HONOLULU – A psychological intervention designed to help chronic back pain patients overcome fear of movement significantly reduced their activity limitations a year later, James E. Moore, Ph.D., said at the annual meeting of the American Psychological Association.
Interventions designed to get back-pain patients moving to combat deconditioning are becoming increasingly popular in pain clinics because a number of recent studies suggest that it is not only possible and safe, but very beneficial, Dr. Moore, director of the pain management program at the Virginia Mason Medical Center, Seattle, said in an interview with this newspaper.
Dr. Moore's study of the four-visit intervention (two to a psychologist and two to a physical therapist) enrolled 119 chronic back pain patients who received the intervention and 121 patients who received usual care and served as controls.
During the first visit, participants met with the psychologist, discussed their fears about back pain and resuming normal activities, and set an exercise goal.
Ten days later, the patients met with a physical therapist, who performed an examination, gave them specific exercises, and counseled them about overcoming barriers to meeting their exercise goal. The third visit was also with the physical therapist and was a follow-up to the prior visit. The final visit was again with the psychologist, to review progress.
The patients who received the intervention had significantly greater improvement in their Roland Disability Questionnaire scores, a worry rating, a fear-avoidance rating, and an average pain intensity score, Dr. Moore said in a poster presentation. Their improvement was greater at each of the follow-up times in the study: 2 months, 6 months, and 12 months.
“The main thing we addressed was fear,” Dr. Moore said in the interview. “The goal was to make people understand that most back pain is benign.”