Chronic non-specific low back pain; has cognitive behavioural therapy effect and

Low back pain (LBP) presents a major public health problem. Half of the population will report acute LBP during the last year; approximately 80-90% is non-specific. Many will develop chronic / intermittent LBP and a part of these patients will become unable to maintain daily function and working life. Although non-specific chronic LBP is common, there is little knowledge of its cause and right treatment. In this paper the cognitive chronification process is seen together with newer neurobiological science on pain networks and central nerve reorganisation and the effect of cognitive behavioural theory is evaluated. The positive effect of cognitive intervention is well documented for chronic LBP patients and cognitive mechanisms seem important in the development of chronic LBP. New science in neurobiology focus on central mechanisms, where central pain networks are reorganized and modulated and thereby creating pain tracks . It is still unknown weather this reorganisation is a cause of the pain, the process of chronification, or a result of the chronic pain state. The cognitive behavioural theory describes the cognitive change in chronic pain patients which could be the psychological aspect of the reorganisation in the brain; the chronification process. In addition, some individuals could be more sensitive to develop sustained pain due to negative coping mechanisms. This could further be associated with specific, sensitive pain networks in the brain and the reorganisation could then be the cause of the pain. The neural pain tracks could be the bio-physiological substance for the cognitive process of chronification