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Behavioural treatment for chronic low back pain
M W van Tulder1, R W Ostelo, J W Vlaeyen
1Institute for Research in Extramural Medicine, Vrije Universiteit, van der Boechorststraat 7, Amsterdam, Netherlands, 1081 BT. mw.van_tulder.emgo@med.vu.nl
The Cochrane Database of Systematic Reviews
|May 5, 2000
Summary
Behavioral therapy offers moderate improvements in pain intensity and functional status for chronic low back pain patients. Further research is needed to identify which patients benefit most from specific behavioral interventions.
Area of Science:
- Rehabilitation Medicine
- Behavioral Science
- Pain Management
Background:
- Chronic low back pain management focuses on disability reduction through cognitive and environmental modifications, not solely on organic pathology.
- Behavioral interventions are frequently employed for treating chronic disabling low back pain.
Purpose of the Study:
- To systematically review the effectiveness of behavioral therapy compared to reference treatments for chronic non-specific low back pain.
- To identify the most effective types of behavioral treatments for this condition.
Main Methods:
- Conducted a systematic review of randomized trials on behavioral treatments for chronic non-specific low back pain.
- Searched major databases (Medline, PsycLit, Embase, Cochrane Controlled Trials Register) up to April/September 1999.
- Assessed methodological quality and extracted data independently; pooled effect sizes were calculated using a random effects model.
Main Results:
- Strong evidence indicates behavioral treatment moderately improves pain intensity and has small positive effects on functional status and behavioral outcomes compared to no treatment.
- Moderate evidence suggests adding a behavioral component to usual care shows no significant short-term benefits for functional status, pain intensity, or behavioral outcomes.
Conclusions:
- Behavioral treatment appears effective for chronic low back pain patients.
- Optimal patient selection for specific behavioral interventions requires further investigation.