BEST Project

Stanford is participating in a multisite trial known as Biomarkers for Evaluating Spine Treatments (BEST). Biomarkers are measurable items that may indicate whether a treatment is working well. The purpose of discovering the biomarkers for this trial is to identify which treatment(s) would be best to manage your chronic low back pain.

Participants eligible for this treatment need to:

• Be over the age of 18
• Have low back pain for at least three months
• Have low back pain at least half of the days in the last six months

Participants in this trial may receive one or two of the following treatments:

1. Acceptance and commitment therapy (the focus is on the whole person, their pain, health and quality of life working with a psychologist)
2. Duloxetine medication (an FDA-approved medication that helps patients manage chronic low back pain)
3. Enhanced Self-Care (an online program that utilizes online platforms and personalized messaging to teach strategies and lifestyle skills to help patients manage their pain)
4. Exercise and Manual Therapy (with the help of a physical therapist, you will complete a few exercises and strength training) 

Participation involves up to 4 in person visits and other study procedures completed from home. Depending on which treatment(s) you receive, you might attend additional in person visits. Study activities and treatments are at no cost and participants will receive compensation for their time.

The study procedures may include: a physical exam, blood draw, at-home surveys, in-person surveys, MRI scans of the spine and brain, and assessments that involve short exercises.