Cognitive therapy as good as physical rehabilitation to treat chronic lower back pain

Training your mind might be just as effective as working your muscles to treat chronic lower back pain. A study published today in the open access journal BMC Musculoskeletal Disorders shows that therapy that helps chronic back pain sufferers overcome the psychological challenges associated with the pain is as effective as treatment that aims to restore back muscle strength and physical ability. Surprisingly, combining both psychological and physical treatments is not more effective than using the individual treatments separately.

Rob Smeets from the Rehabilitation Centre Blixembosch and the University of Maastricht and colleagues from other institutions in The Netherlands randomly assigned 223 chronic back pain sufferers to receive either active physical treatment, psychological ‘cognitive-behavioral’ treatment, a combination of both, or no treatment at all, for a period of ten weeks.

Active physical treatment aims to restore aerobic capacity and back muscle strength – in the study, it consisted of aerobic training on a bicycle and strengthening exercises for the lower back. Cognitive-behavioral treatment aims to help patients overcome their reluctance to be more active and teaches them how to face obstacles for recovery using problem solving skills.

Smeets et al. assessed the overall mobility of the patients before treatment and immediately after the 10-week treatment period. Their results show that both physical treatment and cognitive-behavioral treatment significantly reduce the functional limitations associated with back pain, and reduce the intensity of the pain, compared to no treatment at all. However, combining the treatments does not improve patients’ condition further than using the individual treatment regimens.

“It should be considered that these results are short-term results”, said the authors; follow-up results one year after the end of the treatment period will be available later this year.