In order to effectively treat chronic pain, CBT is usually used in conjunction with other pain management treatments such as pain relief medications, physiotherapy, weight loss regimes, various massage techniques, or indeed surgery

1. Does Cognitive Behavioural Therapy Work For Back Pain?
Here's where Cognitive Behavioural Therapy comes in and chronic pain sufferers should
consider exploring this method as an avenue to back pain relief.
So what is Cognitive Behavioural Therapy and how can it help?
Over a recent couple of decades cognitive-behavioral therapy (CBT) has become an accepted
first-line psychosocial treatment that can help patients to deal with chronic pain, including low
back pain. CBT states that individuals, not the outside environment, create their own
experiences, including pain. The theory behind CBT is that the process of changing the patient's
thoughts about their pain can bring about changes in how the body responds to that pain.
The sensation or perception of pain actually occurs in the brain, so the theory behind CBT
works on the premise that the sufferer can change the perception of physical pain by controlling
the thoughts and behaviors that feed it.
The patient cannot physically stop or alter the level of the pain, but with practice, he or she may
become able to control how their brain deals with that pain. For example, a negative thought
such I can no longer do this activity anymore might be changed into a much more positive
outlook along the lines of "I will do it again just like I used to do."
What the therapist will seek to do is to encourage the patient to focus his or her thoughts
(Cognitive), and then focus on subsequent actions which to address (Behavioural). This process
may take place over many sessions with the therapist seeking to help the patient to identify
negative thoughts and feelings encountered during bouts of back pain. These CBT sessions
would attempt to train the patient in how to convert this negativity into positive thoughts and
actions and to develop healthy thinking. This healthy thinking involves positive thoughts and
calming your mind and body by using techniques such as yoga, massage, or imagery. Positive
or healthy thinking helps to make you feel better, and feeling better reduces pain perception.
This transition of negative to positive thought processes has been demonstrated to help in
enabling the patient to better manage their pain and change the way in which the patient's body
actually responds to the pain. So although the physical pain is still present, changing the
patient's mindset can alter and improve their ability to deal with it.
CBT can relieve pain in several ways. It transforms the way in which the patient perceives the
pain. It changes the thought processes, emotions, and behaviors. In relation to pain help to
develop coping strategies. And puts the level of discomfort into an improved context. As a
result, the pain tends to interfere less with the patient's quality of life. Enabling the patient to
function better. Besides, we can also alter the brain's physical responses that tend to worsen
the pain. When we are in pain, this causes stress. Which can affect the production of pain
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2. control chemicals? Like Norepinephrine and Serotonin, which are the body's natural painkillers.
CBT can thus impact the natural pain relief response. y. Or, click the Write button and compose
something new.
CBT can also help the patient to become more active, which is important because regular, low-
impact exercise, for example, yoga, pilates, walking, and swimming, can help to reduce back
pain in the long term.
So how does CBT work in practice?
In order to effectively treat chronic pain, CBT is usually used in conjunction with other pain
management treatments such as pain relief medications, physiotherapy, weight loss regimes,
various massage techniques, or indeed surgery. In a lot of instances, CBT is considered to be
one of the more effective forms of treatment, having less risk or potential side effects than pain
relief medications or invasive surgery.
CBT sessions can be carried out through a range of formats ie
Individual sessions
Group therapy with other patients addressing the same pain issues
Self Help modules - usually in the form of a book from which assignments are carried
out
A computer program or App (CCBT)
Group and individual CBT sessions generally last between 30 minutes and an hour over
anything from six to twenty sessions
During the CBT sessions, the therapist will work with the patient to break down their problems
surrounding their pain into separate components ie their thoughts, physical feelings, and
actions. These would then be analyzed jointly to determine which are unrealistic or negative and
then analyze the effect they have on each other and the patient. The therapist and patient will
then draw up an action plan to alter unhelpful or negative thought patterns and behaviors.
The challenge then for the patient to practice the application of these changes in their daily life
and provide feedback at the next session, with the objective being to teach the patient the
application of these skills during the CBT sessions to daily life. By doing this the patient is
learning to manage their issues or problems to prevent or reduce the negative impact on their
lives and to carry this on after the CBT has been completed.
To summarise cognitive behavioral therapy involves
Developing a positive or problem-solving attitude in the patient to reduce the sense of
helplessness over their pain and giving them a sense of control
The patient carrying out homework or assignments designed to keep track of thoughts or
feelings associated with pain and recording these for review
Developing life skills and coping mechanisms for not only in pain control but in other problems
encountered in life such as stress or anxiety
Self-help for pain management.
How to benefit from CBT for pain control
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3. Have faith in the concept. There are many research papers demonstrating its
effectiveness in assisting pain relief or pain reduction so its important to engage with the
process
Actively engage with the concept. You have to put the effort in to get a positive outcome
from the sessions
Ensure that you finish all the modules. For CBT to be effective it's important to attend
each session and complete all the assignments given to you. Indeed one of the major
drawbacks of CBT is that of patient non-compliance. Ie skimping or not bothering with all
the elements of the CBT program
Be open-minded about the possibility that CBT could work for you, but it does need your
full commitment.
What now with CBT
If you are interested in trying CBT for pain management, talk to your GP or healthcare
professional in the first instance. They can point you in the direction of cognitive-behavioral
therapists specializing in back pain available in the UK through the NHS although there are
likely to be waiting lists.
Conclusion
If you wish to have CBT privately then ask your GP to recommend, or alternatively contact the
British Association for Behavioural and Cognitive Psychotherapies (BABCP) who will be able to
provide details of accredited CBT practitioners.
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