A pain grade that is not inferior to cognitive behavioral therapy for low back pain – mahrgan

September 23, 2021

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Source/disclosure

Disclosure: Darnall reports that he charged personal fees unrelated to the current research when he served as the chief scientific adviser to AppliedVR; received royalties on four pain treatment books written or co-authored by her; served as the Patient Centered Outcome Institute (PCORI) Pain Principal investigator of the research award; received consultant fees from Axial Healthcare related to physician education for opioid prescriptions and cancellations, not related to current work; served on the board of directors of the American Academy of Pain Medicine and the Institute of Brain Potential; NIH Interdepartmental Pain Scientific member of the Research Coordination Committee, the CDC Opioid Task Force, and the Pain Advisory Group of the American Psychological Association; and served as the principal investigator for another NIH research award. Please refer to the research for the relevant financial disclosures of all other authors.


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According to the results of a randomized clinical trial, a 2-hour pain management course provided adults with chronic low back pain with the same pain catastrophic benefits as eight 2-hour cognitive behavioral therapies.

“CBT provided in a group form can provide important elements such as contact with therapist and peer support,” Helen Langevin, Doctor of Medicine, The director of the NIH National Center for Complementary and Comprehensive Health (NCCIH) said in a press release. “But we realize that the 16 hours of treatment time and related costs may be unaffordable for some patients.”

The data shows that a single pain management course provides patients with chronic low back pain with the same pain catastrophic benefits as multiple cognitive behavioral therapies.
Image source: Adobe Stock

Dr. DelawareThe director of the NCCIH off-campus research program told Healio primary care that “efficient, low-cost treatment” is needed to reduce the burden on patients and expand access to treatment.

for research, Beth D. Danar, PhD, Professors from the Department of Anesthesiology, Perioperative and Pain Medicine at Stanford University School of Medicine and their colleagues randomly assigned 263 adults with a pain score of at least 4 on the 10-point pain score scale, and their pain was catastrophic. The scale score is moderate at least 20 to one of the following interventions:

  • A 2-hour “authorized relief” course that provides information on pain neuroscience, mindfulness concepts, and CBT. The researchers wrote that the course was designed to help participants identify “distressing thoughts and emotions, cognitive reconstruction, relaxation response exercises, and self-comforting action plans.”
  • The health education curriculum reflects authorized mitigation interventions regarding length, structure, form, and location. It also outlines warning signs of back pain and when to consult a doctor, general nutrition, and medication.
  • According to a previous study, eight 2-hour CBT courses taught participants “maladaptive automatic thinking”, managing their own pain, “activity rhythm and scheduling, preventing recurrence and maintaining benefits”.

Approximately half of the study participants were women, more than 60% were white, and the average age was 47.9 years. Participants’ progress was measured after 3 months.

Researchers report that authorized relief interventions are not inferior to CBT in terms of pain catastrophe (difference from CBT = 1.39 [97.5% CI, to 4.24]). Authorized relief and CBT are both superior to health education intervention (difference between authorized relief and health education = –5.9 [95% CI, –8.78 to –3.01]; The difference between CBT and health education = -7.29 [95% CI, –10.2 to –4.38]).

In addition, the decrease in pain catastrophic scores in the authorized relief group and CBT cohort is “clinically significant” (authorized relief = –9.12 [95% CI, –11.6 to –6.67]; CBT = –10.94 [95% CI, –13.6 to –8.32] And health education = –4.6 [95% CI, –7.18 to 2.01]), according to the researchers. Although enhanced relief is not as good as CBT in terms of physical function, the two interventions produced similar benefits for factors such as pain intensity, pain interference, sleep interruption, depression, and anxiety.

According to Darnell and colleagues, research limitations include the use of pain catastrophe—”a known primary mediator of pain and function [that] Not so important to most patients and clinicians”-as the main result. The researchers also emphasized that their findings should encourage the addition of effective mitigation measures for chronic low back pain treatment equipment.

White, who has nothing to do with the study, said, “The results of the study are promising.”

“The scalability of this intervention is significant for providing effective, low-cost, accessible, and less burdensome treatments for pain,” she said. “However, additional research is needed on different patients and other pain conditions.”

refer to:

Cut gold DC and so on. Trial. 2014; doi: 10.1186/1745-6215-15-211.

Press release

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