Chronic low back pain — lasting more than three months — is the leading cause of disability worldwide and has been fueled partly by overprescription of opioids that provide limited long-term benefit. The research landscape is shifting toward understanding the spine, nerves, and brain together rather than treating the back in isolation.
What's actually going on in research
Biologics targeting nerve growth factor and IL-17 are in trials for specific back pain subtypes including modic changes and inflammatory back pain. Non-invasive and minimally invasive neuromodulation approaches — including transcutaneous electrical nerve stimulation, spinal cord stimulation, and dorsal root ganglion stimulation — are being compared in large trials. Multidisciplinary pain rehabilitation programs and targeted psychological therapies are showing robust results and being delivered digitally to reach more patients.
NGF inhibitors
Nerve growth factor inhibitors reduce chronic back pain significantly in trials targeting discogenic and osteoarthritis-related low back pain, and are being re-evaluated at doses that minimize side effects.
Spinal cord stimulation
Newer closed-loop spinal cord stimulators that continuously adapt to nerve signals are being compared with open-loop devices and pain medications for chronic low back pain.
Biopsychosocial rehabilitation
Programs addressing both the physical and psychological drivers of chronic back pain — including acceptance-based therapy and graded activity — show sustained pain and function improvements.
What to know before you search
Eligibility requires pain duration of at least 3 months, specific pain characteristics or imaging findings, prior treatment failure, and often exclusion of inflammatory arthritis.
What types of trials are currently open
- Drug trials — Testing non-opioid medications including NGF inhibitors, anti-inflammatories, and nerve-targeted drugs.
- Neuromodulation trials — Comparing spinal cord stimulation, DRG stimulation, and TENS for chronic low back pain.
- Injection and procedure trials — Evaluating epidural steroid injections, radiofrequency ablation, and intradiscal therapies.
- Behavioral and rehabilitation trials — Testing multidisciplinary programs combining physical therapy, psychology, and education.
- Surgical trials — Comparing spinal fusion, disc replacement, and decompression for specific anatomic causes.
Recently added Chronic Low Back Pain trials
Reformer Pilates vs Conventional Physiotherapy in Chronic Low Back Pain
Non-specific chronic low back pain is one of the most prevalent musculoskeletal disorders worldwide and is associated with functional limitations and reduced quality of life. Exercise-based physiotherapy approaches are strongly recommended in clinical guidelines. Pilates exercises are frequently used due to their potential effects on core stability and movement control, while conventional physiotherapy remains a commonly applied treatment method. However, randomized controlled trials directly comparing these interventions are limited. This study aims to compare the short-term effects of reformer Pilates exercises and conventional physiotherapy on pain intensity, functional disability and health-related quality of life in individuals with non-specific chronic low back pain.
COMPARATIVE EFFECTIVENESS OF EXERCISE, COGNITIVE BEHAVIOURAL THERAPY, AND THEIR COMBINATION FOR PEOPLE WITH CHRONIC MUSCULOSKELETAL PAIN AND POOR SLEEP: SLEEPFIT TRIAL
This study aims to find out which lifestyle approach works best for people with chronic musculoskeletal pain (such as low back pain or hip/knee osteoarthritis) who also have poor sleep. Participants will be randomly assigned to one of three 12-month home-based programs: exercise, cognitive behavioral therapy for insomnia (CBT-I), or a combination of both. Each program includes up to 10 online sessions with a physiotherapist and guidance on managing pain, sleep, and physical activity. We will measure changes in pain, sleep quality, and overall health using questionnaires, wearable devices, sensory tests, and blood samples. The goal is to improve understanding of non-medication treatments for pain and sleep problems.
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