CBT better for back pain than physical therapy

Patients with chronic lower back pain could benefit more from cognitive behavioural therapy (CBT) than from physical therapy, according to Dutch research.

The study showed that patients given 30 hours of CBT experienced less pain than those given more than 55 hours of intensive physical therapy, suggesting that the cheaper therapy may also be more effective.

The study included 223 patients who had been referred to a rehabilitation centre for non-specific chronic low back pain. Most of the patients had received treatment, usually physiotherapy, in the past.

The patients were randomised to receive CBT, active physical therapy, a combination of active physical therapy and CBT, or to remain on the waiting list.

All patients receiving therapy attended the clinic three times a week for 10 weeks.

The active physical therapy sessions each lasted one hour 45 minutes and included building aerobic capacity by training for 30 minutes at 65-80 per cent of maximum heart rate.

CBT was administered by a trained therapist. CBT patients also received problem solving training, administered by a clinical psychologist.

At the end of the study, patients in all the treatment groups were found to have reduced disability levels while disability increased in patients still on the waiting list. Patients given CBT had the greatest reduction in disability.

Patients in all treatment groups experienced similar improvements in mood and ability to carry out daily tasks but those who had either CBT or were in the combined treatment group reported less pain than those in the physical therapy group.

Lead researchers Dr Rob Smeets, from the Rehabilitation Centre Blixembosch and the University of Maastricht, said: 'The combination treatment was not better than the single treatment components. We were surprised by that.'

He added that the study supported CBT over physical treatment for patients with chronic back pain: 'It was better in terms of cost and was equally effective.'

Dr Graham Archard, a GP in Bournemouth, Dorset, and member of the Pain Society, said: 'Lower back pain is a hugely important condition. If you can effectively treat it with CBT, this could have huge resource implications.'

www.biomedcentral.com

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

A day in the life of a prison GP

A day in the life of a prison GP

Dr Patrick Staite tells GP Jobs what it is like to work as a prison GP.

GP practice list size up nearly 50% since 2004 contract

GP practice list size up nearly 50% since 2004 contract

The average GP practice list in England has increased by almost half since the new...

Fresh calls to scrap Capita contract as more cervical screening failures emerge

Fresh calls to scrap Capita contract as more cervical screening failures emerge

The BMA has renewed calls for NHS England to strip Capita of its primary care support...

Cost-effectiveness of GP at Hand 'challenging' to assess, interim report warns

Cost-effectiveness of GP at Hand 'challenging' to assess, interim report warns

The cost-effectiveness of the Babylon GP at Hand service will be difficult to determine...

How we improved end-of-life care in our practice

How we improved end-of-life care in our practice

Dr Victoria Middleton explains how her practice has increased the number of patients...

12,000-patient practice forced to close after service charge hike

12,000-patient practice forced to close after service charge hike

A 12,000-patient GP practice in Nottinghamshire has been forced to hand back its...