Multimodal pain management and cognitive behavioral therapy
Low back pain that doesn't go away or keeps returning despite treatment can be very distressing. One way to cope with it is to learn to manage the pain better – for example, using cognitive behavioral therapy or multimodal pain management.
Cognitive behavioral therapy (CBT) is one of the most effective treatments for chronic low back pain. It involves things like getting rid of harmful fears and thoughts. This can help you cope better with the pain, which helps to reduce it.
One example of these fears is the widespread belief that certain activities could damage your back. In the long term it is actually more harmful to rest – exercise can help to strengthen your muscles and prevent pain. If you're in pain, it's not always easy to stay or become physically active again. It is important to set realistic goals, and neither focus too much on the pain nor suppress it.
Cognitive behavioral therapy can help here. During this psychological treatment, you learn to recognize negative thoughts that lead to harmful behavior. You then try to change those thoughts. Examples include:
- “I have to be really careful, or else I'll damage my back even more and the pain will never go away."
- “I'd better stay at home because of my back pain, otherwise it will only get worse."
Thought patterns like these can cause unnecessary anxiety, making you become inactive and withdraw from social activities. But this may lead to other problems over time, and make the pain even worse.