Laxmaiah Manchikanti, MD, a professor of anesthesiology and perioperative medicine at the University of Louisville, in Kentucky, says it’s likely that CBT can help back pain. Although “back pain is a complex problem,” he says, the study suggests that CBT can “[allow] a person to function” without disability.
However, Dr. Manchikanti points out that the American health-care system may not be amenable to CBT for back pain. Insurers may not cover the treatment, he says, and health-care providers may not have the appropriate training to deliver it. “The U.S. system is not set up for CBT [for back pain],” says Dr. Manchikanti, who wrote an editorial accompanying the study and is also the medical director of the Pain Management Center, in Paducah, Ky.
But in the short term, he adds, primary care physicians might begin to incorporate some CBT methods into their appointments with back pain patients.
In the study, the researchers note that CBT was a very cost-effective treatment for low back pain, at least in the U.K., which has a government-run health-care system. One year of CBT for back pain would cost about $2,700 in the U.K., the researchers estimate. By contrast, a year of physical therapy, acupuncture, or chiropractic care would cost about $5,800, $6,500, and $13,300, respectively.
In the U.K., Hansen says, health professionals will soon be trained to deliver this intervention in the hopes of lessening back pain for a wide range of patients. “We trained existing health professionals in two days and it’s shown success, so we’re not talking about extensive training,” she says. “It’s very practical.”