Efficacy of combined relaxation procedures in the treatment of chronic low back pain
Chronic low back pain (CLBP) is a widespread problem, affecting 25 to 45 percent of people at some point during their lifetime (Gatchel & Turk, 1996; Gervirtz, Hubbard, & Harpin; Linton, 1994). The etiology of CLBP is often unclear, and physiological causes are determined in only 10 to 15 percent of cases. Psychopathology, external stressors, and coping skills may interact with CLBP. Relaxation techniques have been established as efficacious treatments in people with cancer pain, chronic headaches, and hypertension, but have not been well researched in the CLBP population, and the efficacy of relaxation as a treatment for CLBP has not been well established. Research has suggested that no single relaxation technique is consistently superior in treatment, and there is the possibility that combining different techniques may optimize treatment efficacy (Cott et al., 1992; Spence, Sharpe, Newton-John, & Champion, 1995; Rasid & Parish, 1998; Woolfolk & Lehrer, 1984). The present study examined the efficacy of a relaxation procedure that uses a combination of progressive muscle relaxation autogenic training, and breathing exercises in comparison to a treatment-as-usual control for 32 individuals with CLBP. Results showed that the relaxation treatment group showed improvements in weekly pain ratings, life interference, and sleep duration from pre-test to post-test and maintained gains at the two week follow-up, but no changes were noted in the treatment-as-usual control group. In the relaxation group, short-term gains were noted for perceived life control, though medication, tension, and affective distress levels decreased across time for both groups, and activity did not change for either group. Relaxation treatment appears to be a beneficial treatment for some psychosocial and physical aspects of CLBP, and most gains were maintained over time.