Dr. Matthew Bair discusses his study comparing medication management with nonpharmacologic approaches for low back pain.
We tried to optimize medication management with the use of a nurse care manager that was really on the front line interacting with veterans with low back pain and following a medication algorithm from simple analgesics, simple pain medications, to more complex and different categories of pain medications and really trying to optimize the dose, the response and minimize side effects.
In terms of the cognitive behavioral therapy arm, that is our nonpharmacologic arm, cognitive behavioral therapy is the most commonly used nonpharmacologic treatment for low back pain and chronic pain in general. And how I would explain it is basically teaching patients strategies and skills to help better cope with their pain.
So it teaches them goal setting and managing flare ups and handling their sleep challenges that are often common in low back pain, how they interact and communicate with their providers.
Sometimes cognitive behavioral therapy involves a term called cognitive restructuring where some of the thoughts a patient has where some of the thoughts a patient has where some of the thoughts a patient has about their pain is actually not helpful.
It’s what we call maladaptive, and cognitive behavioral therapy tries to restructure and changes those thoughts to be more helpful to manage and to cope with their chronic pain.