Psychological Methods Can Help Treat Low Back Pain

Chronic low back pain, is unfortunately, all too common. It takes its toll on individuals' lifestyles and their quality of life, and can be very expensive, resulting in everything from lost work hours - and jobs - to permanent disability.

There are many different ways to treat low back pain, ranging from simple painkillers to complex surgery. Now, it seems that less-common methods may actually be the most successful at reducing some of its symptoms.

Robert Kerns, PhD, who leads the psychology service at the VA Connecticut Health Service, decided to analyze 22 different trials of treatment methods spanning more than 20 years. All the study participants had suffered from low back pain, of varying origins (except cancer), for a long time - an average of seven years. They'd all tried many different forms of treatment, but Dr. Kerns concentrated on psychological methods like cognitive therapy, traditional counseling, and "self-help" techniques like biofeedback, relaxation, and hypnosis.

Psychological treatment of chronic low back pain has traditionally been aimed at helping patients cope with pain they can't do anything about, and that was initially the focus of Dr. Kerns' research. He measured variables like the participants' quality of life, their use of health care services, and symptoms like depression and the level of pain they experienced, as well as how that pain affected their daily activities.

The results surprised him. He wanted to know which methods were the most successful at helping patients deal with the pain, but instead he found that some methods actually helped reduce it. And the most successful pain relief came from the cognitive and self-help methods.

Pain is real, but it's also subjective, and very individual. This may explain why psychological methods work as well as they do. Self-help techniques in particular give pain sufferers more control over their ailments, which helps them feel better about their lives as well.

Low back pain is an expensive business. Almost $50 billion a year is spent on traditional treatments like surgery, nerve blocks, and strong narcotic pain relievers, many of which provide little or no relief. Unfortunately, it's easier to get insurance companies to pay for these kinds of treatments than to convince them to cover less tangible and longer-term options like psychotherapy and biofeedback.

This new research, though, may encourage insurers to reconsider that coverage. In the long run, it might be cheaper to pay for psychotherapy that helps people manage their pain better. At the very least they'll have an improved quality of life, but they may also miss less work, or possibly even re-enter the workforce - which could end up saving health care dollars for other purposes.