• Carolina Gassen Fritsch, Paulo H Ferreira, Thomas Lung, Andrew J McLachlan, and Manuela L Ferreira.
• Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Level 10, Kolling Building, Royal North Shore Hospital, Reserve Road, St Leonards, Sydney, NSW, 2065, Australia. carolina.gassenfritsch@sydney.edu.au.
• Eur Spine J. 2023 Sep 1; 32 (9): 327232793272-3279.

PurposeTo determine: (1) the smallest change in function patients would need to see following a self-management intervention for low back pain (LBP) to consider it worthwhile; (2) the association between patient-related factors and the magnitude of the smallest worthwhile change.MethodsA cross-sectional analysis of 212 participants of the TEXT4myBACK randomised trial was conducted. At baseline, participants nominated the smallest change in function (0-30 scale) following a self-management program they would need to reach to consider it worthwhile. A multivariate regression model estimated the effects of demographic, comorbidities, lifestyle and LBP-related factors on the smallest worthwhile change estimates.ResultsOn average, people with LBP need to experience an improvement of at least 9.4 points (SD: 5.7) in function to consider a self-management intervention worthwhile. Only baseline function severity was significantly associated with the smallest worthwhile estimate (-0.60; 95%CI  - 0.76,  - 0.44).ConclusionOn average, an improvement of 9.4 points (or 31%) in function is considered by people with LBP as the smallest change that makes self-management worthwhile. Those with lower levels of function needed to experience greater improvements.© 2023. The Author(s).

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