Group cognitive behavioural therapy is clinically and cost effective in tackling low back pain, a major study has found.
The findings of the study, led by physiotherapist Sallie Lamb, professor of rehabilitation at Warwick University, were first reported in Frontline nearly 18 months ago (19 November 2008). The study has recently hit the national headlines after being published on the Lancet’s early online site on 26 February. Professor Lamb and colleagues set out to investigate whether a group CBT approach would bring any extra benefit to patients given the normal GP advice on exercise and remaining active. Seven hundred patients with troublesome subacute or chronic low back pain were recruited from a range of areas and given a 15 minute session of advice on actively managing their condition, then randomised to two groups: 468 were given an extra assessment and up to six sessions of group CBT, and 233 received no further intervention. Practitioners were trained in CBT over two days. Eighty per cent of the CBT programme was delivered by physios, and focused on helping patients to identify and counter negative automatic thoughts about hurting themselves, graded activity, relaxation and other skills. The trial found that the CBT treatment’s short-term effects were at least as effective as alternative interventions but the outcomes were sustained at a year, and the cost was at most half that of the other interventions.
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