Can you tell me more about cognitive behavioral therapy? I went to the Mayo Clinic for evaluation of my chronic low back pain. The team strongly recommended CBT treatment. What is it exactly?

Cognitive behavioral therapy (CBT) is one of several different kinds of treatment models for patients with chronic pain of any kind. It has been shown effective for patients with pain and disability associated with the low back.

The basic principle behind CBT is that people with chronic pain start to change the way they act and move. These changes occur over time and limit what they can do and how they function. Beliefs and avoidance behaviors get started that keep the patient from ever getting better.

During CBT you will be taught how to increase your activity level. The goal isn't to reduce pain, though that may happen as a by-product. The plan is to increase what you can do each day.

So for example, each day you may be asked to do more repetitions of a particular exercise no matter what happens with your pain. The pain may get worse but you still perform all the activities and exercises. The hope is that your attitude toward pain will change and your activity level will become more normal.

Daily life goals are set and reviewed periodically. Pain levels are not recorded or compared from day to day. Physical and occupational therapists, social workers, psychologists, and vocational rehab counselors are usually all a part of a CBT program for low back pain.

Reference: 

Psychological or Physical Treatment of Disabling Chronic Back Pain: Which is More Effective? In The Back Letter. April 2006. Vol. 21. No. 4. Pp. 37, 43-45.

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