Spined
Online pain rehabilitation program for persistent back and leg pain
An evidenced-based online rehabilitation program developed by a Rehabilitation Medicine specialist for people with ongoing back and lower limb pain including non-surgical back pain, recovery after spinal surgery and lumbar canal stenosis.
How Spined differs from standard rehabilitation programs
Spined is not an exercise-only rehabilitation program.
Rather than focussing only on the back, Spined is a comprehensive rehabilitation program that brings together education, movement retraining and self-management strategies used in rehabilitation medicine.
The program includes core modules relevent to most people with persistsent low back pain with specific instructions tailored to non-surgical back pain, persistent pain after spinal surgery and for those with lumbar canal stenosis.
Spined is designed for people who have been medically assessed and are not experiencing new or progressive neurological symptoms requiring urgent review.
Spined has been by clinical practice and the research underpinning Kneed.
How does Spined work?
Spined is a 13-module online program focused on understanding and managing persistent back pain. Spined provides a structured, flexible way to move forward when pain has persisted longer than expected.
• You choose which modules to complete and when
• Clear written content to explain pain and recovery
• Videos by an accredited Australian Physiotherapist demonstrating safe exercises
• Support to set goals, create personalised exercise and activity plans and manage flare-ups
• Accessible online, from home, on any device
Why back pain can persist
Many people recover well after an episode of back pain.
However, for some people, pain can continue for months or even years despite the back healing as expected.
When back pain persists, walking, bending, lifting, standing and participating in enjoyable activities can all become difficult. Over time, confidence may reduce and quality of life can be reduced.
Persistent back pain is rarely explained by changes in one part of the back.
Instead, pain reflects how the body and nervous system respond to injury or surgery and how it adapts over time. When pain has been present for longer periods, this system can become more sensitive and protective, even after injured or surgical tissues have recovered.
Pain is also influenced by movement patterns, exercise, sleep, stress and mood, all of which can decline due to pain.
This does not mean that the back is damaged beyond recovery. It means that persistent back pain can become a complex condition that benefits from a more comprehensive rehabilitation approach.
Spined was developed within rehabilitation medicine to address these multiple connected factors. It provides structured education, movement retraining and self-management strategies designed to support understanding, rebuild confidence and help people return to meaningful activities.
What does the Spined Program include?
Spined brings together multiple connected components used in rehabilitation medicine. These elements are designed to work together, not in isolation, to support understanding, restore movement and rebuild confidence when pain has persisted longer than expected.
Understanding Persistent Pain
Education
Clear written and video explanations to help you understand why non-surgical and post-surgical back pain can both persist. This knowledge provides a foundation for the structured rehabilitation program and strategies to promote recovery.
Movement, Sleep and Activity Retraining
Exercise and movement retraining
Guidance on safe, progressive exercise and movement that helps you build confidence to move normally, to reduce pain and restore fitness and health.
Sleep and Activity Strategies
Support to establish routines for sleep and develop strategies to enable a graduated and safe return to enjoyable routines, activities, study and work.
Desensitisation - Nervous System Retraining
Brain retraining
Targeted strategies that include motor imagery to address changes in sensitivity affecting movement control and pain processing by the brain.
Can you quickly and easily judge whether the model is twisting to her left or right?
Relaxation and stress regulation
Practical techniques you can use to manage the interaction between stress, tension and pain. A guided progressive muscular relaxation session trains a mindfulness technique combined with developing muscle control.
Self-management and Flare-up Management
Goal setting and self-management
Tools to help you set meaningful goals and apply what you learn in ways that fit your life, values and priorities.
Strategies to manage flare-ups
A structured way to recognise flare-ups early and respond with safe and effective strategies that allow you to continue moving forward without setbacks
The Research Behind Spined
Evidence base
Following additional back pain translational research, the Spined program has been adapted from Kneed.
Kneed was developed as part of a PhD program at Monash University by Dr Nathan Johns, a specialist rehabilitation medicine physician, with the aim of translating contemporary pain science into an accessible online rehabilitation program.
The program was evaluated in a pilot randomised controlled trial, comparing people who completed the Kneed program with those who continued with usual care.
The study examined feasibility, acceptability, and participant-reported outcomes, reflecting the early-stage evaluation of a complex rehabilitation program.
Results from this research were published in the peer-reviewed medical journal Clinical Rehabilitation.
Kneed and spined continue to be refined and developed in line with emerging evidence and clinical research.
Is Spined the right fit?
Spined may be suitable if you have persistent back or leg pain that has been medically assessed and does not currently require further surgical intervention — particularly if pain is affecting your confidence with movement, sleep, exercise or your return to usual activities.
Spined is unlikely to be suitable if you are seeking a diagnosis, have new or worsening neurological symptoms, have concerns about your spinal surgery or have concerns about a serious underlying medical condition that has not yet been assessed by a doctor.
Starting the Spined program
You can start by exploring Spined for free or choose the paid options of a 1 week trial or 3 month full program
Free Spined
Understand why pain can persist
Free Spined is a 6 week educational email series designed to help you better understand persistent back and leg pain, whether non-surgical or after spinal surgery.
Each week you will receive a short, clear email that:
- explains why recovery is not straight forward
- helps you think differently about movement, flare-ups and progress
- introduces key rehabilitation medicine concepts used in specialist pain rehabilitation
The series is educational only. There are no ads, no spam and no obligation to continue.
Free
Spined - Short Access
Explore the program
Full access to the complete Spined pain rehabilitation program for 1 week.
This option allows you to experience how the structured rehabilitation approach works in practice including the education, movement guidance and self-management tools.
Decide whether you are ready to manage on your own or extend the access period. Spined has not been designed to be completed within a week.
7 days full program access,
No subscription
No automatic renewals
$50 AUD (GST included)
Spined – Extended Access
Complete the program
Full access to the complete Spined pain rehabilitation program for 3 months (no renewal).
Spined is a structured, evidence-based rehabilitation program designed to be completed over three months, at your own pace.
The full program combines education, movement retraining, brain training and self-management strategies informed by rehabilitation medicine and contemporary pain science.
Three months access
Self-paced
No subscription or ongoing fees
$ 200 AUD (GST included)
Spined is an education and self-management program designed to complement and not replace care from your doctors.
Frequently Asked Questions
Why do I still have back pain?
Pain is very individual and back pain can persist for different reasons, depending on whether this is a non-surgical or post-surgical condition.
Persistent back pain is common and does not mean that there is a serious underlying medical condition.
Whilst the back problem, injury or surgery that originally started the pain may itself have healed well, pain can continue due to how the nervous system and body responded it.
Factors such as sleep, stress, changed movement patterns and how one feels about the back can all contribute to pain.
Is Spined a medical treatment or a replacement for my doctor?
No.
Spined is an education and self-management program designed to complement and not replace care from your doctor.
It does not provide a medical diagnosis or individual clinical treatment. Many people use Spined alongside ongoing medical or physiotherapy care.
Is Spined just exercises?
No.
Spined is not an exercise-only program.
While movement and exercise are important parts of the program, Spined also includes pain education, brain retraining strategies, relaxation, flare-up management, sleep guidance and goal setting to reflect the current evidence about persistent back pain.
Is Spined evidence-based?
Yes.
Spined was adapted by Dr Nathan Johns, a specialist rehabilitation medicine physician, from Kneed which was developed as part of a PhD program at Monash University.
Kneed has been evaluated in a pilot randomised controlled trial and the results were published in a peer-reviewed medical journal.
Will Spined reduce my pain?
Spined does not guarantee pain reduction.
Persistent pain is complex and individual and responses to rehabilitation vary. Spined is designed to help people understand their pain and develop skills to reduce it, manage it safely, improve confidence with movement and support participation in meaningful and enjoyable activities.
How long does the program take?
Spined contains 13 modules that you can complete at your own pace.
Some people focus on specific modules, while others work through the full program over several weeks. The 3 month access option provides enough time for structured engagement, but there is no required schedule.
What if I have a pain flare-up whilst doing the program?
Pain flare-ups are common during recovery and rehabilitation.
Spined includes a specific module on flare-ups that helps you understand why they occur and how to respond safely, so that flare-ups settle quickly and do not automatically mean stopping or losing progress.
Can I start without committing to the full program?
Yes.
You can begin with Free Spined, which is an introductory email series. This allows you to explore the approach and decide whether it feels right for you before choosing any paid access.
Do I need my doctor's permission to do Spined?
No.
You do not need permission to access Spined. However, you should continue to follow the advice from your treating health professionals, particularly if you have specific medical restrictions.
What equipment do I need?
Spined is completed online using a computer, tablet or phone.
Exercises and brain training use minimal equipment that can be found at home.
Prefer to learn more first?
If you’re not ready to start the program, you can receive a short educational email series explaining why back pain can persist and how Spined is designed to help.
