Talk Therapy May Reduce Back Pain

[Justin]

Group cognitive behavioral therapy may help patients with chronic or acute low-back pain, British researchers say...

Talk Therapy May Reduce Back Pain (click here for the full article at MedPage Today)

[KBear]

I think this forum is like talk therapy..... I know it definitely helped me having people who really understood what I was going through, who cared and didn't give me the usual bs people give.

[ajj1001]

I think this forum is like talk therapy..... I know it definitely helped me having people who really understood what I was going through, who cared and didn't give me the usual bs people give.

I agree, I've not seen group support evaluated in a similar way to a CBT intervention. I think support from those who are going through or have gone through the same problems is very effective.

[Justin]

I think this forum is like talk therapy..... I know it definitely helped me having people who really understood what I was going through, who cared and didn't give me the usual bs people give.

I agree, I've not seen group support evaluated in a similar way to a CBT intervention. I think support from those who are going through or have gone through the same problems is very effective.

Very true! :thumpup:

[Justin]

The Lancet, Early Online Publication, 26 February 2010

Group cognitive behavioural treatment for low-back pain in primary care: a randomised controlled trial and cost-effectiveness analysis

Prof Sarah E Lamb DPhil a b , Zara Hansen MCSP a, Ranjit Lall PhD a, Emanuela Castelnuovo MSc a, Emma J Withers a, Vivien Nichols MRes a, Rachel Potter MSc a, Prof Martin R Underwood MD a, on behalf of the Back Skills Training Trial investigators‡. a Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK. b Kadoorie Critical Care Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK. ‡ Members listed at end of paper. © 2010 Elsevier Limited. All rights reserved.

Background
Low-back pain is a common and costly problem. We estimated the effectiveness of a group cognitive behavioural intervention in addition to best practice advice in people with low-back pain in primary care.

Methods
In this pragmatic, multicentre, randomised controlled trial with parallel cost-effectiveness analysis undertaken in England, 701 adults with troublesome subacute or chronic low-back pain were recruited from 56 general practices and received an active management advisory consultation. Participants were randomly assigned by computer-generated block randomisation to receive an additional assessment and up to six sessions of a group cognitive behavioural intervention (n=468) or no further intervention (control; n=233). Primary outcomes were the change from baseline in Roland Morris disability questionnaire and modified Von Korff scores at 12 months. Assessment of outcomes was blinded and followed the intention-to-treat principle, including all randomised participants who provided follow-up data. This study is registered, number ISRCTN54717854.

Findings
399 (85%) participants in the cognitive behavioural intervention group and 199 (85%) participants in the control group were included in the primary analysis at 12 months. The most frequent reason for participant withdrawal was unwillingness to complete questionnaires. At 12 months, mean change from baseline in the Roland Morris questionnaire score was 1·1 points (95% CI 0·39—1·72) in the control group and 2·4 points (1·89—2·84) in the cognitive behavioural intervention group (difference between groups 1·3 points, 0·56—2·06; p=0·0008). The modified Von Korff disability score changed by 5·4% (1·99—8·90) and 13·8% (11·39—16·28), respectively (difference between groups 8·4%, 4·47—12·32; p<0·0001). The modified Von Korff pain score changed by 6·4% (3·14—9·66) and 13·4% (10·77—15·96), respectively (difference between groups 7·0%, 3·12—10·81; p<0·0001). The additional quality-adjusted life-year (QALY) gained from cognitive behavioural intervention was 0·099; the incremental cost per QALY was £1786, and the probability of cost-effectiveness was greater than 90% at a threshold of £3000 per QALY. There were no serious adverse events attributable to either treatment.

Interpretation
Over 1 year, the cognitive behavioural intervention had a sustained effect on troublesome subacute and chronic low-back pain at a low cost to the health-care provider.

Funding
National Institute for Health Research Health Technology Assessment Programme.

[Moni]

Justin, I would like to talk to your cat...he/she seems to have it all together and looks like he/she is quite mellow and pain free.
mg

[muddywaters]

I hope this works in the grab-bag of pain-reduction arsenals.

I find that if my attention is diverted, my pain diminishes a bit.

As an incipient therapist, I'd like to learn more how cog-beh helps in pain reduction.

ans

[Cindylou]

Yes, I agree ans. When I am watching my granddaughter, I swallow up all the happiness oozing out of her, and forget my pain for the time being. :)

[JK2234]

I agree, this forum is great

[Ruth]

I agree with all that's been said . It's so helpful "talking" to other spine patients who have first hand experience of it themselves. It also makes me feel less alone & isolated.

In addition, to help me through the difficult bits, when progress has been frustratingly slow I've had & am currently having reiki which is very therapeutic. After talking things through with the therapist she then does the reiki which gives me an hour of deep relaxation & makes me feel so much calmer/relaxed & able to cope with things.