (BeST) is a new evidence-based treatment for patients with low back pain which uses cognitive-behavioural strategies (a type of therapy that focuses on how thoughts, beliefs and attitudes affect feelings and behaviour) to teach patients how to improve physical activity as well providing life-long skills to self-manage their low back pain.

Low back pain is the leading cause of disability worldwide – affecting nearly one in ten people. Low back pain can be debilitating and life-changing, reducing people's ability to work, function normally and enjoy life.

In 2009, the direct costs of low back pain to the NHS were estimated at £2.8 billion.

Research involving over 700 patients with low back pain has shown BeST significantly reduces disability and pain compared to conventional treatments. The benefits have been shown to last up to 36 months after treatment and significantly improve patient’s quality of life and satisfaction.

BeST can be delivered to groups of patients at the same time, by a wide range of health care professionals. Making BeST not only clinically effective but also highly cost-effective. Especially compared to current recommended treatments.

Yet, to get the BeST programme into common use across the NHS would take a huge amount of time, effort and money using traditional face-to-face workshops to train healthcare professionals, such as GPs, physiotherapists and nurses.

To overcome this, an online education package was tailored to include proven strategies to overcome these barriers, supporting healthcare professionals to change their clinical practice and deliver this new treatment to their patients.

Delivering the BeST training online to healthcare professionals has three main advantages:

  1. Costs would be far lower.
  2. Training would be much more accessible across the NHS.
  3. Uptake of this approach across the NHS could be far more rapid.

All of which work together to bring the benefits of BeST to more patients sooner.

Initially the project aimed to:

  • improve the management of low back pain patients in the NHS by increasing access to training in BeST;
  • optimise an accessible online learning programme that trains and supports healthcare professionals to deliver this effective new treatment (BeST) to their patients; and
  • identify, understand and overcome the barriers to healthcare professionals accessing and using the BeST treatment in the NHS.

To date, >1200 NHS therapists had enrolled on the online training course, of which >700 have begun the programme and 462 have 100% completed the training.

This translates to 21 NHS sites currently running BeST classes, across 36 NHS Trusts.

To date, 447 patients have completed baseline assessment. With collection of follow up outcomes underway. Although the final analysis has not yet been completed, clinical outcomes appear consistent with those observed in the original trial.

That the project is now being piloted on the well know Future Learn site further expands both the access and impact of this effective treatment for low back pain among the English public, and beyond.

Find out more at:

Original iBeST video:

Future Learn link: