The Psychological Management of Chronic Low Back Pain: A Controlled Trial.

The present study compared a group of patients with chronic low back pain (N=23) treated in a comprehensive multi-disciplinary pain management programme with a group of patients (N=15) who were evaluated but not treated. Comparisons were made at initial assessment and on completion of the programme. Patients in the treatment group demonstrated significant improvements in physical and functional ability, reductions in perceived pain intensity, improved self-efficacy in their ability to perform activities despite pain and clear reductions in anxiety compared to the control group. Little difference between groups was demonstrated on measures of depression and pre-occupation with somatic symptoms, and in terms of medication reduction and employment status, although more of the treatment group took medication on a time-contingent basis at post-treatment. A ‘floor effect’ emerged from the data indicating that the majority of both treated and control group patients assessed for the programme obtained anxiety and depression scores which fell below levels indicative of pathology. The drop out rate for this study was extremely low and reasons for termination of treatment were associated with factors external to the programme. Furthermore, the majority of the treatment group’s satisfaction ratings indicated that once on the programme, patients were satisfied with the service. However, a higher attrition rate was found at the initial assessment stage. Possible interpretations of these findings, their clinical and cost-benefit implications and suggestions for future research are discussed.&#xa0