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NEWS ITEMS - Physiotherapy in low back pain

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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.
Source: Disability & Rehabilitation 2013;35(1):1-10.
Further reading: www.ncbi.nlm.nih.gov/pubmed/22607157