| Back pain is a very common and expensive medical problem. When the medical model failed to account for certain aspects of the pain experience, psychological factors were combined with biological factors in a comprehensive model of pain, the gate control theory. This theory led to an increase in psychological approaches to pain management. The present study used the technique of meta-analysis to examine the effectiveness of psychological approaches to back pain treatment. The 146 psychological interventions included used a wide variety of approaches to back pain treatment. Research designs, outcome measures, and the types of patients treated also varied among interventions.; Overall, psychological treatments for back pain showed small effects. For unimodal interventions, no treatment of choice emerged. Adding physical therapy and medical components to psychological treatment resulted in increased effectiveness. Compensated patients were worse off than non-compensated patients. Treatment and patient characteristics, like pain duration and treatment intensity, were unrelated to treatment effectiveness. These results were compared with previous meta-analytic findings. Furthermore, the present findings were discussed in terms of their clinical significance. Observations about the reporting of back pain treatment studies were described. Directions for future research were provided. |
