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Chronic Back Pain Soothed by Cognitive Behavioral Therapy
Date:2/25/2010

Cognitive behavioral therapy for health problems is based on a psychological model, Hansen said.

"The model explains that the way that we think about our health problems will determine how we behave or, put another way, how we manage them," Hansen said. "If we have unhelpful ways of thinking about back pain, we'll behave or manage it in unhelpful ways. A cognitive behavioral intervention targets the thoughts or behaviors directly."

"For example, if I have persistent back pain and I think that I should avoid anything that brings on pain in case I am damaging myself, then I will slowly become less and less active, less and less fit, and then the stiffness and weakness that comes with using my back less will make my back feel worse," Hansen said.

Therapy, offered individually or in a group setting, helps patients identify this vicious cycle. The aim is to understand that pain doesn't usually signify ongoing damage and that by gradually increasing activity they can relieve the stiffness and weakness, Hansen said. "The main aim of the intervention is to help people get back to doing enjoyable and/or rewarding activities that they may have stopped or avoided due to back pain," she said.

Back pain is increasingly common, said Dr. Laxmaiah Manchikanti, medical director of the Pain Management Center of Paducah, Ky. "However, it can be managed effectively for a significant proportion of patients in a primary-care setting with (therapy) when it is available."

Therapy costs about half of other treatments, such as acupuncture, the researchers noted. But as a treatment for back pain, it is not usually covered by health insurance in the United States.

Manchikanti noted that in Great Britain such therapy is available at a low-cost paid for by insurance. "Other countries than the U.S. should apply cognitive behavioral therapy prior to embarking on specialty referrals with other interventions or surgery," he said. "For th
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