Cognitive behavioral therapy (CBT) and meditation in the treatment of persistent low back pain: Interventional Study

  • R Mahendra Kumar Cognitive Behavioural Therapist, Sanjeevini Speciality Hospital and Heart care center, Vidyanagar, Hubli, Karnataka, India - 580031 https://orcid.org/0000-0001-7108-166X
  • Kumbar Rajeshwari Assistant Professor, Department of Pharmacology, HKE Society’s Matoshree Taradevi Rampure Institute of Pharmaceutical Sciences, Kalaburagi, Karnataka, IN – 585105 https://orcid.org/0009-0003-9733-0646
  • S Sandeep Department of Pharmacy Practice, HKE Society’s Matoshree Taradevi Rampure Institute of Pharmaceutical Sciences, Kalaburagi, Karnataka, IN – 585105 https://orcid.org/0009-0007-8480-0281
  • B S Sudarshan Clinical operations, Clindus Research Solutions, Kolar, Karnataka, IN – 563133
  • B K Rakshith Clinical operations, Clindus Research Solutions, Kolar, Karnataka, IN – 563133

Abstract

Objective: To compare the effect of both CBT and Meditation in chronic lower back pain patients.


Method: Participants fulfilling the exclusion and inclusion criteria and who are between the age group of 35-50 years with CLBP were included.  Numerical pain rating scale and Montreal Cognitive Assessment (MOCA) was used for the participant selection. The participants were further divided into three groups and 4-week intervention of conventional physiotherapeutic exercise, meditation and CBT, was given to the participants. Numerical Pain Rating Scale and Oswestry Low Back Pain Disability Questionnaire were used as outcome measures.


Results: 40 chronic back pain patients were enrolled and randomized. All enrolled participants completed baseline tests, providing cross-sectional data for this study. Simple randomization allocated 14 patients to the control group and 13 patients each to Experimental Group 1 and Experimental Group 2. Significant within-group improvements occurred on the Numerical Rating Scale and Oswestry scores between baseline and final visits for all groups. However, the experimental groups showed significantly greater decreases in pain intensity versus controls, evidenced by reduced mean Numerical Rating Scale and Oswestry scores at follow-up. One-way ANOVA and Welch tests revealed significantly reduced Numerical Rating Scale and Oswestry scores after treatment across groups. Both tests yielded statistically significant p-values <0.01.


Conclusion: The findings show that meditation and cognitive behavioural therapy (CBT) are beneficial in reducing pain. As a result, for patients with persistent low back pain, taking into consideration these two treatment techniques is critical.


Keywords: Cognitive Behavioural Therapy, Chronic Pain, Oswestry Questionnaire

Keywords: Cognitive Behavioural Therapy, Chronic Pain, Oswestry Questionnaire

Downloads

Download data is not yet available.

Author Biographies

R Mahendra Kumar, Cognitive Behavioural Therapist, Sanjeevini Speciality Hospital and Heart care center, Vidyanagar, Hubli, Karnataka, India - 580031

Cognitive Behavioural Therapist, Sanjeevini Speciality Hospital and Heart care center, Vidyanagar, Hubli, Karnataka, India - 580031

Kumbar Rajeshwari, Assistant Professor, Department of Pharmacology, HKE Society’s Matoshree Taradevi Rampure Institute of Pharmaceutical Sciences, Kalaburagi, Karnataka, IN – 585105

Assistant Professor, Department of Pharmacology, HKE Society’s Matoshree Taradevi Rampure Institute of Pharmaceutical Sciences, Kalaburagi, Karnataka, IN – 585105

S Sandeep, Department of Pharmacy Practice, HKE Society’s Matoshree Taradevi Rampure Institute of Pharmaceutical Sciences, Kalaburagi, Karnataka, IN – 585105

Department of Pharmacy Practice, HKE Society’s Matoshree Taradevi Rampure Institute of Pharmaceutical Sciences, Kalaburagi, Karnataka, IN – 585105

B S Sudarshan, Clinical operations, Clindus Research Solutions, Kolar, Karnataka, IN – 563133

Clinical operations, Clindus Research Solutions, Kolar, Karnataka, IN – 563133

B K Rakshith, Clinical operations, Clindus Research Solutions, Kolar, Karnataka, IN – 563133

Clinical operations, Clindus Research Solutions, Kolar, Karnataka, IN – 563133

References

1. Harkness EF, Macfarlane GJ, Silman AJ, McBeth J. Is musculoskeletal pain more common now than 40 years ago? Two population-based cross-sectional studies. Rheumatology (Oxford) 2005;44:890-895. https://doi.org/10.1093/rheumatology/keh599 PMid:15784630
2. Hoy D, Bain C, Williams G, March L, Brooks P, et al. A systematic review of the global prevalence of low back pain. Arthritis Rheum 2012;64:2028-2037. https://doi.org/10.1002/art.34347 PMid:22231424
3. Vos T, Flaxman AD, Naghavi M, Lozano R, Michaud C, et al. Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380:2163-2196. https://doi.org/10.1016/S0140-6736(12)61729-2 PMid:23245607
4. Last AR, Hulbert K. Chronic low back pain: evaluation and management. Am Fam Physician. 2009;79(12):1067-1074.
5. Deyo RA, Dworkin SF, Amtmann D, Andersson G, Borenstein D, et al. Report of the NIH Task Force on research standards for chronic low back pain. J Pain 2014;15:569-585. https://doi.org/10.1016/j.jpain.2014.03.005 PMid:24787228 PMCid:PMC4128347
6. Jella Ramdas, Vasantha Jella. Prevalence and risk factors of low back pain. Int J Adv Med. 2018;5(5):1120-3 https://doi.org/10.18203/2349-3933.ijam20183413
7. Haldeman S, Dagenais S. A supermarket approach to the evidence-informed management of chronic low back pain. Spine J. 2008;8(1):1-7. https://doi.org/10.1016/j.spinee.2007.10.009 PMid:18164448
8. NHS Choices, 2012. Cognitive behavioural therapy. [online] Available at:http://www.nhs.uk/conditions/cognitive-behavioural-therapy/Pages/Introduction.aspx[Accessed 8th Jan 2014]
9. Monticone M, Ferrante S, Rocca B, Baiardi P, Dal Farra F, Foti C. Effect of a long-lasting multidisciplinary program on disability and fear-avoidance behaviors in patients with chronic low back pain: results of a randomized controlled trial. The Clinical journal of pain. 2013 Nov 1;29(11):929-38. https://doi.org/10.1097/AJP.0b013e31827fef7e PMid:23328343
10. Hanscom DA, Brox JI, Bunnage R. Defining the Role of Cognitive Behavioral Therapy in Treating Chronic Low Back Pain: An Overview. Global Spine J. 2015;5(6):496-504 https://doi.org/10.1055/s-0035-1567836 PMid:26682100 PMCid:PMC4671906
11. Reid MC, Otis J, Barry LC, Kerns RD. Cognitive-behavioral therapy for chronic low back pain in older persons: a preliminary study. Pain Med. 2003; 4(3):223-3 https://doi.org/10.1046/j.1526-4637.2003.03030.x PMid:12974821
12. Ghorbanpour A, Azghani M.R, Taghipour M, Salahzadeh Z, Ghaderi F, Oskoui A.E.Effects of McGill stabilization exercises and conventional physiotherapy on pain, functional disability, and active back range of motion in patients with chronic nonspecific low back pain. J Phys Ther Sci. 2018;30(4):481-5 https://doi.org/10.1589/jpts.30.481 PMid:29706690 PMCid:PMC5908986
13. Chiesa A, Serretti A. Mindfulness-based interventions for chronic pain: a systematic review of the evidence. Journal of Alternative and Complementary Medicine. 2011;17:83-93. https://doi.org/10.1089/acm.2009.0546 PMid:21265650
14. Morone NE, Greco CM, Weiner DK. Mindfulness meditation for the treatment of chronic low back pain in older adults: a randomized controlled pilot study. Pain. 2007;134(3):311-9. https://doi.org/10.1016/j.pain.2007.04.038 PMid:17544212 PMCid:PMC2254507
15. Brox J I, Nygaard O P, Holm I, Keller A, Ingebrigtsen T, Reikerås O. Four-year follow-up of surgical versus non-surgical therapy for chronic low back pain. Ann Rheum Dis. 2010;69(9):1643-1648. https://doi.org/10.1136/ard.2009.108902 PMid:19635718 PMCid:PMC2938881
16. Brox J I, Sørensen R, Friis A. et al.Randomized clinical trial of lumbar instrumented fusion and cognitive intervention and exercises in patients with chronic low back pain and disc degeneration. Spine (Phila Pa 1976) 2003;28(17):1913-1921. https://doi.org/10.1097/01.BRS.0000083234.62751.7A PMid:12973134
17. Leong IY, Farrell MJ, Helme RD, et al. The relationship between medical comorbidity and self-rated pain, mood disturbance, and function in older people with chronic pain. J Gerontol A Biol Sci Med Sci. 2007;62:550-555. https://doi.org/10.1093/gerona/62.5.550 PMid:17522361
18. Edwards R R, Cahalan C, Mensing G, Smith M, Haythornthwaite J A. Pain, catastrophizing, and depression in the rheumatic diseases. Nat Rev Rheumatol. 2011;7(4):216-224. https://doi.org/10.1038/nrrheum.2011.2 PMid:21283147
19. Zhu Z, Zhang L, Jiang J. et al.Comparison of psychological placebo and waiting list control conditions in the assessment of cognitive behavioral therapy for the treatment of generalized anxiety disorder: a meta-analysis. Shanghai Arch Psychiatry. 2014;26(6):319-331.
20. Hoffman B M, Papas R K, Chatkoff D K, Kerns R D. Meta-analysis of psychological interventions for chronic low back pain. Health Psychol. 2007;26(1):1-9. https://doi.org/10.1037/0278-6133.26.1.1 PMid:17209691
21. Kabat-Zinn J, Lipworth L, et al. The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal of Behavioral Medicine. 1985;8:163-90. https://doi.org/10.1007/BF00845519 PMid:3897551
22. Cramer H, Haller H, Lauche R, Dobos G. Mindfulness-based stress reduction for low back pain. a systematic review. BMC Complement Altern Med. 2012;12:162. https://doi.org/10.1186/1472-6882-12-162 PMid:23009599 PMCid:PMC3520871
23. Bowen S, Chawla N, Marlatt GA. Mindfulness-based Relapse Prevention for Addictive Behaviors: A Clinician's Guide. New York, NY: The Guilford Press; 2011.
24. Veehof MM, Oskam MJ, Schreurs KM, Bohlmeijer ET. Acceptance-based interventions for the treatment of chronic pain: a systematic review and meta-analysis. Pain. 2011;152(3):533-42 https://doi.org/10.1016/j.pain.2010.11.002 Mid:21251756
Crossmark
Statistics
84 Views | 25 Downloads
How to Cite
1.
Mahendra Kumar R, Rajeshwari K, Sandeep S, Sudarshan BS, Rakshith BK. Cognitive behavioral therapy (CBT) and meditation in the treatment of persistent low back pain: Interventional Study. JDDT [Internet]. 15Jan.2024 [cited 25Feb.2024];14(1):29-4. Available from: https://jddtonline.info/index.php/jddt/article/view/6186