7 Relationship between comorbidities in patients with chronic low back pain undergoing interventional pain management techniques, and patient satisfaction and clinical response

Abstract Background: Chronic low back pain (cLBP) is the leading cause of disability among older adults and one of the top reasons for seeking healthcare, resulting in significant decrements in physical functioning. Because older adults are among the fastest growing cohorts in the United States, both the incidence and burden of cLBP are expected to increase considerably, rendering geriatric pain management a top health priority. Resilience is defined as a process allowing individuals to adapt and recover from adverse and stressful conditions and it has been highlighted as a crucial factor in positive health-related functioning. While a growing body of literature supports the use of resilience-based interventions in chronic pain, research examining their effectiveness in older adults with cLBP remains limited.Methods: In this article, we describe the rationale and design of the Adaptability and Resilience in Aging Adults (ARIAA) study, a single-arm intervention in which 50 participants (ages >60 years) with cLBP will be recruited to participate in a 7-week group-based program aimed at enhancing psychological resilience. Intervention sessions will target positive psychology concepts (e.g., positive affect, pain acceptance, hopeful thinking, pain self-efficacy) and cognitive-behavioral techniques that have established benefits in pain management. Primary study outcomes include intervention feasibility and acceptability as measured by treatment engagement, intervention credibility and satisfaction, ability to meet recruitment and retention metrics, and the feasibility of questionnaire and home activity completion. Outcomes will be assessed at baseline, immediately at post-treatment, and at the 3-month follow-up period. Discussion: This study will establish the feasibility and acceptability of a novel intervention aimed at enhancing positive, psychological functioning and resilience in older adults with cLBP. Achievement of these aims will provide a rich platform for future intervention research targeting improvements in pain and disability among geriatric populations and will serve as a foundation for a fully powered trial to examine treatment efficacy of the proposed intervention.Trial Registration: Clinicaltrials.gov, identifier NCT04068922. Registered 28 August 2019, https://clinicaltrials.gov/ct2/show/NCT04068922

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Comparison of a Single-Session Pain Management Skills Intervention With a Single-Session Health Education Intervention and 8 Sessions of Cognitive Behavioral Therapy in Adults With Chronic Low Back Pain

JAMA Network Open ◽

10.1001/jamanetworkopen.2021.13401 ◽

2021 ◽

Vol 4 (8) ◽

pp. e2113401

Author(s):

Beth D. Darnall ◽

Anuradha Roy ◽

Abby L. Chen ◽

Maisa S. Ziadni ◽

Ryan T. Keane ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Management ◽

Health Education ◽

Chronic Low Back Pain ◽

Behavioral Therapy ◽

Low Back ◽

Management Skills ◽

Single Session ◽

Health Education Intervention

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Identifying Subgroups of Patients With Chronic Nonspecific Low Back Pain Based on a Multifactorial Approach: Protocol For a Prospective Study (Preprint)

10.2196/preprints.9224 ◽

2017 ◽

Author(s):

Kevin Rose-Dulcina ◽

Nicolas Vuillerme ◽

Anne Tabard-Fougère ◽

Romain Dayer ◽

Dennis E Dominguez ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Prospective Study ◽

Chronic Low Back Pain ◽

Functional Disability ◽

Therapeutic Management ◽

Low Back ◽

Study Results ◽

Management Techniques ◽

Multifactorial Approach

BACKGROUND Low back pain, especially nonspecific chronic low back pain (LBP), the leading cause of disability worldwide, represents both social and economic problems. Different therapeutic management techniques can be used, but their effects vary. Clinicians and researchers attribute the variation in the efficacy of therapeutic and management techniques to the heterogeneity of the nonspecific chronic low back pain population, and they agree that nonspecific chronic LBP must be subgrouped. OBJECTIVE This study aims to identify nonspecific chronic LBP subgroups based on a multifactorial approach, including biomechanical, physical, and psychosocial data. METHODS A total of 100 nonspecific chronic LBP patients and 30 healthy participants aged between 18 and 60 years will be recruited for this prospective study. A psychosocial profile will be established using questionnaires on anxiety, depression, functional disability, pain, fear of pain, avoidance belief, and physical activity. A physical capacity evaluation will be conducted. It will evaluate flexibility of the hips, lumbar spine, and lateral thoracolumbar segment, as well as trunk (extensor and flexor) muscle endurance. The subjects will perform functional daily life activities, such as walking, object lifting, forward bending, sit-to-stand, stand-to-sit, balance, and usual postures. Full body kinematics, kinetics, and surface electromyography of the trunk and hip muscles will be assessed during these tasks. The clustering classification methods for the statistical analysis will be determined according to the data and will be used to identify the subgroups of nonspecific chronic LBP patients. RESULTS Data collection started in September 2017 and will be completed with the inclusion of all the participants (100 nonspecific chronic LBP and 30 control). The study results will be published in peer-reviewed journals and presented at relevant international conferences. CONCLUSIONS Numerous studies have showed that the therapeutic management of nonspecific chronic LBP is difficult and has inconstant effects caused by the complexity and heterogeneity of nonspecific chronic LBP. Identifying subgroups with a multifactorial approach is more comprehensive and closer to the pathophysiology of nonspecific chronic LBP. It also represents benefit interests and a challenge both clinically and socially. The perspective of this study is expected to support clinicians for a more adapted therapeutic management for each subgroup.

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