ABSTRACT
The outcome of the management of chronic low back pain in 42 men and 36 women by a comprehensive rehabilitation program consisting of biofeedback training, counseling in self-control techniques, self-regulated medication reduction, physical therapy, vocational rehabilitation services and education conducted in a therapeutic milieu was examined at 6 months and 12 months after discharge. The mean age of the subjects was 43.4 years: the mean highest school grade completed, 12.6; and the mean full scale WAIS IQ, 106.7. On admission 72 were unemployed and had been disabled and unemployed for a median time for 3 years. Almost two-thirds were involved in litigation. Thirty-three were working or accepted for employment t 6 months after discharge and 35 at 12 months (p less than 0.001). Success rates are higher when only those who stayed in the program for more than 4 weeks are considered. The employed patients rated their pain lower, used less medication and relied less on attention from physicians. They did not seem to differ in their use of relaxation skills or exercise. A similar study has been initiated of patients randomly assigned to treatment and waiting list control groups.
Subject(s)
Back Pain/rehabilitation , Adult , Biofeedback, Psychology , Counseling/methods , Female , Follow-Up Studies , Humans , Male , Middle Aged , Outcome and Process Assessment, Health Care , Physical Therapy Modalities , Rehabilitation, Vocational , Relaxation Therapy , Substance-Related Disorders/rehabilitationABSTRACT
The literature on conventional medical procedures for restoring high-risk patients having chronic low back pain reveals that these procedures are ineffective and may even be iatrogenic. An alternative, noninvasive approach, which takes into consideration the critical role of cognitive and emotional factors, is practiced at Casa Colina Hospital for Rehabilitative Medicine. Details of the approach as well as comments confirming its efficacy are presented.