Volume 22, Issue 1 (January-February 2023)                   Payesh 2023, 22(1): 29-38 | Back to browse issues page

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1- Department of Health Psychology, School of Psychology, Islamic Azad University, Roudehen Branch, Tehran, Iran
2- Population Health Research Group, Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
3- Department of Public Health, School of Health, Mazandaran University od Medical Sciences, Sari, Iran
Abstract:   (868 Views)
Objective (s): Chronic low back pain is one of the most common chronic diseases that influence people's health and quality of life. The first line of non-medical management of chronic low back pain is psychological interventions. The current scoping review aimed to determine psychological interventions usually are used to treat chronic low back pain.
Methods: This scoping review examined studies published in English language with related keywords including ‘chronic low back pain’, ‘cognitive behavior therapy’, ‘behavioural/behavioral therapy’, ‘mindfulness’, ‘mediation’, ‘stress reduction’, ‘biofeedback’, ‘pain education’, ‘counselling’ and ‘acceptance and commitment therapy’ in PubMed. The data were extracted and tabulated to summarize evidence. In addition, information on instruments used to measure pain were addressed.
Results: In all 156 papers was retrieved. Of these, 21 papers fulfilled the inclusion criteria. 19 articles out of 21 articles had a control group. The findings of the study showed that cognitive behavioral therapy, behavioral therapy, mindfulness and biofeedback were used more than other types of interventions. The results of cognitive behavioral therapy, behavioral therapy and mindfulness interventions confirmed their effectiveness, but using biofeedback intervention did not show certain result in the treatment of chronic back pain. The Numerical Rating Scale (NRS) was the most widely used instrument for pain assessment.
Conclusion: The findings showed that psychological interventions were effective in the treatment of chronic low back pain (especially back pain with psychosomatic causes). In cases where chronic low back pain has a specific cause, psychological intervention alone is not effective and should be used in combination with clinical interventions or other non-medical interventions such as rehabilitation.
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type of study: Descriptive | Subject: Health Psychologhy
Received: 2022/12/31 | Accepted: 2023/01/14 | ePublished ahead of print: 2023/01/16 | Published: 2023/02/7

1. Hoy D, Bain C, Williams G, March L, Brooks P, Blyth F, et al. A systematic review of the global prevalence of low back pain. Arthritis & Rheumatism 2012;64:2028- 2037 [DOI:10.1002/art.34347]
2. Van Tulder M, Becker A, Bekkering T, Breen A, del Real MT, Hutchinson A, et al. European guidelines for the management of acute nonspecific low back pain in primary care. European Spine Journal 2006;15:s169 [DOI:10.1007/s00586-006-1071-2]
3. Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. The Lancet 2012;379:482-491 [DOI:10.1016/S0140-6736(11)60610-7]
4. Wang L,Ye H, Li Z, Lu C, Ye J, Liao M, et al. Epidemiological trends of low back pain at the global, regional, and national levels. European Spine Journal 2022;31:953-962 [DOI:10.1007/s00586-022-07133-x]
5. Ghafouri M, Teymourzadeh A, Nakhostin-Ansari A, Sepanlou SG, Dalvand S, Moradpour F, et al. Prevalence and predictors of low back pain among the Iranian population: Results from the Persian cohort study. Annals of Medicine and Surgery 2022;74:103243 [DOI:10.1016/j.amsu.2022.103243]
6. James SL, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet 2018;392:1789-1858 [DOI:10.1016/S0140-6736(18)32279-7]
7. Ma K, Zhuang ZG, Wang L, Liu XG, Lu LJ, Yang XQ, et al. The Chinese Association for the Study of Pain (CASP): consensus on the assessment and management of chronic nonspecific low back pain. Pain Research and Management 2019;2019:8957847 [DOI:10.1155/2019/8957847]
8. Andersson GB. Epidemiological features of chronic low-back pain. The Lancet 1999;354:581-585 [DOI:10.1016/S0140-6736(99)01312-4]
9. Deyo RA, Mirza SK, Martin BI. Back pain prevalence and visit rates: Estimates from US national surveys, 2002. Spine 2006;31:2724-2727 [DOI:10.1097/01.brs.0000244618.06877.cd]
10. Koes BW, Van Tulder M, Lin C-WC, Macedo LG, McAuley J, Maher C. An updated overview of clinical guidelines for the management of non-specific low back pain in primary care. European Spine Journal 2010;19:2075-2094 [DOI:10.1007/s00586-010-1502-y]
11. Alhowimel A, AlOtaibi M, Radford K, Coulson N. Psychosocial factors associated with change in pain and disability outcomes in chronic low back pain patients treated by physiotherapist: A systematic review. SAGE Open Medicine 2018;6:2050312118757387 [DOI:10.1177/2050312118757387]
12. Alleva J, Hudgins T, Belous J, Kristin Origenes A, Alleva J, Hudgins T, et al. Chronic low back pain. Disease-a-Month 2016;62:330-333 [DOI:10.1016/j.disamonth.2016.05.012]
13. Fujii T, Matsudaira K. Prevalence of low back pain and factors associated with chronic disabling back pain in Japan. European Spine Journal 2013;22:432-438 [DOI:10.1007/s00586-012-2439-0]
14. Linton SJ, Hellsing A-L, Halldén K. A population-based study of spinal pain among 35-45-year-old individuals: prevalence, sick leave, and health care use. Spine 1998;23:1457-1463 [DOI:10.1097/00007632-199807010-00006]
15. Fritz JM, George SZ, Delitto A. The role of fear-avoidance beliefs in acute low back pain: relationships with current and future disability and work status. Pain 2001;94:7-15 [DOI:10.1016/S0304-3959(01)00333-5]
16. Kahere M, Ginindza T. The prevalence and risk factors of chronic low back pain among adults in KwaZulu-Natal, South Africa: an observational cross-sectional hospital-based study. BMC Musculoskeletal Disorders 2021;22:955 [DOI:10.1186/s12891-021-04790-9]
17. Valat JP, Goupille P, Védere V. Low back pain: risk factors for chronicity. Revue Du Rhumatisme 1997;64:189-194
18. Ramond A, Bouton C, Richard I, Roquelaure Y, Baufreton C, Legrand E, et al. Psychosocial risk factors for chronic low back pain in primary care-a systematic review. Family Practice 2011;28:12-21 [DOI:10.1093/fampra/cmq072]
19. Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M, et al. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA 1998;280:1569-1575 [DOI:10.1001/jama.280.18.1569]
20. Wolsko PM, Eisenberg DM, Davis RB, Kessler R, Phillips RS. Patterns and perceptions of care for treatment of back and neck pain: results of a national survey. Spine 2003;28:292-297 [DOI:10.1097/01.BRS.0000042225.88095.7C]
21. Qaseem A, Wilt TJ, McLean RM, Forciea MA. Noninvasive treatments for acute, subacute, and chronic low back pain: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine 2017;166:514-530 [DOI:10.7326/M16-2367]
22. Ho EK, Chen L, Simic M, Ashton-James CE, Comachio J, Wang DX, et al. Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis. BMJ 2022;376:e067718 [DOI:10.1136/bmj-2021-067718]
23. Cohen MJ, Heinrich RL, Naliboff BD, Collins GA, Bonebakker AD. Group outpatient physical and behavioral therapy for chronic low back pain. Journal of Clinical Psychology 1983;39:326-333 https://doi.org/10.1002/1097-4679(198305)39:3<326::AID-JCLP2270390305>3.0.CO;2-7 [DOI:10.1002/1097-4679(198305)39:33.0.CO;2-7]
24. Nouwen A. EMG biofeedback used to reduce standing levels of paraspinal muscle tension in chronic low back pain. Pain 1983;17:353-360 [DOI:10.1016/0304-3959(83)90166-5]
25. Bush C, Ditto B, Feuerstein M. A controlled evaluation of paraspinal EMG biofeedback in the treatment of chronic low back pain. Health Psychology 1985;4:307 [DOI:10.1037/0278-6133.4.4.307]
26. Turner JA, Clancy S, McQuade KJ, Cardenas DD. Effectiveness of behavioral therapy for chronic low back pain: A component analysis. Journal of Consulting and Clinical Psychology 1990;58:573 [DOI:10.1037/0022-006X.58.5.573]
27. Newton-John TR, Spence SH, Schotte D. Cognitive-behavioural therapy versus EMG biofeedback in the treatment of chronic low back pain. Behaviour Research and Therapy 1995;33:691-697 [DOI:10.1016/0005-7967(95)00008-L]
28. Carson JW, Keefe FJ, Lynch TR, Carson KM, Goli V, Fras AM, et al. Loving-kindness meditation for chronic low back pain: Results from a pilot trial. Journal of Holistic Nursing 2005;23:287-304 [DOI:10.1177/0898010105277651]
29. Morone NE, Greco CM, Weiner DK. Mindfulness meditation for the treatment of chronic low back pain in older adults: a randomized controlled pilot study. Pain 2008;134:310-319 [DOI:10.1016/j.pain.2007.04.038]
30. Kapitza KP, Passie T, Bernateck M, Karst M. First non-contingent respiratory biofeedback placebo versus contingent biofeedback in patients with chronic low back pain: a randomized, controlled, double-blind trial. Applied Psychophysiology and Biofeedback 2010;35:207-217 [DOI:10.1007/s10484-010-9130-1]
31. O'Sullivan K, O'Sullivan L, O'Sullivan P, Dankaerts W. Investigating the effect of real-time spinal postural biofeedback on seated discomfort in people with non-specific chronic low back pain. Ergonomics 2013;56:1315-1325 [DOI:10.1080/00140139.2013.812750]
32. Tan G, Rintala DH, Jensen MP, Fukui T, Smith D, Williams W. A randomized controlled trial of hypnosis compared with biofeedback for adults with chronic low back pain. European Journal of Pain. 2015;19:271-280 [DOI:10.1002/ejp.545]
33. Michalsen A, Kunz N, Jeitler M, Brunnhuber S, Meier L, Lüdtke R, et al. Effectiveness of focused meditation for patients with chronic low back pain-a randomized controlled clinical trial. Complementary Therapies in Medicine 2016 ;26:79-84 [DOI:10.1016/j.ctim.2016.03.010]
34. Ardito RB, Pirro PS, Re TS, Bonapace I, Menardo V, Bruno E, et al. Mindfulness-based stress reduction program on chronic low-back pain: A study investigating the impact on endocrine, physical, and psychologic functioning. The Journal of Alternative and Complementary Medicine 2017;23:615-623 [DOI:10.1089/acm.2016.0423]
35. Day MA, Ward LC, Ehde DM, Thorn BE, Burns J, Barnier A, et al. A pilot randomized controlled trial comparing mindfulness meditation, cognitive therapy, and mindfulness-based cognitive therapy for chronic low back pain. Pain Medicine 2019;20:2134-2148 [DOI:10.1093/pm/pny273]
36. Day MA, Ward LC, Thorn BE, Burns J, Ehde DM, Barnier AJ, et al. Mechanisms of mindfulness meditation, cognitive therapy, and mindfulness-based cognitive therapy for chronic low back pain. The Clinical Journal of Pain 2020;36:740-749 [DOI:10.1097/AJP.0000000000000862]
37. Darnall BD, Roy A, Chen AL, Ziadni MS, Keane RT, You DS, et al. Comparison of a single-session pain management skills intervention with a single-session health education intervention and 8 sessions of cognitive behavioral therapy in adults with chronic low back pain: a randomized clinical trial. JAMA Network Open 2021;4:e2113401 [DOI:10.1001/jamanetworkopen.2021.13401]
38. Caldas DA VV, Maciel DG, Cerqueira MS, Barboza JA, Neto JB, Dantas G, et al. Effect of Pain Education, Cryotherapy, and Transcutaneous Electrical Nerve Stimulation on the Pain, Functional Capacity, and Quality of Life in Patients With Nonspecific Chronic Low Back Pain: A Single-Blind Randomized Controlled Trial. American Journal of Physical Medicine & Rehabilitation 2021;100:243-249 [DOI:10.1097/PHM.0000000000001552]
39. Bablis P, Pollard H, Rosner AL. Stress reduction via neuro-emotional technique to achieve the simultaneous resolution of chronic low back pain with multiple inflammatory and biobehavioural indicators: A randomized, double-blinded, placebo-controlled trial. Journal of Integrative Medicine 2022;20:135-144 [DOI:10.1016/j.joim.2021.12.001]
40. Bushey MA, Slaven JE, Outcalt SD, Kroenke K, Kempf C, Froman A, et al. Effect of Medication Optimization vs Cognitive Behavioral Therapy Among US Veterans With Chronic Low Back Pain Receiving Long-term Opioid Therapy: A Randomized Clinical Trial. JAMA Network Open 2022;5:e2242533 [DOI:10.1001/jamanetworkopen.2022.42533]
41. Pulling BW, Braithwaite FA, Moseley GL, Jensen MP, Burke AL, Collins KL, et al. Suggestions in Hypnosis to Aid Pain Education (SHAPE) in People with Chronic Low-Back Pain: A Pilot Feasibility Randomized, Controlled Trial. International Journal of Clinical and Experimental Hypnosis 2022;70:251-276 [DOI:10.1080/00207144.2022.2105147]
42. Reid MC, Otis J, Barry LC, Kerns RD. Cognitive-behavioral therapy for chronic low back pain in older persons: A preliminary study. Pain Medicine 2003;4:223-230 [DOI:10.1046/j.1526-4637.2003.03030.x]
43. Pagé I, Marchand AA, Nougarou F, O'Shaughnessy J, Descarreaux M. Neuromechanical responses after biofeedback training in participants with chronic low back pain: an experimental cohort study. Journal of Manipulative and Physiological Therapeutics 2015;38:449-457 [DOI:10.1016/j.jmpt.2015.08.005]
44. Dowell D, Haegerich TM, Chou R. CDC guideline for prescribing opioids for chronic pain-United States, 2016. JAMA 2016;315:1624-1645 [DOI:10.1001/jama.2016.1464]
45. Dunn KM, Saunders KW, Rutter CM, Banta-Green CJ, Merrill JO, Sullivan MD, et al. Opioid prescriptions for chronic pain and overdose: a cohort study. Annals of Internal Medicine 2010;152:85-92 [DOI:10.7326/0003-4819-152-2-201001190-00006]
46. Ikemoto T, Miki K, Matsubara T, Wakao N. Psychological treatment strategy for chronic low back pain. Spine Surgery and Related Research 2019;3:199-206 [DOI:10.22603/ssrr.2018-0050]

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