Medical experts have seen how pain education and cognitive behavioral therapy or CBT classes effectively manage chronic back pain; even a one-time pain management class can help. Individuals experiencing back pain often try a variety of remedies to find relief. These include:
Eliminating activities
Over-the-counter medications
Prescription pain medications
Support devices and braces
Pain specialists
Surgery
All treatment options can help alleviate discomfort and pain, but sometimes taking a pain management class and getting educated on what is happening in the body has been shown to help individuals gain a better understanding helping them to find relief. A recent study suggests that a one-time class may be all that is needed. These quick classes can give more individuals immediate access to information and skill sets that can help reduce the pain and everything that comes with it.
Cognitive Behavioral Therapy Classes
Cognitive Behavioral Therapy for chronic pain provides individuals with information and pain management skills. Cognitive-behavioral therapy is handled by a therapist and can take multiple individual or group sessions that last one or two hours. A session can include:
Education on pain and how it works.
How thoughts and emotions influence pain.
How pain affects mood.
Sleep and pain.
Activity and action plan development.
Chronic lower back pain or CLBP is considered a physical ailment; cognitive behavioral therapy can provide mental health strategies to manage symptoms better. For example, individuals with chronic pain begin to fear doing activities that could increase their pain level and begin to constantly worry about worsening the injury or creating a new injury. This can lead to severe stress that exacerbates the chronic symptoms and can lead to other health issues.
Single Session Vs. Multiple
Doctors and medical experts are trying to make pain education and relief skills more accessible. They do not require multiple sessions and instead consist of single-session, two-hour management classes. A randomized clinical trial of adults with chronic low back pain was compared to:
2-hour back pain health education class with no skill set training.
16-hour, 8-session cognitive behavioral therapy group class.
The study found that three months after treatment, the Empowered Relief group showed positive results. In the randomized trial, a single-session pain relief class was found to be non-inferior to an eight-session cognitive behavioral therapy class to:
Reduce pain-related distress
Pain intensity
Pain interference
Benefits
The individuals that completed the one-time 2-hour class reported positive results after three months. They found that the course had significantly reduced:
Pain intensity
Pain interference
Sleep disturbance
Anxiety
Fatigue
Depression
However, doctors caution that the two-hour class does not replace comprehensive cognitive-behavioral therapy. This is to get individuals on a positive path of pain management that can further develop into a healthy lifestyle. The objective is to create a range of options that meets an individual’s needs. The most significant advantage of a two-hour class is the convenience. Individuals can participate in these classes in person or online.
Body Composition
Supplements That Can Help Improve Lean Body Mass
A few dietary supplements that directly support body composition improvement.
Protein Powders
Protein powders are common nutritional/dietary supplements. Protein powders come in a variety of sources:
Plant-based – rice, hemp, pea, pumpkin seed, and soy.
Rice Protein
Rice protein is a plant-based protein powder used by vegans, vegetarians, and individuals who can’t tolerate dairy products. Research has found that rice protein has similar effects on body composition as whey. Scientists found that individuals who took rice protein and individuals that took whey protein both experienced positive body composition changes.
References
Cochrane Database of Systematic Reviews. (Oct 2015) “Psychological therapies for the management of chronic neuropathic pain in adults.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6485637/
Darnall BD, Roy A, Chen AL, et al. 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: A Randomized Clinical Trial. JAMA Netw Open. 2021;4(8):e2113401. doi:10.1001/jamanetworkopen.2021.13401
Future Neurology. (Nov 2014) “Neuroimaging chronic pain: what have we learned and where are we going?” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5289824/
HRB Open Research. (Aug 2020) “The relative effectiveness of psychotherapeutic techniques and delivery modalities for chronic pain: a protocol for a systematic review and network meta-analysis” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459872/
Journal of Psychosomatic Research. (Jan 2010) “Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice.”
National Institutes of Health. (March 2016) “Meditation and cognitive-behavioral therapy ease low back pain.” https://www.nih.gov/news-events/nih-research-matters/meditation-cognitive-behavioral-therapy-ease-low-back-pain
Pain. (Feb 2008). “Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2254507/
Pain and Therapy. (Jun 2020) “Rehabilitation for Low Back Pain: A Narrative Review for Managing Pain and Improving Function in Acute and Chronic Conditions.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7203283/
Mental strategy exercises for chronic pain relief and improvement. Living with chronic pain is difficult especially if a doctor is saying that it is all taking place in an individual’s head. However, the pain is very real and happening in the brain, literally. Neuroimagingstudies show that certain areas of the brain become active when chronic pain presents. This is not the only way to know the brain’s role in how an individual experiences pain. What is also known is:
Anxiety, depression, and pain activate similar areas of the brain.
Certain psychiatric drugs used to relieve pain can also alter an individual’s mental state.
Chronic pain can lead to depression.
Clinical depression can cause physical symptoms, including back pain.
A health care provider could recommend/suggest psychological support for chronic pain. Psychological help and mental strategy exercises for chronic pain are not about how to reduce the pain, but more on how to reduce the dominance, interference, and impact of the pain and getting a healthy quality of life back. Consider a few evidence-based, psychological approaches to reduce back pain.
Cognitive-behavioral therapy
Cognitive-behavioral therapy or CBT trains an individual to modify specific thoughts and behaviors. Experts consider this approach a gold standard of psychological interventions for pain. It helps:
Reduce pain
Improves function
Improves quality of life
Individuals work on:
Pain coping strategies
Relaxation skills
Setting goals
Shifting perspectives on pain
A study found that two years after a two-week, intensive course of cognitive-behavioral therapy, patients took fewer pain meds than they did before the therapy.
Mindfulness meditation
Meditation is not all about sitting with crossed legs, hands resting on the knees, although this is a recommended pose for meditative purposes. A modern approach can be done anywhere, in any position that�s comfortable and will help soothe back pain. By oneself or with help from a therapist mental strategies can include
A study suggests that mindfulness meditation can be highly beneficial for older adults that are not as able to get an adequate amount of physical activity to improve pain levels. A group of older adults that participated in eight weeks of a mindfulness program, which consisted of four days a week for 30 minutes per session physical function and pain reduction improved.
Mindfulness stress reduction
Mindfulness stress reduction is a program that teaches individuals meditation techniques, that include basic stretches and postures. It teaches how to separate the physical and psychological aspects of pain. Medical centers across offer this treatment option for a range of disorders, including chronic back pain. It helps reduce pain intensity and improves function in individuals with arthritis as well as back and neck pain from various causes. It has also been found to be effective for fibromyalgia, which can cause intense widespread pain. A study found that mindfulness stress reduction improved:
Wellbeing
Pain episodes
Sleep problems
Fatigue in participants with fibromyalgia
More than half reported significant improvement
Acceptance and commitment therapy
Acceptance and commitment therapy or ACT teaches acceptance and mindfulness strategies with commitment and behavior mental strategies, to change the way pain is experienced. Numerous studies along with the American Psychological Association validate this approach as an established treatment for chronic pain.
Changing expectations
In one study several chiropractic patients who expected their back pain to improve were 58% more likely to improve than those who did not expect favorable outcomes. This mental strategy of manifesting a positive outcome through the power of positive thinking and beliefs about pain influence an individual’s actions.
For example, when thinking that physical activity will cause back pain, individuals are less likely to be active. This is known as fear avoidance. For most individuals with back and neck pain, gentle physical activity is essential because avoiding it will worsen the pain. Having the right mental strategy can go a long way in battling chronic pain, at Injury Medical Chiropractic and Functional Medicine Clinic we can help individuals experiencing/dealing with chronic pain.
Body Composition
Depression and physical health
Depression is debilitating and, in severe cases, a life-threatening disease that affects over 16 million people nationwide. Depression causes are not always clear and can be brought on by:
Biological factors – genetics
Individual brain chemistry
Certain medications
Stress
Unhealthy diet/nutrition
Mental illness and becoming overweight or obese often happen in conjunction, whether as a result of each other or from common risk factors that include:
Smoking
Poor diet
Lack of physical activity
Alcohol consumption
Prescribed medications for depression and anxiety disorders are have been shown to be successful in maintaining mental health. However, a side effect of these medications is weight gain. Like genetics, being educated on the potential side effects will help in reducing the risk of, and controlling weight gain when taking medication.
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Pain and Therapy.�(Jun 2020) �Rehabilitation for Low Back Pain: A Narrative Review for Managing Pain and Improving Function in Acute and Chronic Conditions.��https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7203283/Journal of Psychosomatic Research. (Jan 2010) �Mindfulness-based stress reduction for chronic pain conditions: variation in treatment outcomes and role of home meditation practice.�
European Journal of Pain.�(Jan 2019.) �Beliefs about back pain and pain management behaviors, and their associations in the general population: A systematic review.��https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6492285/
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
