Research Tracking Change in Low Back Pain Practice Over 20 years

We’re proud to share exciting research from Professor Steven Vogel and Emeritus Professor Alan Breen at HSU, part of a unique longitudinal study examining how UK chiropractors, osteopaths and physiotherapists manage low back pain.

The story began in 2003, when Dr David Evans led a team as part of his Doctoral studies. Their protocol and 2010 findings examined whether printed information based on guidelines could shift practitioner behaviour towards evidence-based recommendations.

Now, over 20 years later, David Evans has led a remarkable follow-up study, just published in BMC Musculoskeletal Disorders. The research team also included Nadine Foster, Tamar Pincus and Martin Underwood.

You can access this here.

Using survey methods, the same patient vignette, the same questions, the research reveals how clinical practice has evolved across two decades.

Fascinating Patterns of Change

The research findings show fascinating patterns of change: some professional groups have shifted towards guideline-consistent recommendations, whilst others have moved in unexpected directions.

Significantly, the three professions show some signs of both convergence and divergence in their approaches to managing acute low back pain.

This research has important implications for evidence implementation, professional education and the future of back pain care in the UK.

It demonstrates the value of long-term, rigorous research in understanding how clinical practice actually changes over time.

You can read the full open-access paper here.