The clinical significance of behavioral treatment for chronic low back pain: an evaluation of effectiveness.

The clinical effectiveness of behavioral treatment for chronic low back pain (CLBP) was evaluated using an empirical strategy to quantify individual patient change. Patients with CLBP (n = 17) presenting to an outpatient pain clinic were evaluated at baseline and six months posttreatment on variables of pain, disability and distress. Similar patients receiving usual medical care (n = 17) were evaluated on the same outcome measures and time line for purposes of descriptive comparison. Validated and widely-used measures of pain (McGill Pain Questionnaire), disability (Sickness Impact Profile), and depression (Beck Depression Inventory) served as outcome measures. Forty-seven percent of patients receiving behavioral treatment evidenced clinically significant improvement in at least one of the dimensions of pain, disability and depression associated with CLBP. However, clinically significant improvement across all three measures was rare. These findings are discussed in terms of the viability of behavioral treatment for CLBP, the need to enhance the degree of clinically significant outcome associated with behavioral treatments, and the value of empirical evaluation of clinically significant improvement following treatment interventions.