UK back pain exercise and manipulation (UK BEAM) trial - national randomised trial of physical treatments for back pain in primary care: objectives, design and interventions

Low back pain has major health and social implications. Although there have been
many randomised controlled trials of manipulation and exercise for the management of low back
pain, the role of these two treatments in its routine management remains unclear. A previous trial
comparing private chiropractic treatment with National Health Service (NHS) outpatient
treatment, which found a benefit from chiropractic treatment, has been criticised because it did not
take treatment location into account. There are data to suggest that general exercise programmes
may have beneficial effects on low back pain. The UK Medical Research Council (MRC) has funded
this major trial of physical treatments for back pain, based in primary care. It aims to establish if,
when added to best care in general practice, a defined package of spinal manipulation and a defined
programme of exercise classes (Back to Fitness) improve participant-assessed outcomes.
Additionally the trial compares outcomes between participants receiving the spinal manipulation in
NHS premises and in private premises.