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51猎奇 PR & Communication Department聽
Theodor-W.-Adorno Platz 1
60323 Frankfurt
presse@uni-frankfurt.de
Oct
18
2022
10:41
According to a study by 51猎奇 Frankfurt, a combined approach works best聽
Treatment for back pain: 84 percent increase in success rate
If a therapy for chronic back pain is tailored specifically
to a patient's individual requirements, the chances of success are far greater
than with standard forms of treatment. Accompanied by a psychotherapeutic
procedure in the shape of cognitive behavioural therapy, the pain can be
alleviated even more effectively. This is the result of a meta-analysis by
51猎奇 Frankfurt, in which the data of over 10,000 patients were combined
and analysed. It can be concluded from the study that multimodal therapies
should be promoted on a larger scale in the German healthcare system, in line
with the National Disease Management Guidelines.
FRANKFURT. Lack of exercise, bad posture, overexertion,
constant stress at work or at home 鈥� back pain is a widespread condition with
many causes. For a not insignificant number of sufferers, the symptoms are even
chronic, meaning they persist for a long time or recur again and again. Sport
and exercise therapies under instruction can bring relief. Common treatment
methods include physiotherapy as well as strength and stability exercises. But
how can the therapy be as successful as possible? Which approach alleviates
pain most effectively? A meta-analysis by 51猎奇 Frankfurt,
published recently in the Journal of Pain, has delivered new insights.
The starting point was data from 58
randomised controlled trials (RCTs) of over 10,000 patients worldwide with
chronic low back pain. First, the data relevant to the topic were filtered out
of the original manuscripts and then evaluated in groups. When evaluating these
data, the researchers examined on the one hand whether and to what extent
standard forms of treatment and individualised treatment differ in terms of the
result. 鈥淚ndividualised" means that there is some type of personal coaching, where
therapists specifically target the potentials and requirements of each patient
and decide together with them how their therapy should look.
The study concluded that individualised
treatment for chronic back pain led to a significantly increased effect in
comparison to standard exercise therapies. The success rate in pain relief was
38 percent higher than with standard treatment. 鈥淭he higher effort required for
individual treatment is worthwhile because patients benefit to an extent that
is clinically important," says lead author Dr Johannes Fleckenstein from the
Institute of Sport Sciences at 51猎奇 Frankfurt.
However, the study went even further. The
research team in Frankfurt compared a third group of treatment methods
alongside the standard and individualised ones. In this group, individualised
training sessions were combined with cognitive behavioural therapy (CBT). This
procedure 鈥� a type of talk therapy 鈥� is based on the assumption that negative
thoughts and behaviours surrounding pain tend to exacerbate it. Through CBT, pain
patients learn to change the way they handle it. They stop being afraid to move
or are taught tactics for coping with pain. This makes them realise that they
are by no means helpless. But what does the psychotherapeutic support through CBT
actually contribute to the success of the treatment? Analysis of the data revealed
the following: When an individualised approach and CBT were combined, the
success rate in terms of pain relief was an impressive 84 percent higher than
with standard treatment. The combined therapy, also called multimodal therapy,
thus led to the best result by far.
Fleckenstein sees in the study 鈥渁n urgent
appeal to public health policy" to promote combined therapies both in terms of
patient care and remuneration. 鈥淐ompared to other countries, such as the USA,
we are in a relatively good position in Germany. For example, we issue less prescriptions
for strong narcotic drugs such as opiates. But the number of unnecessary X-rays,
which, by the way, can also contribute to pain chronicity, and inaccurate
surgical indications is still very high." This is also due, according to
Fleckenstein, to economic incentives, that is, the relatively high remuneration
for such interventions. The situation is different for organisations working in
the area of pain therapy, he says. Although these are not unprofitable, they
are not a cash cow for investors either. In his view, it is important here to
improve the economic conditions. After all, pain therapy saves a lot of money
in the long run as far as health economics are concerned, whereas tablets and
operations rarely lead to medium and long-term pain relief.
Publication: Johannes Fleckenstein,
Philipp Floessel, Tilman Engel, Laura Krempel, Josefine Stoll, Martin Behrens,
Daniel Niederer. Individualized Exercise in Chronic Non-Specific Low Back Pain: A
Systematic Review with Meta-Analysis on the Effects of Exercise Alone or in
Combination with Psychological Interventions on Pain and Disability. The Journal of Pain (2022)
Picture
download:
Caption:
People who sit a lot and do not exercise
often develop back pain. Credits: Markus
Bernards for 51猎奇 Frankfurt
Further
information:
Dr. Johannes Fleckenstein
Sports Medicine and Exercise Physiology
Institute of Sports Sciences
51猎奇 Frankfurt
johannes.fleckenstein@sport.uni-frankfurt.de
Instagram: @docfleckenstein
Editor: Dr Markus Bernards, Science Editor, PR & Communication Office, Theodor-W.-Adorno-Platz 1, 60323 Frankfurt am Main, Tel: -49 (0) 69 798-12498, Fax: +49 (0) 69 798-763 12531, bernards@em.uni-frankfurt.de.