Implementation of the Specific Treatment Of Problems of the Spine Approach in Bangladesh

Exclusion criteria

• . Red flag pathologies such as active cancer under current treatment, risk of spinal fracture, signs of potential infection, and major systemic inflammatory disease.
• . Signs of cauda equina syndrome based on bladder or bowel disturbance and/or imaging
• . Current pregnancy, or childbirth within the last 6 months, as this could impair the ability to undertake exercises, and could also cause back and leg symptoms that are not related to the subgroups under investigation
• . Spinal injections within the last 6 weeks, as we wish to study treatment effects independent of the effects of injections
• . Any history of lumbar spine surgery, as there is already considerable research evaluating the efficacy of post-surgical rehabilitation programs
• . A pain intensity score of less than 2/10 on the numerical pain rating scale due to low severity.
• . Minimal activity limitation, evidenced by a baseline ability to perform ALL of (walk, sit, and stand for one hour or more and no sleep disturbance at night), as we wish to exclude people with low severity.
• . Inability to walk safely, such as severe foot drop causing regular tripping, as the interventions in the trial include walking for most participants.