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Non-specific Mechanisms in Orthodox and CAM management of back pain (MOCAM)

This project will include conducting a large-scale longitudinal questionnaire-based study about the role of non-specific factors in the treatment of back pain. Non-specific components of treatment (e.g. therapeutic relationship, patient expectations) contribute significantly to outcomes across musculoskeletal conditions including low back pain (LBP). These need to be better understood to optimise patient outcomes. Complementary and alternative medicines (CAMs) like acupuncture have particularly powerful non-specific components. Existing evidence is based primarily on studies of single non-specific components, in single treatments, in isolation from pain theories. This project will investigate multiple non-specific components in three treatments and relate them to pain theories. The projects aims are to:

• identify the most powerful non-specific treatment components
• compare their effects on patient outcomes across three treatments in naturalistic settings
• develop a deeper understanding of the pathways through which they generate positive patient outcomes.

The research team are recruiting a cohort of adults with LBP attending acupuncturists, physiotherapists, and osteopaths in private and NHS clinics. A quantitative longitudinal questionnaire-based study will use advanced statistical techniques (multi-level modelling) to assess relationships between five domains of non-specific treatment components (e.g. therapeutic relationship, expectations), theoretically-derived mediators (e.g. fear, behaviour change), and patient outcomes (e.g. function). The project will be collecting data across the UK. It is funded by Arthritis Research UK, and led by Dr Felicity Bishop in the Psychology department at the University of Southampton. 

More information about this project.