Cognitive Behavioral Therapy (CBT) for Subacute Low Back Pain: a Systematic Review.

Abstract:

PURPOSE OF REVIEW:Chronic low back pain (CLBP) is a major source of physical and psychiatric morbidity and mortality, and the current overreliance on opioid analgesics has contributed to a burgeoning epidemic in the USA. Cognitive behavioral therapy (CBT) is an empirically supported treatment for CLBP, but little information exists regarding its potential efficacy for CLBP's precursor condition, subacute low back pain (sALBP), defined here as having a 7-12-week duration. Earlier intervention with CBT at the sALBP stage could produce larger clinical benefits. This systematic review was undertaken to characterize and highlight this knowledge gap. RECENT FINDINGS:Of 240 unique articles identified by comprehensive database searches, only six prospective, sALBP-focused, randomized controlled trials (RCTs) published within the past 20 years met criteria for inclusion in this review. These studies varied widely in their sample sizes, precise definition of sALBP, nature of CBT intervention, and outcome measures. Five of the six showed significant improvements associated with CBT, but the heterogeneity of the studies prevented quantitative comparisons. CBT has not been adequately studied as a potential early intervention treatment for sALBP patients. None of the six identified papers studied US civilians or leveraged innovations such as teletherapy-able to reach patients in remote or underserved areas-underscoring critical gaps in current back pain treatment. Given the severity of the US opioid epidemic, non-pharmacologic options such as CBT should be rigorously explored in the sALBP population.

journal_name

Curr Pain Headache Rep

authors

Mariano TY,Urman RD,Hutchison CA,Jamison RN,Edwards RR

doi

10.1007/s11916-018-0669-5

subject

Has Abstract

pub_date

2018-02-23 00:00:00

pages

15

issue

3

eissn

1531-3433

issn

1534-3081

pii

10.1007/s11916-018-0669-5

journal_volume

22

pub_type

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