Easing Chronic Lower Back Pain with… Words?

With many Americans blaming overprescribing for the painkiller abuse epidemic, novel treatments excluding medication — such as the oxygen chamber — are few and far between. However, a new analysis may have uncovered one for patients with chronic lower back pain.

A study conducted by researchers from Royal Holloway, University of London uncovered benefits to a new form of talking therapy. Contextual Cognitive Behavioral Therapy (CCBT) focuses on accepting and learning to live with incurable pain. Lead author Tamar Pincus and her colleagues found that this is a promising technique for chronic lower back pain relief.

“We know that for some people with chronic low back pain psychological stress is a major factor, and therefore there is a significant challenge to find effective treatments,” Stephen Simpson, PhD, director of research and programs at Arthritis Research UK, said in a news release.

The 89 patients included in the research had been suffering from back pain for more than 3 months and scored above the threshold for fear avoidance, catastrophic beliefs, and distress. The participants were split in half and randomly assigned to either receive CCBT or physiotherapy for 8 weeks between September 2010 and December 2013. The CCBT treatment consisted of up to 8 one-hour sessions on a one-on-one basis with a psychologist. Those taking physiotherapy participated in fitness group exercises that included at least 60% exercise-based activities.

“Patients and clinicians felt the best solution would be to deal with both physical difficulties and psychological problems,” said Pincus, a professor of health psychology at the university.

According to the findings published in BMC Musculoskeletal Disorders, the CCBT group experienced a greater reduction in pain at the 6-month mark when compared to the physiotherapy group. Although the authors advised CCBT as a credible way to treat lower back pain, they warned that the study only looked at a small population.

Not only did the results reveal benefits of CCBT, but it turns out that patients prefer to incorporate the method into their treatment.

“Our study found that CCBT is acceptable to patients, but interestingly many patients who took part, as well as several of the clinicians involved — both psychologists and physiotherapists – thought the best treatment was a combination of both physiotherapy and CCBT,” Pincus explained.

Since this was a preliminary trial with a minimal participant pool, the team is planning to analyze long-term benefits of CCBT in combination with physiotherapy in a larger population.

“This pilot study has shown that combining physical and psychological approaches could be the way forward to treat this common, often disabling condition more effectively,” Simpson confirmed.