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The disability impact of severe, chronic LBP (CLBP) has been compared with amputation of both arms without treatment or with cocaine dependency (DW 0.37 with or without leg pain) [ For a proportion of back pain patients the prognosis can be bleak.Once you take time off work for back pain you have with different medical and benefit systems a 1–10% risk of not returning to work for at least a year.The aim of this randomised controlled trial is to compare ECTT with physiotherapy for reducing pain and improving physical function and physical and mental well-being in patients with chronic low back pain.The trial will be held at two hospitals in Vietnam.With a 9.4% global prevalence (95% CI 9.0–9.8), LBP causes more global disability than any other condition.LBP has high disability weights (DW), which means that severe acute LBP is considered as disabling as non-metastatic cancer or long-term stroke consequences (DW 0.27, 0.32 with leg pain).Of the 291 conditions studied in the Global Burden of Disease 2010 Study, low back pain (LBP) rates highest in terms of years lost to disability (YLD) and sixth in terms of overall burden.Because LBP has no mortality, YLD are the same as disability adjusted life years (DALYs).

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The primary outcomes will be changes in pain, physical function per the Quebec Pain Functionality Questionnaire and physical and mental well-being recorded by the Short Form Health Survey (SF-36), with mixed modelling used as the primary statistical tool because the data are longitudinal.

Initial follow-up will be at either 4 or 8 months, with a second follow-up after 12 months.

The trial design has important strengths, because it is to be conducted in hospitals under medical supervision, because ECTT is to be compared with a standard therapy and because the assessor and analyst are to be blinded.

The findings from this trial will provide evidence of the efficacy of ECTT for chronic low back pain compared with standard physiotherapy treatment.

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The authors are unaware of any current treatment for LBP that specifically targets the connective tissue.

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  2. The disability impact of severe, chronic LBP (CLBP) has been compared with amputation of both arms without treatment or with cocaine dependency (DW 0.37 with or without leg pain) [ For a proportion of back pain patients the prognosis can be bleak.

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