Research has demonstrated that individuals suffering from chronic lower back pain can experience significant improvement by adopting a more positive mindset, reducing the need for physiotherapy. This finding challenges traditional approaches that typically prioritize medical interventions over psychological aspects of pain management.
A study published in the journal JAMA Network Open involved over 1,600 patients with chronic lower back pain. It highlighted the effectiveness of the Enhanced Transtheoretical Model Intervention (ETMI), a self-management strategy that emphasizes changing unhelpful beliefs about the condition and encouraging increased physical activity. This approach proved to be as beneficial, if not more so, than conventional physiotherapy.
The trial established that while standard treatment for chronic lower back pain often includes exercise therapy, education, and various physical modalities, ETMI focuses on empowering patients to manage their symptoms. Researchers noted that many clinical guidelines recommend reassurance regarding self-management, yet this is frequently overlooked in practice.
Participants in the study were divided into two groups: one receiving usual care, which could include physiotherapy and pain medication, while the other group underwent ETMI. The latter group engaged in activities like brisk walking and reported improvements in overall function in a shorter time frame compared to those in the usual care group.
The data collected included patients’ levels of physical activity, the number of physiotherapy sessions attended, and changes in their pain levels and beliefs about physical activity. Functionality was measured on a scale from 0 to 100, with higher scores indicating better performance, while pain intensity was rated from 0 to 10, with 10 indicating severe pain.
Of the 1,624 patients, approximately 83 percent received standard care, while 259 patients participated in the ETMI program. Those who engaged in ETMI required fewer treatment sessions and exhibited better improvements in both physical function and fear-avoidance beliefs.
The findings suggested that ETMI was particularly effective in reducing activity limitations, even for patients diagnosed with depression and anxiety. Despite these positive outcomes, researchers acknowledged that there were no significant differences in pain levels across both groups. This was likely because the intervention targeted patients’ beliefs and activity patterns rather than directly addressing pain symptoms.
The study’s authors concluded that transitioning from a clinician-managed approach focused on specific diagnoses and targeted physical exercises to a model prioritizing patient self-management could lead to more sustainable solutions for musculoskeletal care. As the healthcare community considers new methods for addressing chronic lower back pain, this evidence supports the potential of mindset changes as a viable strategy for improving patient outcomes.
