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FROM JAMA
Adults suffering from chronic lower back pain may be better off
pursuing mindfulness-based stress reduction or cognitive-behavioral
therapy rather than more standard, conventional treatments for pain
alleviation, a new study shows.
However, the relatively limited availability of cognitive and
mindfulness-based approaches to stress reduction in many parts of the
country, coupled with the uncertainty about insurance providers covering
such treatments, put the viability of such treatments receiving
widespread acceptance and use in question.
"Low back pain is a leading cause of disability in the United
States, [and] psychosocial factors play important roles in pain and
associated physical and psychosocial disability," said Daniel C.
Cherkin, Ph.D., of the Group Health Research Institute in Seattle, and
his associates. "Cognitive-behavioral therapy [CBT] has
demonstrated effectiveness for various chronic pain conditions and is
widely recommended for patients with chronic low back pain, [but]
patient access to CBT is limited."
Dr. Cherkin and his coinvestigators recruited subjects from Group
Health, an integrated health care system in Washington state, looking
for patients between the ages of 20 years and 70 years with low back
pain persisting for at least 3 months that was both nonspecific and had
not been given a specific diagnosis (JAMA. 2016 Mar;315[12]:1240-9).
Of 1,767 patients evaluated, 342 patients were enrolled and
journey.
"Opioids are often resorted to out of desperation by both
physicians and patients who both feel there isn't any alternative,
and physicians don't like to see their patients continuing to
suffer," said Dr. Cherkin. "Things have gotten way out of
whack over the years, because there has not been an evidence-based
approach to ensuring that what is most helpful for patients is available
and offered by insurance.
"If we can look at the most effective treatment options
available to patients that have low risks of addiction, death, or other
harm and make those available so physicians can include those in their
repertoire of what they feel they can offer patients, we're going
to be in much better shape," Dr. Cherkin noted.
dchitnis@frontlinemedcom.com
http://www.thefreelibrary.com/Mindfulness-basedapproachesbestforlowbackpain.-a0452881771