A staggering 65 million Americans have reported experiencing back discomfort.

An Goethe University Frankfurt study found that a mixed approach is best.

The back pain can be a typical problem that has many causes, which include poor posture, excessive exercise and constant stress whether at home or work, insufficient of exercise and poor posture. For the majority of people, the symptoms are persistent, which means they are long-lasting or are repeated. However, exercise and port therapy, when performed correctly can help relieve the symptoms.

Physical therapy, as well as exercises for strength and stability are the most common treatment options. But how do they become as efficient as is possible? What method can reduce pain most efficiently? A recent meta-analysis that was published by The Journal of Pain by Goethe University Frankfurt revealed new findings.

The research team began by analyzing the results of 58 randomized controlled research trials (RCTs) which involved over 10,000 patients who suffer from chronic low back pain across the world. The pertinent data in the manuscripts originally submitted were removed and then examined in groups. In analyzing the information, the researchers examined the ways in which traditional forms of treatment and individualized ones differed in terms of outcomes. “Individualized” is a reference to a form of personal coaching in which therapy professionals are able to precisely address the requirements and capabilities of every patient and work with them in deciding the path they will take to pursue their treatment.

People who sit a lot and do not exercise often develop back pain. Credit: Markus Bernards for Goethe University Frankfurt

According to research that individualized treatment for chronic back discomfort had a more positive effect than standard exercise therapy. The rate of relief from pain was 38% higher than conventional treatment.

“The greater effort needed to provide individual therapy is worth it since patients gain in a way that is clinically significant,” says lead author Dr. Johannes Fleckenstein from the Institute of Sport Sciences at Goethe University Frankfurt.

However, the research went further. Researchers from Frankfurt evaluated a third set of treatment techniques alongside traditional as well as individualized. In this study, individualized training sessions were paired along with cognitive behavioral therapies (CBT). This method – which is a form of therapy that involves talking – is built on the belief that negative thoughts and behavior related to pain are likely to cause more the problem. Through CBT, people suffering from pain are taught to alter the way they approach the pain.

They are no longer afraid to move, or learn strategies for dealing with discomfort. The patients realise that they are far not completely helpless. What does psychotherapeutic assistance via CBT actually aid in the success of treatment? Analyzing the data revealed that when individualized approaches and CBT were paired and successful, the result for pain relief was an impressive 85 percent more than the standard approach. The therapy that was combined, known as multimodal therapy resulted in the highest outcome by far.

Fleckenstein believes that the study is “an urgent call to the government health policies” to support the use of combined therapies, both in terms of care for patients as well as compensation. “Compared with other countries like the USA and the United States, we’re quite a bit better off in Germany. We, for instance, issue lesser prescriptions for stronger opioids such as opiates. However, the quantity of unnecessary X-rays that is a fact can contribute to chronic pain and inaccurate surgical prescriptions are extremely high.”

This is due to, according to Fleckenstein to the economic incentives which is the high amount of compensation for the treatments. This is not the case for those working in the field of pain treatment according to him. While they aren’t profit-making, they’re not an investment vehicle for investors. According to him that is why it is essential to improve the economic situation. In the end, pain treatment can save a significant amount of dollars in the long term when health economics is involved, but surgeries and tablets rarely lead to long-term and medium-term pain relief.

Source “Individualized exercise in chronic Non-specific Low Back Pain A Systematic Review and Analyses of the effects of exercise alone or in combination with Psychological Interventions for disability and pain” from Johannes Fleckenstein, Philipp Floessel, Tilman Engel, Laura Krempel, Josefine Stoll, Martin Behrens and Daniel Niederer 29 July 2022. Journal of Pain.

DOI: 10.1016/j.jpain.2022.07.005