When Volker Rehbocks started to experience back pain, his doctor told him his gardening days were over.
According to the Perth man, whose pain was so debilitating he could barely tie his own shoelaces, the doctor said his best chance at managing pain was to take anti-inflammatories and rest.
But a chance stroll through the Curtin University campus, where Mr Rehbocks saw a flyer for a study into chronic back pain, brought him into contact with a treatment program he said had nearly eradicated his pain.
"It's all about teaching you how to regain your movement, and how to kind of do stretches and get confidence back into your movements,' Mr Rehbocks said.
"Because the problem is that when you develop chronic pain like this, you tend to move your body in protective ways … but those movements actually can tend to contribute to the pain itself."
Mr Rehbocks was among 500 participants in a trial of the cognitive functional therapy program, which was tested across 20 clinics in Perth and Sydney.
Curtin University worked with Macquarie and Monash universities on the study.
Huge improvements, researchers say
Published on Wednesday in prominent medical journal, The Lancet, the trial found dramatic improvements in the intensity of pain — and quality of life — experienced among 500 trial participants.
Co-author and Curtin School of Allied Health Professor Peter O'Sullivan said the program took an approach that went against common beliefs about back pain.
"We have all these rules around, 'sit up straight', 'brace your core', 'lift with a straight back', which actually teaches people to over-protect their back, stop moving it normally and start over-protecting it, and that creates pain and distress," Professor O'Sullivan told ABC Radio Perth's Stan Shaw.
"What's healthy for your spine is to learn to relax it and move it in a normal way, engage with activity, movement," he said.
"Load it, but do it in a progressive way to build confidence back."
Participants in the program, delivered by physiotherapists, received personalised and intensive coaching in up to seven sessions over a 12-week-period, then a "booster" session after six months.
Of the 500 participants, 80 per cent reported being satisfied with the program a year after they started it.
The study also found the improvements delivered "work productivity" savings of more than $5,000 per person by reducing the amount of work they missed because they were in pain.
Mental health benefits
Professor O'Sullivan said the study participants also experienced mental health improvements, not only because their pain was reduced, but because they were able to re-engage with physical and social activities.
"This is a wonderful story for people with back pain because it's about empowering them to be in charge of the pain … so they don't need us," he said.
"And that's a good health story.
"It kind of tipped on to other things, like less anxiety, less depression, less distress."
Professor O'Sullivan, and co-author Associate Professor Peter Kent, said the results gave hope to millions of people whose back pain had not responded to other treatments.
Mr Rehbocks said it had made him more hopeful about the future, having regained the ability to not only do basic tasks like tying a shoelace, but to ride his bicycle long distances.
"My pain has effectively gone," he said.
