EDUCATIONAL AND BEHAVIORAL INTERVENTIONS FOR BACK PAIN IN PRIMARY-CARE

Study Design and Objectives. A review of the literature was undertaken to identify and summarize randomized trials of educational, cognitive , and behavioral interventions for people with chronic low back pain. Summary of Background Data. Studies of back schools have varied widely in patient characteristics, back school length and content, and compa rison treatment. The available evidence suggests that back schools do not affect long-term outcomes of people with back pain. Methods. MEDLI NE and PsycLIT databases were searched to identify randomized trials o f cognitive and behavioral treatments for chronic low back pain. Outco me data were extracted from articles that met the meta-analysis inclus ion criteria. Results. The meta-analysis found that cognitive and beha vioral treatments were superior to control conditions after treatment on measures of chronic low back pain, pain behavior, and disability. F ollow-up comparisons of cognitive and behavioral treatments Versus con trol conditions were not available. This meta-analysis did not find co gnitive and behavioral therapies to differ from other active treatment s on specific outcome measures, although only a few studies were avail able for each measure. Conclusion. It may be useful to incorporate cog nitive-behavioral interventions in primary care settings, but addition al research is needed to evaluate their efficacy in improving specific outcomes.