A single two-hour session on pain management skills could offer as many benefits as a longer CBT

According to a study published in JAMA network open. Supported by the National Center for Complementary and Integrative Health (NCCIH) and the National Institute on Drug Abuse, both of which are part of the National Institutes of Health, the study investigated whether a compressed intervention could result in the same benefits as longer treatment for CBT. .

CLBP is the most common source of chronic pain in the United States and around the world. Although the use of surgical and pharmaceutical interventions to manage chronic low back pain is on the increase, the body of evidence has led to recommend pain education and CBT as first-line treatments.

Group CBT can offer important elements such as contact with a therapist and peer support. But we realize that 16 hours of treatment and the associated costs might be out of reach for some patients, so this research could expand treatment options and make non-surgical, non-pharmaceutical pain management accessible to more patients. “

Hélène Langevin, MD, Director of NCCIH

The research team, led by Beth D. Darnall, Ph.D., of Stanford University School of Medicine, Calif., Recruited 263 adults who had suffered from chronic low back pain for at least six months, with an average intensity of pain of 4/10 or greater, and randomized them to three different treatment arms. All 87 patients randomized to the empowered relief group participated in a single, two-hour pain relief skills-building course. The enhanced relief intervention included pain education, mindfulness principles, and self-regulatory skills such as relaxation, cognitive reframing, and self-soothing. The 88 patients in the CBT group participated in eight two-hour courses on pain management education and active reinforcement of cognitive-behavioral skills. Within the health education group, 88 patients participated in a single two-hour back health class, which was designed to match the empowered relief class in terms of duration, structure, format. and class site.

In the study, the primary endpoint was measured by the differences in the pain catastrophism score three months after treatment. The researchers designated several secondary outcomes, including the intensity and discomfort of pain in the previous seven days, interference of pain with daily life such as sleep or physical function, and other outcomes. of judgment.

Pain catastrophism can lead to heightened attention to pain and a feeling of helplessness or loss of control. These responses can cause neural circuits in the brain to amplify pain signals. A catastrophic decrease in pain can have a favorable impact on brain function and structure, and research suggests a reduction in disability as well. The Pain Catastrophism Scale was introduced in 1995 and measures 13 various cognitive and emotional responses to pain.

Comparing the scores of the Pain Catastrophic Scale three months after the intervention, the results in the enhanced relief group were comparable to those in the CBT group (1.39, confidence interval (CI) 97.5 %), while the researchers found that CBT and enhanced relief were superior to the health education session (-7.29, 95% CI and -5.90, 95% CI, respectively) .

“When it comes to pain, we know that the connection between mind and body runs deep, and coping skills can have a profound impact on how – and to what extent – people experience pain.” , said Dr Langevin. “When people are overwhelmed by chronic pain, they face daily stresses and limitations. This study is exciting because it offers another treatment option for patients and clinicians to consider. “