Almost everyone will deal with back pain at some point in their lives. Most recover quickly—but for about 20% of people, acute pain becomes a chronic condition that interferes with daily life and keeps them out of the workforce.

Low back pain is one of the leading causes of disability worldwide, and more money is spent managing it in the United States than any other health condition. Despite that, the most effective way to prevent a short-term episode from becoming a long-term problem has not been clear—especially for people who are most at risk.

“Chronic low back pain prevention is a public health issue,” said Michael Schneider, D.C., Ph.D., professor in the School of Health and Rehabilitation Sciences at the University of Pittsburgh and co-principal investigator of the Pitt arm of the study. “The 20% of patients who turn chronic account for 80% of the costs and the suffering. This paper shows that helping people self-manage their pain through a properly trained physical therapist or chiropractor is a great way to mitigate this public health problem.”