Wednesday 22 January 2020

Ouch! Good chinwag is best cure for chronic back pain

Jeremy Laurence in London

DOCTORS have found a novel way of curing a bad back - positive thought.

Patients with chronic back pain who received cognitive behaviour therapy (CBT) were almost twice as likely to recover as those who were told to keep active and use painkillers -- the more conventional treatment.

CBT is established as the most effective of the talking treatments and has revolutionised the way doctors approach psychological conditions such as depression and anxiety. But it is not usually associated with physical ailments such as back pain.

The technique involves helping patients to break habitual ways of seeing things and to think positively instead of negatively.

Zara Hansen, a member the research team from the University of Warwick said: "We are not saying back pain is all in the mind. It is very much a physical problem but the way you understand it affects the way you manage it.

"When a person gets pain in their back they may well think they have harmed themselves or caused injury so they back away from more activity and movement, become more de-conditioned and fearful of pain.

This is the picture we see again and again with back pain, a very common cycle of avoidance. It is the most natural thing to do but, unfortunately, it drives people down a path of more stiffness and more pain."

The researchers recruited 700 patients from 56 general practices who had suffered back pain of at least moderate intensity for at least six weeks. Two-thirds were allocated to receive six sessions of group cognitive therapy, with eight patients per group on average, and the outcome was compared with the remaining third.

The results showed that after one year, 59pc of those who received the cognitive therapy said they had recovered, compared with 31pc of the control group.

Objective measures of pain also showed improvement was doubled among those who had the therapy. The findings are published in 'The Lancet'.


Ms Hansen said: "These are quite amazing results. We have shown that cognitive behaviour therapy is twice as effective as a single session of advice and at least as effective as manipulation, exercise therapy or acupuncture but at half the cost. The problem with many treatments is that they only work short term. We have shown improvement was sustained at 12 months, suggesting a long-term effect."

Back pain is the third most common reason for consulting a doctor, after headaches and tiredness, but GPs often cannot find a specific cause.

An estimated £1.6bn (€1.8m) is spent on treating back pain in Britain every year and billions more are lost in days off work.

An editorial in the Lancet said the results were "impressive" and suggested the therapy was "an excellent option" for back pain sufferers. (© Independent News Service)

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