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: Innovative therapy offers hope to chronic lower-back pain sufferers

After an innovative trial that combined psychological and physical approaches, there is new hope for chronic lower-back pain sufferers. Patients were empowered to manage their pain and move, which led to a dramatic reduction of the condition and its related mobility issues.

Around 80% of adult will experience lower-back pain in their lifetime. Its prevalence increases with age. Around a quarter of adults will experience chronic lower back pain that can last more than three months or even persist for years.

In a randomized, controlled clinical trial, cognitive functional therapy (CFT), a new treatment for chronic back pain, was tested on nearly 500 patients in 20 physiotherapy clinics. The results of the trial showed that those who received CFT, which involved seven individual sessions over 12 weeks with specially trained clinicians, and a booster six months later, reported great improvements in movement and pain levels.

CFT was developed by Professor Peter O’Sullivan of Perth’s Curtin School of Allied Health in Australia. It takes a physical-psychological approach to equip chronic pain sufferers with the tools they need to manage their condition confidently and to move in a way that reduces disibility.

“This new treatment takes into account the individual characteristics and limitations of the person living with chronic back problems by addressing their concerns under the expert guidance of a trained physical therapist,” said O’Sullivan. “This is different from traditional, passive approaches, including massage, spinal manipulative, medication, and injections, because it puts the patient in control of their condition. It helps them understand the factors that are contributing to their back pain, and builds confidence in their own body to get back into valued activities.

He added that it was “particularly rare and exciting” to find that the significant reduction of pain and distress experienced by these people with chronic back pain had lasted for an entire year.

According to a study conducted by researchers at Curtin University, Monash University and Macquarie University in Australia, over 80% of patients who had received CFT were satisfied with the results, noting that they felt empowered to move confidently.

“Lower Back Pain is the leading cause of Disability across the globe. It contributes to a loss of productivity and early retirement in many countries,” said Peter Kent, lead author, an associate professor at Curtin School of Allied Health. “These exciting results give new hope to millions of people who are disabled by chronic back pain around the globe. It also provides a roadmap for clinicians and policymakers to reduce the growing burden from chronic back pain using a low-risk, high-value approach based on scientific evidence.

Mark Hancock from Macquarie University who led the Sydney CFT trial is now teaching principles of the therapy to student. Five months of intensive training was required to upskill 18 practitioners who took part in the trial.

Mark Hancock, a physiotherapist at Macquarie University, helped physiotherapists deliver cognitive-functional therapy to patients in a clinical trial

Macquarie University

“It took a lot of physiotherapists training to develop the skills, confidence, and ability to deliver the intervention to a high-standard, despite the experience that many already had,” he said. He added that the results made it worthwhile.

“More that 80% of participants who received CFT were satisfied with the treatment and its results,” he said. “They reported significant improvements in pain levels, and were able to resume activities they previously enjoyed.

Some people we’ve spoken to following the study told us that they are still reaping benefits three years after the study.

Researchers believe this therapy approach, that tackles both the psychological aspect of chronic conditions as well as the individual physical issues has another huge benefit.

“The main economic results showed that participants who took part the CFT treatment were able to save more than AU$5,000 ($3,330) per individual, largely due to improvements in their productivity, both in paid and unpaid jobs,” said Terry Haines, a Monash University professor who investigated the efficiency of healthcare and workplace saving. This has the potential to save the global economy significant amounts of money because we know that lower back pain contributes to early retirement and loss of productivity.

The study was published by The Lancet.

Sources: Curtin University, Macquarie University