THE CLINICAL-SIGNIFICANCE OF BEHAVIORAL TREATMENT FOR CHRONIC LOW-BACK-PAIN - AN EVALUATION OF EFFECTIVENESS

The clinical effectiveness of behavioral treatment for chronic low bac k pain (CLBP) was evaluated using an empirical strategy to quantify in dividual patient change. Patients with CLBP (n = 17) presenting to an outpatient pain clinic were evaluated at baseline and six months postt reatment on variables of pain, disability and distress. Similar patien ts receiving usual medical care (n = 17) were evaluated on the same ou tcome measures and time line for purposes of descriptive comparison. V alidated and widely-used measures of pain (McGill Pain Questionnaire), disability (Sickness Impact Profile), and depression (Beck Depression Inventory) served as outcome measures. Forty-seven percent of patient s receiving behavioral treatment evidenced clinically significant impr ovement in at least one of the dimensions of pain, disability and depr ession associated with CLBP. However, clinically significant improveme nt across all three measures was rare. These findings are discussed in terms of the viability of behavioral treatment for CLBP, the need to enhance the degree of clinically significant outcome associated with b ehavioral treatments, and the value of empirical evaluation of clinica lly significant improvement following treatment interventions. (C) 199 7 International Association for the Study of Pain. Published by Elsevi er Science B.V.