Low back pain (LBP) is the leading cause of disability worldwide and is one of the most common reasons for people seeking health care and medical services. In most cases the specific cause of LBP remains elusive, and these presentations are classified as non-specific LBP. Genetic, biophysical, psychological, and social factors contribute to the manifestation of non-specific LBP. In addition, recent evidence demonstrates substantial alterations in central nervous system processing (CNSP) in patients with LBP, which may have a significant influence on the LBP experience.

A new treatment approach (also called RESOLVE) addresses these alterations as part of a comprehensive, integrated, rehabilitation package and indicates promising results. Unique to the field, a recent high-quality trial demonstrated clinically relevant and long-term benefits of this approach relative to a complex sham intervention, however, the effectiveness and cost effectiveness of this approach in comparison to usual physiotherapy care are unknown.

The objective of this study is to determine whether a combination of pain education and graded sensorimotor relearning is more effective in reducing disability in patients with non-specific LBP than usual, guidelines based physiotherapy consisting of individual manual therapy and exercises.