Behavioural treatments for chronic low back pain

Operant therapy appears to be more effective than waiting list and behavioural therapy more effective than usual care for short-term pain relief in chronic low back pain patients.

A Cochrane review included 30 studies with a total of 3 438 subjects. Operant therapy was more effective than waiting list (SMD -0.43, 95%CI -0.75 to -0.11; 3 studies, n=153) for short-term pain relief. Little or no difference existed between operant, cognitive, or combined behavioural therapy for short- to intermediate-term pain relief. Behavioural treatment was more effective than usual care for short-term pain relief (MD -5.18, 95%CI -9.79 to -0.57; 2 studies, n=330), but there were no differences in the intermediate- to long-term, or on functional status. There was little or no difference between behavioural treatment and group exercise for pain relief or depressive symptoms over the intermediate- to long-term. Adding behavioural therapy to inpatient rehabilitation was no more effective than inpatient rehabilitation alone.

Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment).

Ədəbiyyat

1. Henschke N, Ostelo RW, van Tulder MW, Vlaeyen JW, Morley S, Assendelft WJ, Main CJ. Behavioural treatment for chronic low-back pain. Cochrane Database Syst Rev 2010;(7):CD002014. .