Physiotherapy as cognitive behavioral therapy for acute/subacute low back pain
Emanuel Brunner is a physiotherapist from Switzerland doing his PhD in Belgium (University of Leuven).
He formulated a couple of significant questions addressing the implementation of cognitive behavior therapy in
physiotherapy practice. Cognitive behavior therapy is an umbrella term including graded activity, acceptance
and commitment therapy, graded exposure in vivo, among others.
Even though the focus was on acute and subacute low back pain, these questions apply to pain treatment provided
by physios in general.
Based on the limited research data available for addressing the questions, he came to the following implications
for clinical practice:
Physiotherapist can integrate operant treatment approaches into their standard pain management for
acute/sub-acute low back pain.
Graded activity, based on operant conditioning, is a promising treatment approach for the prevention
of chronic low back pain.
Health care providers, other than only clinical psychologists, should deliver cognitive behavior
therapy-based treatment strategies, which aim to decrease pain behavior by reinforcing exercise behavior
and active coping strategies.