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Study identifier: NCT04142177 Synced from ClinicalTrials.gov · July 29, 2026
● Recruiting

Sequential and Comparative Evaluation of Pain Treatment Effectiveness Response

Condition: Chronic Low Back Pain  ·  Sponsor: VA Office of Research and Development

PhaseNA
Planned participants2529
Who can joinAll sexes, 18 Years to no upper limit
Healthy volunteersNo

About this study

VETERANS ONLY. Chronic low back pain (cLBP) is common. Most Americans will have at least one episode of low back pain in their lifetimes. Approximately 50% of all US Veterans have chronic pain, and CLBP is the most common type of pain in this population. This study will use a sequential randomized, pragmatic, 2-step comparative effectiveness study design. The main goal is to identify the best approach for treating cLBP using commonly recommended non-surgical and non-pharmacological options. The first step compares continued care and active monitoring (CCAM) to internet-based pain self-management (Pain EASE) and an enhanced physical therapy intervention that combines Pain EASE with tailored exercise and physical activity. Patients who do not have a significant decrease in pain interference (a functional outcome) in Step 1 and those desiring additional treatment will be randomized in Step 2 to yoga, spinal manipulation therapy (SMT), or therapist-delivered cognitive behavioral therapy (CBT). Participants proceeding to randomization in Step 2 will be allowed to exclude up to one of the three Step 2 treatments based on their preferences. The investigators' primary hypothesis for the first treatment step is that an enhanced physical therapy intervention that combines pain self-management education with a tailored exercise program will reduce pain interference greater than internet-based pain self-management alone or CCAM in Veterans with cLBP. The primary outcome is change in pain…

This description comes directly from the study's public registry record.

Talk to the study team

Brandon J Stevenson, MSW BS  ·  (319) 388-0581  ·  Brandon.Stevenson@va.gov

Always discuss trial participation with your own doctor first.

Locations (19)

Phoenix VA Health Care System, Phoenix, AZPhoenix, Arizona, United StatesRecruiting
VA Loma Linda Healthcare System, Loma Linda, CALoma Linda, California, United StatesRecruiting
VA Long Beach Healthcare System, Long Beach, CALong Beach, California, United StatesRecruiting
VA Palo Alto Health Care System, Palo Alto, CAPalo Alto, California, United StatesRecruiting
Rocky Mountain Regional VA Medical Center, Aurora, COAurora, Colorado, United StatesWithdrawn
Bay Pines VA Healthcare System, Pay Pines, FLBay Pines, Florida, United StatesTerminated
Orlando VA Healthcare System, Orlando, FLOrlando, Florida, United StatesRecruiting
Atlanta VA Medical and Rehab Center, Decatur, GADecatur, Georgia, United StatesRecruiting
Richard L. Roudebush VA Medical Center, Indianapolis, INIndianapolis, Indiana, United StatesRecruiting
Baltimore VA Medical Center VA Maryland Health Care System, Baltimore, MDBaltimore, Maryland, United StatesTerminated
VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MABoston, Massachusetts, United StatesRecruiting
St. Louis VA Medical Center John Cochran Division, St. Louis, MOSt Louis, Missouri, United StatesRecruiting

+ 7 more locations — full list on the registry record.

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Source record: clinicaltrials.gov/study/NCT04142177