Professor Deborah Falla, Chair in Rehabilitation Science and Physiotherapy, Director and Research Co-Lead at the Centre of Precision Rehabilitation for Spinal Pain

Dr Alison Rushton, Deputy Director at the Centre of Precision Rehabilitation for Spinal Pain


Spinal pain – a national and international challenge


Low back pain is the leading cause of ‘years lived with disability’ globally.

The incidence of low back pain has reached epidemic proportions, affecting up to 84% of adults at least once in their lives. Neck pain ranks 4th as a cause of ‘years lived with disability’ and affects 30% - 50% of the population in any one year. The burden of spinal pain for the individual manifests not only in the symptoms and physical complaints, but in it's impact on their work, social participation and the related financial, family and emotional consequences.

The treatment of spinal pain is an international challenge and comes at great individual and societal cost. In the UK, direct costs of low back pain alone are estimated to be £2.8 billion annually and the enormous indirect socioeconomic costs due to chronic pain, exceed those estimated for heart disease, cancer and diabetes.


Current treatment of spinal pain


Even though recovery is observed in a proportion of people following their first episode of spinal pain, for the rest recovery is slow and the risk of persistent and chronic pain is very high (80% people). The treatment of chronic spinal pain is challenging and many established interventions have limited effects. Treatment often provides only temporary improvement and many people continue to have ongoing symptoms and problems.


The Centre of Precision Rehabilitation for Spinal Pain (CPR Spine)


CPR Spine was founded in 2016 and is providing a step change in the development and delivery of patient-specific rehabilitation programmes for people with spinal pain. This multidisciplinary Centre is the first Centre dedicated to spinal pain research in the UK.

"Low back pain has reached epidemic proportions, affecting up to 84% of adults at least once in their lives."

Director, Professor Deborah Falla and Deputy Director Dr Alison Rushton explain “we are fostering a radical new approach to rehabilitation, which takes into account individual variability in presentation, functional deficits, genetics, environment, work and lifestyle, to enable people to maximise their recovery, activity and work potential”. Research is being conducted to identify factors associated with the development of long-term pain and disability. This in turn facilitates the development and implementation of precision rehabilitation that matches specific interventions to projected risk of recovery, with the aim of preventing poor long-term outcomes.

For example, exercise is one of the most effective treatments for the prevention and management of spinal pain, yet it typically only provides small to moderate treatment effects, which are rarely long-lasting.

The appropriate identification of patient-specific exercise interventions is a major issue and current rehabilitation programmes that rely on a “one size fits all” approach usually fall short of success. At CPR Spine, we undertake a comprehensive evaluation, taking into consideration the multidimensional nature of spinal pain, to inform safe and precise rehabilitation including exercise and novel strategies tailored to the individual person.

Patient and Public Involvement is central to our research at CPR Spine. We run annual conferences for patients, public, clinicians and students to inform our understanding of spinal pain complaints and rehabilitation, and to share our ideas and findings.


Innovation at CPR Spine


CPR Spine acts to foster spin-off companies and accelerate the translation of our world-leading research into clinical practice and patient benefit. With an emphasis on the development and advancement of telemedicine and wearable, patient-accessible, technologies to enhance rehabilitation, we anticipate better outcomes for patients with spinal pain in a shorter time.


Education and recruitment for the future


Our new MRes Spinal Pain Research programme starting in 2018 will build on the existing success of our international market-leading MSc Manipulative Physiotherapy programme at the University of Birmingham to support capacity building of early career researchers and experts on spinal pain.

We aim to recruit 1000 people to join our CPR Spine Pain Register by the end of 2018 to work in collaboration with us in projects and events. To join our CPR Spine Pain Register please email us at


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Twitter: @CprSpine