Psychological Approaches for the Integrative Care of Chronic Low Back Pain: A Systematic Review and Metanalysis.
Study Goal
The researchers aimed to identify and describe common psychological approaches, including mindfulness-based stress reduction (MBSR), for treating chronic low back pain (CLBP).
Results Summary
MBSR interventions were associated with improvements in pain intensity, quality of life, and disability compared to usual care, though no significant differences in fear-avoidance beliefs were noted compared to CBT.
Population
Adults with chronic low back pain (CLBP).
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
cognitive behavioral therapy (CBT) | decrease | pain intensity | patients who suffer from CLBP | - | associated with an improvement | #1 |
cognitive behavioral therapy (CBT) | increase | quality of life | patients who suffer from CLBP | - | associated with an improvement | #2 |
mindfulness-based stress reduction (MBSR) | decrease | pain intensity | patients who suffer from CLBP | - | associated with an improvement | #3 |
mindfulness-based stress reduction (MBSR) | increase | quality of life | patients who suffer from CLBP | - | associated with an improvement | #4 |
cognitive behavioral therapy (CBT) | decrease | disability | patients who suffer from CLBP | - | improved | #5 |
mindfulness-based stress reduction (MBSR) | decrease | disability | patients who suffer from CLBP | - | improved | #6 |
cognitive behavioral therapy (CBT) | decrease | fear-avoidance beliefs | patients who suffer from CLBP | - | significant differences | #7 |
cognitive behavioral therapy (CBT) | neutral | pain-related outcomes | patients who suffer from CLBP | - | modify | #8 |
mindfulness-based stress reduction (MBSR) | neutral | pain-related outcomes | patients who suffer from CLBP | - | modify | #9 |
Chronic low back pain (CLBP) is the most common cause of disability worldwide, affecting about 12% to 30% of the adult population. Psychological factors play an important role in the experience of pain, and may be predictive of pain persistence, disability, and long-term sick leave. The aim of this meta-analysis was to identify and to describe the most common psychological approaches used to treat patients who suffer from CLBP. A systematic search was performed on PubMed/MEDLINE and Cochrane Central. Overall, 16 studies with a total of 1058 patients were included in the analysis. Our results suggest that cognitive behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR) interventions are both associated with an improvement in terms of pain intensity and quality of life when singularly compared to usual care. Disability also improved in both groups when compared to usual care. Significant differences in fear-avoidance beliefs were noted in the CBT group compared to usual care. Therefore, psychological factors are related to and influence CLBP. It is crucial to develop curative approaches that take these variables into account. Our findings suggest that CBT and MBSR modify pain-related outcomes and that they could be implemented in clinical practice.