While people dealing with chronic back pain are often directed to physical therapy, research shows that psychological approaches that teach strategies to manage your experience of pain can help. So, would combining these approaches do more to ease the pain?
Worldwide, low back pain is a leading cause of disability. A recent systematic review of multiple studies suggests that it might.
Jone Mark
How big is this problem, and what did this study find?
Worldwide, low back pain is a leading cause of disability and affects more than 560 million people. In the US, four in 10 people surveyed in 2019 had experienced low back pain within the past three months, according to the Centers for Disease Control and Prevention.
- For improving physical function and fear-avoidance, pain education programs in conjunction with physical therapy offered the most sustained effects.
- For improving pain intensity, behavioral therapy combined with physical therapy offered the longest-lasting benefits.
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The review revealed that physical therapy plus psychological approaches, such as pain education and cognitive behavioral therapy, more effectively improved chronic low back pain than physical therapy alone.
The study shows the advantages of an interdisciplinary approach to chronic low back pain. Integrating behavioral therapy and physical therapy helped people achieve better function, reduce the cycle of avoidant behavior, and reduce the intensity of their pain.
]]>But when the time comes for treatment, up to a third of men still decide against it. Now, a new study finds that for some of these men, treatment can be safely delayed.
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80% of the men in the early-surgery group were still cancer-free three years later, compared to 87% of the men who put the surgery off for up to five years.
Jone Mark
Researchers from the University of California, San Francisco identified 531 men whose cancers progressed while they were on active surveillance. All the men were diagnosed initially with Grade Group 1 prostate cancer, which is the bottom rung on a classification scheme that ranks cancers from low to high risk of aggressive spread.
Outcomes and observations
When the researchers compared long-term outcomes among the men who got surgery within six months and those who waited longer for their operation, they found little difference between them. Forty-five men from both groups combined had their cancer return within three years after surgery.
Furthermore, prostate tissues observed by a pathologist immediately after surgery showed similar rates of adverse biological features that predict worse outcomes later. Tumors from about half the men from either group had this type of adverse pathology.
]]>- A focus on gratitude for what is going well in my life and for those around me
- Mindfulness and presence at the moment
- Engaging in healthy habits: exercise, good nutrition, and, ideally, sleep (not my specialty!)
- Connection with others, open and honest communication, and empathy, including self-empathy.
The first is overcoming a vicious addiction to prescription painkillers, and the second is training to be a health and wellness coach.
Jone Mark
Unhelpful thinking and why we do it
Additionally, a critical component to attaining the serenity and focus one needs to be a wellness coach, and to move past an addiction, is learning how to recognize and defuse the cognitive distortions that we all employ. Cognitive distortions are internal mental filters or biases that increase our misery, fuel our anxiety, and make us feel bad about ourselves.
What are unhelpful cognitive distortions?
Finally, many of us engage in emotional reasoning, a process in which our negative feelings about ourselves inform our thoughts, as if they were factually based, in the absence of any facts to support these unpleasant feelings.
In other words, your emotions and feelings about a situation become your actual view of the situation, regardless of any information to the contrary. Emotional reasoning often employs many of the other cognitive filters to sustain it, such as catastrophizing and disqualifying the positive. Examples of this may be thinking:
- I’m a whale, even if you are losing weight
- I’m an awful student, even if you are getting some good grades
- My partner is cheating on me, even if there is no evidence for this (jealousy is defining your reality)
- Nobody likes me, even if you have friends (loneliness informs your thinking).
A big part of dismantling our cognitive distortions is simply being aware of them and paying attention to how we are framing things to ourselves. Good mental habits are as important as good physical habits. If we frame things in a healthy, positive way, we almost certainly will experience less anxiety and isolation.
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