Low back pain patients who completed a 12-week rehabilitation program offering both cognitive-behavioral therapy (CBT) and physical therapy improved on several outcomes, according to researchers from the Cleveland Clinic.
These outcomes included the extent to which pain interfered with daily life, perceived disability, depression, and anxiety.
“We’re hoping that this is something that can change the way chronic low back pain is treated,” says author Sarah Rispinto, PhD, a psychologist at the Cleveland Clinic in Ohio, according to Medscape Medical News.
The study was presented recently at the American Academy of Pain Medicine 2018 Annual Meeting.
In 2016, the Cleveland Clinic launched the Back on TREK program, where frontline behavioral medicine specialists and physical therapists teach patients self-management using CBT for pain and psychologically informed physical therapy.
Researchers collected data on 116 patients who had chronic low back pain for at least 3 months. Over 12 weeks, study participants devoted at least 1 hour three times a week to individual and group sessions focusing on physical or behavioral therapy.
At the beginning and end of the program, study participants completed the Oswestry Disability Index (ODI) and Patient-Reported Outcomes Measurement Information System (PROMIS) assessments.
The study revealed clinically significant changes across multiple functional measures, including the ODI and all PROMIS measure subscales (such as social role satisfaction, fatigue, pain and global physical health), the Medscape Medical News story explains.
Another PROMIS subscale that assesses the degree to which pain interferes with functioning also improved.
Close to half of the participants completing the program showed clinically significant changes in depression and anxiety.
This initiative aims to change the standard of care for back pain, says Rispinto in the news story.
“We’re hoping that patients try this interdisciplinary approach first, that this can be a first-line treatment as opposed to a tertiary approach.”
Rispinto and colleagues are now assessing whether the program affected opioid use.
“One of the goals of the program is to reduce the reliance on opioids, so we’re hoping to look into that to see how much of a reduction there was — how many patients came into the program on opioids, and how many were discharged without opioids.”
A future goal is to compare those who went through program to those who did not, Rispinto adds.
The investigators also want to replicate the program to treat other chronic conditions. Rispinto notes in the news story that many patients with chronic low back pain have comorbidities, such as fibromyalgia.
[Source: Medscape Medical News: Integrated Approach for Low Back Pain May Shift Standard of Care – Medscape – May 02, 2018.]