December 3, 2023

Patients with chronic low back pain have new hope from an innovative trial that combines psychological and physical approaches that allow patients to control pain and movement, resulting in a dramatic reduction in the condition and associated mobility problems.

estimated to be nearby 80% of adults Low back pain is experienced throughout their lives, and its prevalence only increases with age. For about a quarter of people, it becomes a frustrating chronic condition that lasts more than three months and can last for years.

A new treatment called cognitive functional therapy (CFT) has worked in a randomized controlled clinical trial involving nearly 500 patients with chronic back pain in 20 physical therapy practices. Results of the trial showed that those who underwent CFT — which included seven individual sessions with a specially trained clinician over 12 weeks and a booster visit six months later — reported improvements in movement and pain levels. Improvements were dramatic and persisted long after treatment.

Developed by Professor Peter O’Sullivan at Curtin School of Allied Health in Perth, Australia, CFT uses a physical and psychological approach to provide people with chronic pain with the tools to confidently manage their condition and the skills to move in ways that reduce disability.

“This new therapy takes into account the individual characteristics of people with chronic back pain by addressing their concerns and movement limitations under the skilled guidance of a trained physical therapist,” O’Sullivan said. traditional, more passive approaches — including massage, spinal manipulation, medication, and injections — because it holds people accountable for their condition, helps them understand what causes pain, builds control and confidence in their bodies, and returns to worthwhile activity.

He added: “It is particularly rare and exciting to discover that the significant reduction in aches and pains experienced by these individuals with chronic back pain persisted for a year.”

According to a study by researchers at Curtin University, Monash University and Macquarie University in Australia, more than 80 percent of patients who undergo CFT are satisfied with the results, noting the psychological benefit of being able to act with renewed confidence.

“Low back pain is a leading cause of disability globally, leading to reduced productivity and early retirement globally,” said lead author Peter Kent, Associate Professor at Curtin School of Allied Health. “These exciting results give hope to the millions of people around the world who are disabled by back pain. It also provides clinicians, health services and policymakers with a clear roadmap on how to evidence, a high-value, low-risk approach to reducing the growing burden of chronic back pain.”

Mark Hancock from Macquarie University led CFT’s Sydney trial and is now teaching students the principles of the therapy. The 18 practitioners participating in the clinical trial required five months of intensive training to improve their skills.

Macquarie University's Mark Hancock helps physiotherapists deliver cognitive function therapy to patients in clinical trial
Macquarie University’s Mark Hancock helps physiotherapists deliver cognitive function therapy to patients in clinical trial

Macquarie University

“While many already have experience, physiotherapists require extensive training to develop the skills and confidence to deliver a high standard of intervention,” he said, adding that the results were worth it.

“More than 80 percent of participants who underwent CFT reported that they were satisfied with their treatment and its results,” he added. “They reported a significant improvement in pain levels and were able to return to activities they previously enjoyed.

“Some of the people we spoke to after the study told us they were still benefiting from it Three years later

According to the researchers, there is another huge benefit of this type of treatment that addresses the psychological aspects of chronic disease as well as addressing the physical problems of the individual.

“The main economic efficiency results showed that participants in CFT treatment saved more than A$5,000 (US$3,330) each, largely due to their increased productivity in paid and unpaid work,” said co-author Terry Haines, A Monash University professor who investigates economic efficiency in healthcare and workplace savings. “This has the potential to save a lot of money for the global economy, as we know lower back pain is a burden that leads to lost productivity and early retirement around the world.”

The study was published in Lancet.

source: curtin university, Macquarie University