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Mon 1 Jan 2007 02:58 PM

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Psychological therapies best for back pain

A review of data from 22 clinical trials show that psychological interventions help individuals with chronic low back pain experience less actual pain, less pain-related interference with daily living, less depression and work-related disability, and greater health-related quality of life.

A review of data from 22 clinical trials show that psychological interventions help individuals with chronic low back pain experience less actual pain, less pain-related interference with daily living, less depression and work-related disability, and greater health-related quality of life.

Dr Robert Kerns, who led the analysis, said: "The data across randomized, controlled studies are consistent." Psychological interventions for chronic low back pain elicit "positive results."

Kerns, of the US-based VA Connecticut Healthcare System, and colleagues limited their pooled analysis to studies involving adults with low back pain not related to cancer, that had persisted for at least three months.

In the overall analysis, psychological treatments, namely, behavioural and cognitive-behavioural therapies; self-regulatory therapies such as hypnosis, biofeedback and relaxation; and supportive counselling proved superior to no treatment or "treatment as usual."

"The largest and most consistent effect was a reduction in pain intensity," said Kerns in a statement. "This is good news for providers who struggle to find effective and sustained approaches for reducing unnecessary pain and suffering of the lower back."

The finding of an actual drop in pain with psychological therapy is also somewhat surprising, the researchers note, because traditionally the goal of psychological therapy for chronic back pain was not to reduce the pain but to help patients learn to live with it more successfully.

Kerns hopes the study will convince care providers and physicians that psychological treatments are both effective and cost-effective for people who suffer chronic low back pain.

"We need to specifically target health care system administrators and third-party payers to try to engage them in a more productive dialogue about the importance of these interventions," Kerns said.

The findings appear in the December edition of the journal Health Psychology.

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