Psychological Treatment Strategy for Chronic Low Back Pain
Open accessAbstract
Studies have indicated that chronic low back pain (LBP) should be approached according to its morphological basis and in consideration of biopsychosocial interventions. This study presents an updated review on available psychological assessments and interventions for patients with chronic LBP. Psychosocial factors, including fear-avoidance behavior, low mood/withdrawal, expectation of passive treatment, and negative pain beliefs, are known as risk factors for the development of chronic LBP. The Örebro Musculoskeletal Pain Questionnaire, STarT Back Screening Tool, and Brief Scale for Psychiatric Problems in Orthopaedic Patients have been used as screening tools to assess the development of chronicity or identify possible psychiatric problems. The Pain Catastrophizing Scale, Pain Self-Efficacy Questionnaire, and Injustice Experience Questionnaire are also widely used to assess psychosocial factors in patients with chronic pain. With regard to interventions, the placebo effect can be enhanced by preferable patient-clinician relationship. Reassurance to patients with non-specific pain is advised by many guidelines. Cognitive behavioral therapy focuses on restructuring the negative cognition of the patient into realistic appraisal. Mindfulness may help improve pain acceptance. Self-management strategies with appropriate goal setting and pacing theory have proved to improve long-term pain-related outcomes in patients with chronic pain.
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The impact of pain on daily functioning and quality of life (pain interference) can be improved by cognitive behavioral techniques, regardless of the person's level of physical function.
“Our results add to the body of literature showing that the impact of pain on a person’s daily functioning and quality of life (ie, pain interference) can be improved by cognitive behavioral techniques, such as cognitive restructuring and addressing maladaptive thought patterns, regardless of the person’s level of physical function [49,50].”
From Digital Mental Health Intervention Plus Usual Care Compared With Usual Care Only and Usual Care Plus In-Person Psychological Counseling for Orthopedic Patients With Symptoms of Depression or Anxiety: Cohort Study (2022) · cites this paper as [49]
The Psychotherapeutic approach section reports that CBT improves disability and pain catastrophizing in people with chronic pain and describes restructuring negative thoughts. It does not establish that these improvements occur regardless of a person’s level of physical function. (LLM, conf=0.87)
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References 84 · Cited by 67
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- Authors
- Ikemoto, T., Miki, K., Matsubara, T., & Wakao, N.
- Affiliations
- Aichi Medical University (JP)
- Center for Pain, Hayaishi Hospital
- Kobe Gakuin University (JP)
- Venue
- Spine Surgery and Related Research
- Published
- 2019-07-27
- Volume
- 3
- Issue
- 3
- Pages
- 199-206
- ISSN
- 2432-261X (ISSN-L)
- PMC
- PMC6698517
- OpenAlex
- W2896490772
- Cited by
- 67
- References
- 84
- Citations by year
- 2026: 6 · 2025: 3 · 2024: 11 · 2023: 18 · 2022: 8 · 2021: 11 · 2020: 9 · 2019: 1
- FWCI
- 0.61
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Spine Surgery and Related Research (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Keywords
- chronic low back pain, psychological intervention, biopsychosocial model, fear-avoidance beliefs, pain catastrophizing, pain self-efficacy, placebo effect, patient-clinician relationship, reassurance, cognitive behavioral therapy, mindfulness, self-management, goal setting, non-specific low back pain
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