Effective back pain treatment should combine physical and mental therapies

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Effective back pain treatment should combine physical and mental therapies

Chronic back pain can be a debilitating condition. It can severely impact patients’ quality of life, force people into retirement or prevent the usual fun activities, such as sports or taking a walk.

Back pain is usually treated with drugs and physiotherapy, but now scientists at the University of Sydney said that the most effective back pain treatments would not neglect the mind.

Scientists in Australia and Canada decided to investigate the effectiveness and safety of common psychological interventions on physical function and pain intensity. Their focus was chronic back pain and they performed an analysis of a total of 97 randomised controlled trials involving 13,136 participants and 17 treatment approaches. 

Researchers classified psychological interventions into 6 categories: behavioural interventions, cognitive behavioural therapies, mindfulness, counselling, pain education programmes, and two or more combined psychological approaches. Then they looked at what results therapies from each category yielded.

First of all, researchers discovered that psychological interventions combined with traditional physiotherapy treatments led to clinically important improvements in physical function up to two months after treatment. In particular, results from cognitive behavioural therapies (often called ‘talking treatments’) and pain education delivered these kinds of results. 

Meanwhile behavioural therapy, cognitive behavioural therapy, and pain education helped reduce the intensity of the pain, but only behavioural therapy delivered with physiotherapy maintained these effects for up to 12 months after therapy.

Why is mental health so important in cases of chronic back pain? Well, back pain is an impairment on one’s way of living. It leads to  anxiety, depression or fear of pain from movement. Because of these mental factors patients often are afraid to partake in physiotherapy and sports, both of which are often crucial for improving the condition.

Emma Ho, one of the authors of the study, said: “Clinical guidelines consistently recommend a combination of exercise and psychosocial therapies for managing chronic low back pain, however very little is actually known about the different types of psychological therapies available and their effectiveness”.

Various health conditions can compromise the body, but these impairments often lead to mental health challenges that are not easy to overcome. Improving the mental aspect of the treatment helps patients take physical therapies easier and could improve the overall results. This is very important for chronic back pain, but is likely to be a factor in other similar conditions as well.

Source: University of Sydney

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