{
  "abstract": "Background and objectives\n\nChronic nonspecific low back pain (CNLBP) is a leading cause of disability, and its management remains a significant challenge. While non-pharmacological interventions like exercise are recommended, the optimal treatment strategy is unclear. This study compared the effectiveness of a comprehensive, five-modality holistic program (behavior therapy, exercise, nutrition optimization, drugs, and posture training) with a standard two-modality intervention (exercise and drugs) for patients with CNLBP.\n\nMethods\n\nThis prospective interventional study included 123 patients with CNLBP. Participants were randomly allocated to either a two-modality intervention (Group 1; n = 60) or a five-modality holistic program (Group 2; n = 63). The primary outcome was the between-group difference in pain (Visual Analogue Scale, VAS) at the six-month follow-up. Secondary endpoints, including changes in anxiety scores and analysis by pain location, were treated as exploratory.\n\nResults\n\nAfter six months, both groups showed clinical improvement. However, the five-modality group (Group 2) demonstrated statistically significant and superior improvements in pain compared to the two-modality group (Group 1). The between-group difference in mean improvement for the VAS score (3.65 vs. 1.55) was statistically significant (p < 0.001). Subgroup analysis revealed that patients with higher baseline anxiety showed significantly greater improvement with the holistic approach.\n\nConclusions\n\nFindings from the current study support the adoption of a holistic, multidisciplinary strategy for the management of CNLBP. The integration of behavior therapy, nutrition optimization, and posture training alongside conventional exercise and medication provides a superior, long-term therapeutic approach. A comprehensive, five-modality treatment program is significantly more effective than a standard two-modality intervention for improving pain in patients with chronic nonspecific spinal pain.",
  "abstract_shown": true,
  "affiliations": [
    "Neurosurgery, Park Hospital, Panipat, IND",
    "Neurorehabilitation, Medanta - The Medicity, Gurgaon, IND",
    "Neurosurgery, Max Hospital, Gurgaon, IND",
    "Neurosurgery, Medanta - The Medicity, Gurgaon, IND",
    "Neurosurgery, All India Institute of Medical Sciences, Bhopal, IND"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Sameep H Koshti"
    },
    {
      "affs": [
        1
      ],
      "name": "Amit Soni"
    },
    {
      "affs": [
        2
      ],
      "name": "Himanshu Champaneri"
    },
    {
      "affs": [
        3
      ],
      "name": "Deepak K Bhangale"
    },
    {
      "affs": [
        4
      ],
      "name": "Amit Agrawal"
    },
    {
      "affs": [
        3
      ],
      "name": "Sudhir Dubey"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5j7y0214vz150.bib",
  "cited_by": 0,
  "doi": "10.7759/cureus.117483",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13733605/",
  "id": "5j7y0214vz150",
  "issns": [
    "2168-8184"
  ],
  "landing_url": "https://doi.org/10.7759/cureus.117483",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Neurosurgery"
    ],
    [
      "heading",
      "Occupational Health"
    ],
    [
      "openalex",
      "3612|Musculoskeletal pain and rehabilitation"
    ]
  ],
  "openalex": "W7220359834",
  "pdf_url": "https://www.cureus.com/articles/534549-a-prospective-interventional-study-comparing-a-multimodal-intervention-incorporating-behavior-exercise-nutrition-medication-and-posture-with-exercise-and-medication-in-patients-with-chronic-nonspecific-low-back-pain.pdf",
  "pmcid": "PMC13733605",
  "pmid": "42985311",
  "published": "2026-10-05",
  "publisher": "Cureus Inc.",
  "ris": "https://research.draconitic.com/paper/5j7y0214vz150.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:23:21Z",
      "native_id": "PMC13733605",
      "source": "pmc",
      "url": "https://doi.org/10.7759/cureus.117483"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "A Prospective Interventional Study Comparing a Multimodal Intervention Incorporating Behavior, Exercise, Nutrition, Medication, and Posture With Exercise and Medication in Patients With Chronic Nonspecific Low Back Pain",
  "title_text": "A Prospective Interventional Study Comparing a Multimodal Intervention Incorporating Behavior, Exercise, Nutrition, Medication, and Posture With Exercise and Medication in Patients With Chronic Nonspecific Low Back Pain",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:23:21Z",
  "url": "https://research.draconitic.com/paper/5j7y0214vz150",
  "venue": "Cureus",
  "versions": []
}