Psychological Treatments for Back Pain

[admin]

Biofeedback or cognitive-behavioral therapy can actually reduce feelings of pain by about 30 percent, according to a 2007 study, and may even be more effective than drugs or surgery.

These results were published in the journal Health Psychology, by researchers from Duke University Medical Center.

The research team looked at 22 earlier studies of people with chronic lower back pain. Some people in these studies were getting psychological treatments, while others – with similar severity of disease – were being treated with more conventional means such as analgesics or even surgery.

Cognitive-behavioral therapy (CBT) appeared stronger than anything else, lead author Robert Kerns reports. CBT teaches patients to divert their attention from pain and to think about it in a less alarming manner.

The biggest challenges are:
- insurance companies often don't reimburse patients for these treatments.
- psychological pain specialists are not widely available

[admin]

Further support for cognitive-behavioral therapy was provided in a paper published in the Annals of Internal Medicine in 2008. Supported by the American Pain Society and American College of Physicians this research looked at Nonpharmacologic therapies for acute and chronic low back pain.

This research again looked at multiple prior reports and concluded :

" Therapies with good evidence of moderate efficacy for chronic or subacute low back pain are cognitive-behavioral therapy, exercise, spinal manipulation, and interdisciplinary rehabilitation. For acute low back pain, the only therapy with good evidence of efficacy is superficial heat."

[admin]

Further support for CBT (Cognitive Behavioural Therpay) in treating back pain was presented at the Forum X "Primary Care Research On Low Back Pain"


The conclusions were:
CBA has important and sustained benefits at 12 months.
Clinical gains are important at public health and individual level.
Gains at a population level are consistent with twice as many people reporting improvement
The intervention is highly cost-effective.

[admin]

Here's some interesting research, where the results indicate that your views and what you think of the process/procedure will have a big impact on your outcomes. In a paper presented at "Primary Care Research On Low Back Pain" Forum X in June 2009, the authors (Jon Lurie, Dartmouth Medical School; Sigurd Berven, UCSF; Emily Blood, Dartmouth Medical School; Anna Tosteson, Dartmouth Medical School; Kevin Spratt, Dartmouth Medical School; Tor Tosteson, Dartmouth Medical School; James Weinstein, The Dartmouth Institute for Health Policy and Clinical Practice ) concluded:

"High expectations of benefit from surgery were associated with overall better outcomes regardless of treatment, while expectations of benefit from non-operative care was specifically associated with better outcomes from non-operative care."

Their paper was titled "The Effect of Treatment Preferences and Expectations on Intervertebral Disc Herniation Outcomes in Sport"