May 27, 2016
The treatment of chronic low back pain has been changing as scientific research provides a better understanding of the factors involved in the development and treatment of chronic pain. Current thinking recognizes that chronic pain is the result of interrelating factors and requires intervention on many levels. Psychological and social factors are no longer considered just secondary reactions to pain.
The best treatment is now based not only on an understanding of anatomy and
pathology (the changes in tissues and organs of the body that cause disease)
but on a recognition of the total influences affecting a patient at a given
time. These include physical symptoms, attitudes and beliefs, emotional stress,
occupational and social factors, and spiritual concerns. Consideration of
all these issues can lead to treatment combinations that address the person's
needs on multiple levels and that are also based on each patient's needs,
abilities and interest.
The integrative approach to chronic low back pain is thus attuned to the care of the whole person. Fundamentally, this approach is parallel to the "chronic illness" model that is accepted by pain specialists as the best way to approach chronic pain. The approach recognizes that chronic pain is a biopsychosocial phenomenon and has the following characteristics:
Treatments are drawn from a wide scope of practices that address the complex nature of pain.
- It offers various therapeutic options based on whether pain is processed in a more physical or more psychological way.
- Therapies often give the patient's more control over the pain by emphasizing interventions that patients can do themselves - such as meditation/relaxation, imagery, tai chi, etc. Patient control has been shown to improve patient outcomes and quality of life.
- These therapies may fit the patient's worldview to a greater extent and
thus may help to support a patient's sense of meaning and purpose, self-acceptance,
- Because these approaches often involve a greater level of interaction between patient and practitioner, this may be an added benefit---from the care-giving occurring more as a partnership rather than a hierarchical relationship.
- These approaches often represent a shift from the idea of cure to the concept of the healing process.