Addressing (Low) Back Pain in the Era of the European Pillar of Social
Rights: Assessing Impact and Sharing Good Practices Across Europe.

Abstract
The manuscript provides the scientific society and experts involved in pain relief and patient empowerment with a good practice focused on low back pain (LBP). Such best practice is particularly relevant today, taking into account the important advancements in the fight against pain and the new context of the European Pillar of Social Rights. In particular, key principle N.17 on the “Inclusion of people with disabilities” declares that “People with disabilities have the right to income support that ensures living in dignity, services that enable them to participate in the labor market and in society, and a work environment adapted to their needs” [1].
In continuity with its long-term policy on the fight against pain, the Italian NGO Cittadinanzattiva APS [2], through its EU branch Active Citizenship Network [3] (ACN), has become an official Ambassador for the EU Social Pillar, following the invitation by the EU Commission-DG EMPL in 2020, in order to contribute to better implement the European Pillar of Social Rights for people suffering from chronic pain. This article has been written with the hope that the collection and dissemination of good practices against chronic pain, which ACN has been carried out across Europe for years, as well as the online publication of good practices by experts and committed operators, could be valued in the contest of the European Pillar of Social Rights and contribute to transfer the recent achievement on chronic pain from the European political agenda to the European culture as fast as possible.


Abstract
The manuscript provides the scientific society and experts involved in pain relief and patient empowerment with a good practice focused on low back pain (LBP). Such best practice is particularly relevant today, taking into account the important advancements in the fight against pain and the new context of the European Pillar of Social Rights. In particular, key principle N.17 on the "Inclusion of people with disabilities" declares that "People with disabilities have the right to income support that ensures living in dignity, services that enable them to participate in the labor market and in society, and a work environment adapted to their needs" [1].
In continuity with its long-term policy on the fight against pain, the Italian NGO Cittadinanzattiva APS  For instance, back pain has been the most common reason for sick leaves in Germany for years.

Keywords:
According to a recent study by the German health insurance company DAK-Gesundheit, the trend continues. In 2019, 21,2% of the sick leave diagnoses were related to back pain and similar disorders. This is slightly more than in the previous year (20,9%), as found by DAK-Gesundheit, after analyzing data from around 2.4 million employed insured persons [5].
More in general, a study conducted by the Global The global burden of disability caused by low back pain has increased by more than 50% since 1990 and is due to increase even further in the coming decades as the population ages.

Results and Discussion
With concern to low back pain, Active Citizenship Network, through its EU project "EU Civic Prize on  Additionally, a pain specialist gets involved via telemedicine from the beginning of the treatment to maximally prevent the development of chronic pain.

Objective
A shared electronic case report form which also guides the general practitioner through the treatment algorithm provides access to the patients' data to all involved professionals.

Outcomes and Impact on Participants:
Questionnaires Bundesausschuss (G-BA). Altogether a team of more than 25 experts collaborate in this project.

Factors Enabling the Process:
By unburdening the doctor's staff through a bottom up approach, patients' inclusion substantially increased. Rise-up has deserved such award and flattering judgement for well satisfying the following criteria, which are essential to recognize a good practice from a citizen perspective [9].

Development of the Good
© Isabelle Pateer. The area of pain is no exception: reducing inequalities to allow a better quality of life for people suffering from chronic pain is the challenge we will face in the coming years. The hope is that the European Pillar of Social Rights could represent the "incubator" for a better and increased access to pain management, starting from a more efficient share of knowhow at European level.

Reproducibility
Accordingly, Active Citizenship Network, through the III° Edition of the European level "EU Civic Prize on Chronic Pain -Collection of good practices" [10], will continue to identify, collect, and disseminate good practices regarding the fight against pain [11] and a better quality of life. This will allow us to keep expanding the "agora" of operators of good practices on pain [12], encouraging the