By Frank Long, MS, Editorial Director
Some chronic pain patients have an internal tug-o-war between wanting to feel better and wanting to avoid physical activity. To get the outcome they want they first need to get past their fear. To prove how a multi-disciplinary approach to treatment can lead chronic back pain patients toward the results they want researchers once again pitted physical therapy against yoga.
Toss the Self-Help Books
Researchers from Boston Medical Center (BMC) compared the effects of physical therapy, yoga, and evidence-based self-help materials on patients affected by chronic low back pain. What they found was that those who set aside their fear of exercise and participated in yoga or physical therapy fared significantly better than fearful patients who stayed home, read self-help books, and tried to treat themselves.
This study highlights the effect that fear can have on patient outcomes. Among the participants identified to have less fear around physical activity, 53% were more likely to respond to yoga and 42% were more likely to respond to physical therapy than self-care (13%).Boston Medical Center Study
Cast Your Fears Aside
The study published in Pain Medicine, revealed one thing clearly, according to a media release from the center: mind-set matters. Although the positive health effects of a mind-set that include optimism and enthusiasm have circulated for decades, they have been scientifically re-certified by the BMC research team.
While it may not be entirely surprising that physical therapy treatment or yoga practice achieved better results than self-treatment, the intensity of those results was notable. According to the BMC release, “…what is significant is that a much larger effect was observed among those already taking pain medication to treat their condition and those who did not fear that exercise would make their back pain worse.”
To further amplify that point, the media release notes “…people with chronic low back pain (cLBP) have better results from yoga and physical therapy compared to reading evidence-based self-help materials.”
The diversity of the research team, which includes physicians, physical therapists, and a chiropractor, not only assures the experiments were designed from a well-rounded approach but hints that the findings may have implications across healthcare disciplines.
“Adults living with chronic low back pain could benefit from a multi-disciplinary approach to treatment including yoga or physical therapy, especially when they are already using pain medication,” Team leader Eric Roseen, DC, MSU, confirms.
About the Research
The study involved 299 participants with chronic lower back pain at a safety net hospital and seven federally qualified community health centers, across 12 weeks of treatment.
The self-care intervention used by the study group that opted out of exercise was The Back Pain Handbook, a book that provides guidance for self-management of chronic lower back pain symptoms.
Psychological characteristics were among the treatment modifiers studied as predictors of improvement. Treatment expectations, general health, and sociodemographic data were also evaluated for their effect on treatment.
Read the complete study published in Pain Medicine.