Talk therapy can help people with lower back pain, research finds
Treatment options for chronic back pain have long been limited and offer only 'small to moderate' benefits that do not last a long time.
Now, experts believe they have found a 'novel' approach to helping sufferers with a talking therapy that is focused on educating and improving activity levels, according to a study published in the Lancet Rheumatology journal.
A trial involving more than 1,000 people with lower back pain found that a new form of therapy, called Cognitive Functional Therapy (CFT), improved participants' quality of life and reduced the 'disabling' effect of back pain.
The researchers, led by experts at Macquarie University in Sydney, Australia, found that CFT was more effective than the usual care given to back-pain sufferers and the benefits lasted for three years after treatment – when the study ended.
Typically, psychotherapists use various forms of established talking therapies to help people with mental health conditions such as anxiety or depression, or other emotional issues, from tackling stress to breaking bad habits.
But there is also now increasing evidence that it may be able to help people overcome pain or reduce their experience of it.
For some people, lower back pain is a one-off event that gets better with time, but for others it can become chronic and cause long-term issues, affecting their mental and physical health.
Most treatments for the condition have 'small to moderate' effects that do not last for a long period of time, the experts said.
The new study focused on CFT – a type of psychotherapy to 'address the causal mechanisms' of chronic lower back pain and help to change the way people think about and respond to pain.
Of the 1,000 patients from Australia, a third were given 'usual care', a third were given CFT and the final third were given CFT plus another technique known as biofeedback, which tries to teach a person to control automatic body functions.
People who received 'usual care' were given what their GP surgery recommended or what they chose from their local services, which can include a combination of pain medication, self-management tips, and being encouraged to resume activities as soon as possible, including work.
Those receiving CFT had seven treatment sessions over 12 weeks, plus a booster session at 26 weeks, which last between 30 and 60 minutes.
Some 300 people with an average age of 48 continued the study to the three-year follow-up point, split between each of the three groups.
The main measure of the study was to assess people's activity levels at different intervals.
'Sustained effects'
Researchers found that CFT, also combined with biofeedback, were both more effective than usual care in reducing 'activity limitation' caused by lower back pain.
The improvements in activity levels among those who had undertaken the therapy grew over the first year and were still intact after three years, when the study ended.
There were no significant differences among patients who did and did not use biofeedback techniques, prompting researchers to say the use of biofeedback 'did not add to effectiveness'.
The researchers, led by Professor Mark Hancock of Macquarie University, said: 'Treatment sessions of CFT produced sustained effects at three years for people with chronic disabling low back pain.
'These long-term effects are novel and provide the opportunity to markedly reduce the effect of chronic back pain if the intervention can be widely implemented.'
They added: 'CFT is the first treatment for chronic disabling low back pain with good evidence of large, long-term effects on disability.
'It offers a high-value, low-risk intervention with long-term benefits for patients with persistent, disabling low back pain.'
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