Lessening Pain in the
Pain Symptoms for Inner City Patients
Participation in a
self-management program decreases symptoms associated with low back pain and
increases confidence in managing low back pain symptoms for inner city patients,
according to a recent study funded by the Department of Health and Human
Services' National Institute of Arthritis and Musculoskeletal and Skin Diseases
(NIAMS) and the Department of Veteran Affairs.
The study, carried out by Teresa
Damush, Ph.D., and others at the Indiana University School of Medicine,
initially involved 211 patients with acute low back pain (symptoms lasting less
than three months) from inner city neighborhood health centers and the emergency
department of a public teaching hospital. Patients were randomly assigned to
participate in a self-management program or to receive standard care. The
self-management program included three in-person classes, handouts, audiotapes,
physician letters of support and telephone follow-up. Classes involving goal
setting, problem solving, social support, exercise and back education were also
given. The standard care group received medications, back exercise sheets and
referrals to health care specialists as needed.
After four months, the 76
patients remaining in the self-management program reported improved emotional
functioning (less anxiety and depression), less low back pain, less fear of
physical activity and movement, and more confidence in managing back pain
symptoms compared with the 87 patients remaining in the standard care group.
Despite the high prevalence of
back pain in the United States, research on reducing back pain disability in
socioeconomically vulnerable patients has been lacking. Self-management
strategies show promise as a tool to improve the quality of life for selected
individuals who experience acute low back pain.
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