Fledgling chronic back pain therapy needs more rigorous study

Date:
March 2, 2023
Source:
University of New South Wales
Summary:
Cognitive Functional Therapy treats chronic back pain as part of
a person's entire pain experience, but more research is needed to
assess its effectiveness.


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FULL STORY ==========================================================================
A systematic review of relatively new treatment for chronic back pain -
- Cognitive Functional Therapy -- has found that it is no better than traditional therapies based on evidence from past studies.


========================================================================== Leading the review was Mr Jack Devonshire, a PhD candidate with UNSW
Sydney and Neuroscience Research Australia (NeuRA). He looked at studies
of Cognitive Functional Therapy (CFT) as a treatment for chronic back pain which, for the purposes of his research, was defined as pain experienced continuously for three months or more in the region between the 12th
rib and the crease of the buttocks.

CFT has been growing in popularity and gaining attention among
practitioners since the first clinical trial in 2013 based on theory
developed in 2005. There have been multiple trials across the world on
CFT since, says Mr Devonshire.

"CFT integrates treatments that may be helpful in managing chronic lower
back pain, such as pain education, exercise, and lifestyle coaching,
into a model of care informed by a contemporary understanding of a
person's entire pain experience," he says.

"The therapy aims to build upon the biopsychosocial model to provide
health professionals with what we call a clear 'clinical reasoning
framework' to tailor strategies to manage this chronic condition."
Global interest in CFT Despite the therapy being integrated into
healthcare systems in the UK and Finland, as well as having multiple
training courses online for clinicians, there hasn't yet been a
comprehensive analysis of research into this therapy.

"So we decided to perform a systematic review and meta-analysis,
the highest level of evidence, to look at past studies to find out
how effective the treatment is on pain, disability and safety," Mr
Devonshire says.

After examining all the studies that fit the research criteria, Mr
Devonshire and his fellow authors found that ultimately the effectiveness
of CFT remains unknown at this stage, and the group calls for future
trials featuring blinded participants -- those who are unaware whether
the therapy being administered is actual or sham -- and studies that
recruit larger sample sizes.

"The results of our study found that CFT may not reduce pain intensity
and disability in people with chronic low back pain, compared to manual
therapy and core exercises, either at the end of treatment or at the
12-month follow-up," Mr Devonshire says.

"This is important as we want our exercise physiologists, physios and
other health professionals who manage people with low back pain to be
armed with the best available information on the available effective
treatments -- especially since learning to deliver CFT as a therapist
is quite intensive, taking an average 106 hours of training to properly
deliver the treatment." The researchers otherwise found that no adverse
events were reported among patients after receiving the CFT treatment.

Mr Devonshire notes that certainty in the researchers' systematic review
was limited by differences between study controls, small sample sizes
and a high risk of bias across all included studies, impacting the trustworthiness of the findings from these studies. The group looks
forward to further research that improves current evidence via clinical
trials on CFT.

The review was published recently in the Journal of Orthopaedic & Sports Physical Therapy.

* RELATED_TOPICS
o Health_&_Medicine
# Pain_Control # Back_and_Neck_Pain # Workplace_Health
# Medical_Topics
o Mind_&_Brain
# Caregiving # Behavior # Mental_Health # Depression
* RELATED_TERMS
o Back_pain o Chronic_pain o Anesthesia o Pain o Suicide o
Gate_control_theory_of_pain o Nociceptor o Opioid_drug

========================================================================== Story Source: Materials provided by
University_of_New_South_Wales. Original written by Lachlan Gilbert. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Jack J Devonshire, Michael A Wewege, Harrison J Hansford, Hasibe A
Odemis, Benedict M Wand, Matthew D Jones, James H
McAuley. Effectiveness of cognitive functional therapy for reducing
pain and disability in chronic low back pain: a systematic review
and meta-analysis. Journal of Orthopaedic & Sports Physical Therapy,
2023; 1 DOI: 10.2519/ jospt.2023.11447 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2023/03/230302093411.htm

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