Psychological interventions in patients with chronic low back pain: a scoping review

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.

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.

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.

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.