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Does Cognitive Functional Therapy Help People With Chronic Low Back Pain?
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Posted on: 11/30/1999
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Persistent low back pain is a challenging disability and successful management can be a challenging part of any health care practitioner’s schedule. Effective treatment of patients suffering from chronic low back pain that does not stem from a specific injury or disease and lasts more than three months remains a hot topic in pain research. Research faculty at the University of Bergen in Norway took on this complex topic, as often non-specific chronic low back pain is treated unsuccessfully with many different health care treatments. Some of current treatments include: physical therapy, acupuncture, medication, spinal injections, and cognitive behavioral therapy to name a few. The many different treatment options is indicative of the difficult nature of treating this painful back condition. The failure rate of many of these therapies is frustrating for the patient, time-demanding and expensive for our health care system. This recent pain science article aimed to specify which treatments are most effective at improving spine pain by thoroughly classifying the patient’s into person-centered management categories.
The two treatment categories compared were typical physical therapy-type treatments of back stretches, strengthening, and hands-on therapies versus a newer type of therapy that focuses on a more mind-body approach that challenges the behaviors that contribute to sustained back pain in a graduated manner. Cognitive functional therapy aims to bridge the gap between pain as a mental health condition and a physical disability that limits the patient’s daily functions. A total of 121 voluntary patients with non-specific low back pain, that met the classification system requirements, were randomized into the two treatment groups. They underwent three months of one of two therapies and were re-assessed at the end of their treatment and again one year afterwards.
The results of this study found both groups improved significantly, but the cognitive functional therapy produced more effective outcomes in reducing low back pain over the traditional physical therapies. The statistical numbers were favorable right after the therapies were completed and at the 12 month follow-up when comparing pain levels, perceived back function scores and lost days from work. Getting at the whole issue or person-centered nature of cognitive functional therapy was found to have higher odds of the patient being completely satisfied were over three times higher three months after the treatment, and five times higher at the 12 months after. The only exception in the assortment of outcome scores used to measure improvement was typical physical therapy improved total lumbar spine range of motion better.
This study brings light to a shift in how to best treat non-specific low back pain from the typical model that addresses the injured anatomy to a method that addresses a broader scope of treating the patient’s physical, mental, social and behavioral health. This requires a more thorough evaluation and classification of the patient and their beliefs and fears, as well as their pain and type of back injury. This shift in reducing their fear of movement and improving their mood has a growing body of evidence to support these interventions. The authors concluded that both treatments are effective for managing low back pain, however the cognitive functional therapy was far superior.
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References:
Fersum, KV., et al. Efficacy of classification-based cognitive functional therapy in patients with non-specific chronic low back pain: A randomized controlled trial. In: European Journal of Pain. July 2013. Vol. 17. No. 6. Pp. 916–928.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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