When back pain or injury becomes chronic, health-care costs escalate dramatically. By offering effective treatment right away, chronic problems might be avoided and costs reduced. But which treatments work best to keep back problems from becoming chronic?
The way people think about their back problem affects how well they recuperate, which may explain why new types of treatment that help people change their thoughts and behaviors about back pain are showing good results in preventing chronic problems.
One idea is to help back patients learn to overcome their fears about doing activities. Another school of thought is the cognitive-behavior approach, which gives people ways to cope with their situation in order to counteract chronic problems.
Researchers tested how well the cognitive behavior model compared to simply giving patients information about their problem. The patients in this new model took part in six group sessions led by a behavioral therapist. They learned and practiced ways to solve problems that might happen to people with pain. Other patients only received information. Some got a pamphlet about back pain. The rest received a packet each week for six weeks showing how to keep their backs safe and healthy.
Major benchmarks of how well patients did included the amount of time people were out of work and how often they needed to see their doctor or physical therapist. Levels of pain and ability to do activity were also measured. The authors also kept track of whether fear kept people from doing activities and how patients though about their back problem.
The results show that the new model can really help, especially when it is used when people first start having back problems. Patients receiving the behavior treatment were nine times less likely to develop chronic problems. They also had fewer visits to their doctor and physical therapist.
The chance of helping people avoid chronic problems improves when a program like this is started soon after back pain or injury. “These findings,” say the authors, “underscore the significance of early interventions that specifically aim to prevent chronic problems.”