Treating Back Pain with Cognitive Behavioral Therapy
Cognitive Behavioral Therapy for Lower Back Pain is a treatment approach that uses a combination of techniques to help people identify and correct faulty patterns of thoughts, feelings, and behaviors. The goal is to increase function and reduce pain.
A Brief History
Cognitive Behavioral Therapy for Lower Back Pain was developed in the mid-1970s by Dr. John Sarno, a clinical professor of rehabilitation medicine at New York University School of Medicine. It is based on his belief that most lower back pain results from unconscious emotional factors, particularly feelings of stress and anxiety that are held in the muscles of the lower back and abdomen.
According to Dr. Sarno, when people unconsciously repress feelings or emotions they often experience physical symptoms in the body as a consequence of the unconscious mind acting to protect them in some way.
He believes that most people who develop lower back pain have repressed anger toward someone else or themselves, which he calls ‘core beliefs’. Core beliefs are often formed in childhood and are the result of unresolved emotional conflicts. The pain creates fear, which further suppresses emotions, resulting in a vicious cycle.
Dr. Sarno’s approach focuses on getting patients to become aware of these unconscious emotions and how they affect their physical well-being through persistent pain. He teaches people to reinterpret the pain in a positive way, as a sign that they can now initiate the healing process.
How it Works
Cognitive Behavioral Therapy takes place in six to eight weekly sessions, with each session lasting an hour. The first session is about education and explaining how pain might develop. The remaining sessions are spent talking about memories in the patient’s life that may be linked to the pain, identifying repressed emotions, and working out strategies to deal with them.
The sessions are interactive and aim to help patients become aware of patterns that can trigger their pain, such as poor time management or expectations set too high by family members. They also explore how a patient’s thoughts and emotions affect the sensations in the lower back. A key part of Cognitive Behavioral Therapy is becoming aware of ‘early warning signs’ so they can be acted upon before pain becomes a problem.
Cognitive Behavioral Therapy focuses on the mind-body connection and how emotions affect physical health, partially through stress hormones such as cortisol, which have been linked to chronic pain.
The Approach’s Value
In some cases, Cognitive Behavioral Therapy for Lower Back Pain results in a permanent reduction or elimination of pain. In one study, 78% of people with chronic lower back pain reported that treatment was successful and they were able to return to work.
A review of research found that the approach was effective for chronic lower back pain, but not acute low back pain. In addition to treatment sessions, Cognitive Behavioral Therapy for Lower Back Pain encourages people with lower back pain to keep a daily diary. This helps them become more aware of their thoughts and behavior patterns that may be contributing to or exacerbating the pain.
When to Seek Cognitive Behavioral Therapy for Lower Back Pain
People who meet the following criteria would likely benefit from Cognitive Behavioral Therapy for Lower Back Pain:
• Have experienced pain in their lower back at least once a day for the previous three months.
• Have been unable to take medication or engage in physical therapy because it hasn’t worked for them in the past.
• Do not have a severe, progressive illness that could be causing their lower back pain.
Patients with the most severe pain and functional disabilities may need additional therapy that includes medication, acupuncture, and physical therapy.
Chronic lower back pain is a prevalent and costly condition. It is imperative for people with chronic lower back pain to receive effective treatment that focuses on self-management or self-care measures.
Cognitive Behavioral Therapy for Lower Back Pain may be an effective intervention for this group of people, but the approach works best when both patient and therapist are committed to participating in all sessions without exceptions.