VITAL SIGNS: HEALING; Relieving Back Pain by Starting With the Head
By NICHOLAS BAKALAR
Psychological treatments of lower back pain have a real but modest effect on pain intensity, quality of life, and physical and emotional functioning, a systematic review of recent studies has found. The paper appears in the January issue of Health Psychology.
Researchers reviewed 22 randomized controlled trials that tested psychological treatments for noncancerous chronic lower back pain against control groups that received no treatment or the usual medications and exercises. The interventions included cognitive behavioral treatment, biofeedback, relaxation and hypnosis.
Using statistical techniques to combine and analyze the studies’ results, the researchers concluded that such interventions, alone or as part of multidisciplinary treatment, had moderate effects on pain intensity and quality of life.
The two kinds of therapy that had the greatest effects in pain reduction were cognitive behavioral therapy and ”self-regulatory therapy,” like biofeedback and relaxation. Only the self-regulatory therapies significantly reduced the depression associated with back pain.
”This review provides the most compelling evidence to date of the very real effects of psychological interventions on people’s experience of pain,” said Robert D. Kerns, a co-author of the analysis and chief of the psychology service at the VA Connecticut Healthcare System in New Haven.