Positive Health Online

Abstract

REESE and MITTAG, Department of Quality Management and Social Medicine, University Medical Center Freiburg, Freiburg, Germany. christina.reese@uniklinik-freiburg.de  conducted a review of the literature and summarized evidence and recommendations for psychological interventions in the rehabilitation of patients with chronic low back pain.

Background

The purpose of the article is to summarize evidence and recommendations for psychological interventions in the rehabilitation of patients with chronic low back pain.

Methodology

The authors carried out a systematic literature search in several databases and on the websites of professional associations to identify relevant reviews and guidelines. In addition to the electronic search, a handsearch was carried out. Eligible publications were selected. They extracted and summarized both evidence for psychological interventions and recommendations on psychological diagnostics and interventions. Six systematic reviews and 14 guidelines were included. They collected recommendations and partially restricted evidence on the following psychological interventions: behavioural therapy, fear-avoidance training, stress management, relaxation therapy, patient education and back school.

Results

Most available evidence for psychological interventions in the rehabilitation of patients with chronic low back pain is of moderate to low quality. In addition, some of the older evidence is inapplicable to modern interventions using a bio-psychosocial approach. Thus, high quality and current evidence is needed. The summary of guidelines shows that multimodal, multidisciplinary programmes including psychological interventions have become standard in the rehabilitation of patients with chronic low back pain.

Conclusion

In most guidelines, however, there are no recommendations on which (psychological) intervention should be considered for which specific problem (problem-treatment pairs). Suggestions for future research and future guidelines are made.

References

Reese C(1), Mittag O.  Psychological interventions in the rehabilitation of patients with chronic low back pain: evidence and recommendations from systematic reviews and guidelines.  Int J Rehabil Res. 36(1): 6-12. doi: 10.1097/MRR.0b013e32835acfec. Mar 2013.