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Incorporation of cognitive-behavioral treatment into the medical care of chronic low back patients.

13 Oct

German researchers find that a cognitive-behavioral program of relaxation, imagery, patient education and new postural habits significantly improves the plight of those suffering from lower back pain.

A randomized, controlled trial at the University of Marburg, Germany looked at the effectiveness of cognitive behavioral therapy for alleviating pain, helping with coping ability and reducing disability in patients with lower back pain.

Cognitive behavioral treatment is now a part of standard medical treatment procedures in German pain centers. The program consists of 12 weekly sessions of 2.5 hours each, where patients are offered relaxation and imagery, modification of thoughts and feelings, enhancement of pleasant activities, and training in good postural habits.

Ninety-four consecutive patients with low-back pain were randomly assigned to an experimental group having a combined medical and cognitive-behavioral treatment program (n = 36), or to a control group with medical treatment only (n = 40). Assessments were taken pre-treatment, post-treatment, and--in the treated group only--at a 6-months follow-up. In addition, at each assessment, patients kept a pain diary over a period of 4 weeks, and filled out self-report questionnaires.

Experimental subjects reported less pain, better control over pain, more pleasurable activities and feelings, less avoidance and less catastrophizing. In addition, disability was reduced in terms of social roles, physical functions and mental performance. The results were maintained at follow-up. Patients who received medical treatment only showed little improvement.

The study concludes that the cognitive behavioral program meets the needs of patients and is a significant improvement over standard medical care, and therefore be continued.

Citation: Basler HD, Jakle C, Kroner-Herwig B. Incorporation of cognitive-behavioral treatment into the medical care of chronic low back patients: a controlled randomized study in German pain treatment centers. Patient Education and Counseling. 1997 Jun; 31 (2):113-24. This email address is being protected from spambots. You need JavaScript enabled to view it.
Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award