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CBT effective for managing chronic back pain

By Lilian Anekwe

Cognitive behavioural therapy (CBT) can have a ‘sustained effect' on chronic low-back pain and is a cost-effective way of managing the condition in primary care, according to a randomised controlled trial by UK researchers.

The studied 700 patients from 56 UK practices with troublesome subacute or chronic low back pain who received an ‘active management advisory consultation' followed by either six sessions of group CBT or no further intervention, as a control.

The CBT targeted behaviours and beliefs about physical activity and the avoidance of exercise.

After 12 months the mean change from baseline in the Roland Morris disability questionnaire was 1.1 points in the control group and 2.4 points in the CBT group.

Patients given CBT improved by 13.8% in a second score, the modified Von Korff score, compared with 5.4% in the control group.

No serious adverse events were attributable to either treatment and the incremental cost of CBT was £1,786 per quality-adjusted life year – substantially lower than other interventions including manipulation, exercise and acupuncture.

Study leader Professor Sarah Lamb, director of the clinical trials unit at the University of Warwick medical school, concluded: ‘Effective treatments that result in sustained improvements in low-back pain are elusive. This trial shows that cognitive behavioural intervention is effective in managing subacute and chronic low-back pain in primary care.'

The Lancet, published online February 26

CBT can have a 'sustained effect' on chronic low-back pain, say UK researchers

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