Cognitive Treatment of Illness Perceptions in Patients With Chronic Low Back Pain: A Randomized Controlled Trial

Abstract

This first trial evaluating cognitive treatment of illness perceptions concerning CLBP showed statistically significant and clinically relevant improvements in patient-relevant physical activities at 18 weeks.

“A life of living death”: the experiences of people living with chronic low back pain in rural Nigeria

“…[26] Biomechanical understanding of CLBP has been shown to elevate fear-avoidance beliefs, anxiety, pain intensity, pain catastrophizing, hypervigilance, maladaptive illness perceptions and disability. [84][85][86][87][88][89] Moreover, there is limited evidence linking biomechanical factors to the adverse impact of CLBP. [90] Associating CLBP with ageing led to catastrophic thinking, as reported in previous studies, [25][26][27]58,91] which was more pronounced in the younger participants.…”

The contribution of psychological factors to recovery after mild traumatic brain injury: Is cluster analysis a useful approach?

“…There is growing evidence in other patient populations, particularly coronary heart disease, that targeting such psychological factors can lead to improved outcomes including symptom reduction, improved activity levels and wellbeing and higher return-to-work rates [45]. Interventions have ranged from provision of telephone follow-up targeting illness perceptions in patients discharged following myocardial infarction (MI) [46], three sessions of cognitive behaviour therapy (CBT) in patients with benign chest pain [47], three half-hour CBT sessions provided to inpatients following MI [48] and 10-14 cognitive therapy sessions targeting illness perceptions in patients with chronic low back pain [49].…”

Reconciling movement and exercise with pain neuroscience education: A case for consistent education

“…They specify that: 1) Only patients dissatisfied with their current perceptions about pain are prone to reconceptualization of pain (Siemonsma, Schröder, Roorda, and Lettinga, 2010;Siemonsma et al, 2008;Siemonsma et al, 2013); 2) any new explanation must be intelligible to the patient (Siemonsma, Schröder, Roorda, and Lettinga, 2010; Clinicians often report these subjective and objective findings in people in pain. Each may be correlated with pain, but few studies are available to assess the impact of altering these on pain or movement.…”

“…• it hurts to move • belief that pain equals tissue damage • external locus of control in relation to pain • external locus of control in relation to movement • fear or movement or losing competence • grief, including loss of self-efficacy • high sympathetic arousal, that is difficult to change • belief that a movement is safe, yet difficulty regulating physiological arousal with specific movements Siemonsma et al, 2008;Siemonsma et al, 2013); 3) a new explanation must appear plausible and beneficial to the patient; 4) the new explanation should be shared and confirmed by the direct environment of the patient; and 5) interaction with a therapist is necessary. Additionally, there is some evidence that individual education provides better outcomes than small group education (Moseley, 2003).…”