Behavioural treatment for chronic low-back pain

Abstract

Analysis 2.1. Comparison 2 Respondent therapy (EMG biofeedback) versus waiting list control, Outcome 1 Pain (short term)...... Analysis 2.2. Comparison 2 Respondent therapy (EMG biofeedback) versus waiting list control, Outcome 2 Functional status (short term

Mindfulness Meditation-Based Intervention Is Feasible, Acceptable, and Safe for Chronic Low Back Pain Requiring Long-Term Daily Opioid Therapy

“…Development of strategies for identifying those at risk for nonadherence and boosting their engagement during and after the intervention may extend the potential benefits of MM practice to a larger group of patients. The perceived safety of MM-based interventions 18,19,27,49 was corroborated by this research. It is in stark contrast to opioid therapy, which has been linked to dose-dependent harms.…”

“…27,34,35,49 In addition, there is an overall scarcity of research on long-term efficacy of therapeutic modalities, including MM and CBT, in opioid-treated populations. 5,18,19,27,34,35,49 Although MM modalities are overall considered feasible, acceptable, and safe, these aspects of MM interventions have not been well explored in, and evidence on their efficacy is insufficient for, opioid-treated CLBP. 27,28 Examining the details of MM practice is crucial for discerning whether particular practice patterns have a differential health impact.…”

“…12,13 MM practice can provide a foundation for engagement in life from a place of ''being with'' one's experiences that, when maintained over time, can have longlasting effects. [14][15][16][17] It can result in unique skills for chronic pain management, such as acceptance, complementing those acquired through CBT, a part of ''usual care'' for chronic pain, [18][19][20][21][22] and potentially enhancing its benefits. [21][22][23][24][25][26] MM is perceived as safe and effective for pain reduction and has established empirical support for reducing symptoms of anxiety, depression, and stress-all problems commonly co-occurring with and affecting outcomes in chronic pain.…”

“…29 However, evidence on MM's efficacy for chronic pain is limited and mixed, and MM and CBT interventions have not been sufficiently studied in patients with chronic pain requiring a long-term opioid therapy. 18,19,23,27,28,[30][31][32][33][34][35] A recent randomized controlled trial (RCT) (n = 115) found that a ''mindfulnessoriented recovery enhancement'' intervention, combining MM and CBT, led to decreases in pain severity and opioid desire ratings in adults with opioid-treated chronic pain; however, opioid dose was not quantified in this study. 23 Although MM and CBT have been shown as feasible and acceptable interventions for many chronic health conditions, 18,19,27 including depression, anxiety, and maladaptive stress or pain coping (problems commonly co-occurring with and affecting treatment outcomes in chronic pain 11,27,36 ), the Agency for Healthcare Research and Quality calls for systematic reporting on feasibility and safety of MM-based modalities.…”

Attitudes and beliefs of Brazilian physical therapists about chronic low back pain: a cross-sectional study

“…Low back pain is a significant health problem worldwide and is associated with high levels of disability [1][2][3] and elevated societal costs 4 . Chronic low back pain is defined as pain and/or discomfort between the costal margins and the gluteal folds, with or without leg pain, that lasts for more than 12 weeks 3 .…”