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Diagnosis
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Osteoarthritis
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NICE [4] working diagnosis of osteoarthritis of the hip, knee or lumbar spine defined as:
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• Age 45 years old or over, and
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• Activity related joint pain and
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• Either no morning joint-related stiffness or morning stiffness that lasts no longer than 30 min
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Non-specific low back pain
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Aged ≥ 30 years old with non-specific low back pain of mechanical origin with or without radiation to the lower limb
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Symptom duration
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Chronic (≥ 3 months)
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English language
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Be able to read, understand and speak English without assistance
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Contact status
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Access to a telephone for screening and assessment
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Availability
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Available to attend a 6-week start-stop group class of 1.5 h per week
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Exclusion criteria
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Pathology
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Suspected or confirmed serious spinal pathology (fracture, metastatic, inflammatory or infective diseases of the spine, cauda equina syndrome/widespread neurological disorder)
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Nerve root compromise (2 of strength, reflex or sensation affected for same nerve root)
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Lower limb arthroplasty
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Past medical history
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Spinal surgery or history of systemic / inflammatory disease
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Current medical status
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Scheduled for major surgery during treatment
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Contraindications
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Unstable angina / uncontrolled cardiac dysrhythmias / severe aortic stenosis / acute systemic infection accompanied by fever
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Other
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No confounding conditions, such as a neurological disorder, intellectual disorder or unstable psychiatric condition.
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Bladder or bowel incontinence
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People who are assessed to be at high risk of falls
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Physiotherapy in the preceding 6 months
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Unable or unwilling to attend
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Ongoing litigation related to the pain condition
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