Pooled results from 22 clinical trials show that psychological interventions help individuals with chronic low back pain experience less actual pain, less pain-related interference with daily living, less depression and work-related disability, and greater health-related quality of life.
Dr. Robert D. Kerns, who led the analysis, told Reuters Health, “The data across randomized, controlled studies are consistent.” Psychological interventions for chronic low back pain elicit “positive results.”
Kerns, of the VA Connecticut Healthcare System in West Haven and colleagues limited their pooled analysis to studies involving adults with low back pain not related to cancer for at least three months. Most of the study subjects had suffered with low back pain for much longer — 7-1/2 years on average.
In the overall analysis, psychological treatments — namely, behavioral and cognitive-behavioral therapies; self-regulatory therapies such as hypnosis, biofeedback and relaxation; and supportive counseling — either alone or as part of a multidisciplinary approach proved superior to no treatment or “treatment as usual.”
“The largest and most consistent effect was a reduction in pain intensity,” Kerns told Reuters Health. “This is good news for persons with pain and for providers who struggle to find effective and sustained approaches for reducing unnecessary pain and suffering of the lower back.”
The finding of an actual drop in pain with psychological therapy is also somewhat surprising, the researchers note, because traditionally the goal of psychological therapy for chronic back pain was not to reduce the pain but to help patients learn to live with it more successfully.
The findings appear in the journal Health Psychology.
Kerns hopes to “get the word out” that psychological treatments are effective and cost-effective for people who suffer chronic low back pain. “We need to specifically target health care system administrators and third-party payers to try to engage them in a more productive dialogue about the importance of these interventions,” Kerns said in a statement.
Low back pain affects 15 to 45 percent of adults annually and at least 70 percent of adults over their lifetime. “We continue to have a huge, very costly problem in our society, but we have an intervention that is effective, and we need to do a better job of creating access to these services,” Kerns said.
