Guided internet-based cognitive behavioural treatment for chronic back pain reduces pain catastrophizing: a randomized controlled trial.

OBJECTIVE The aim of this study was to investigate whether an Internet-based cognitive behavioural intervention would have an effect on the symptoms of chronic back pain. DESIGN Experimental design with a treatment group and a control group measured before and after a treatment period. SUBJECTS Participants who met the criteria for chronic back pain (n = 54). METHODS All participants were screened in a live, structured interview before inclusion. The study period was 12 weeks and the treatment consisted of education, cognitive skills acquisition, behavioural rehearsal, generalization and maintenance. The main outcome of interest was the catastrophizing subscale of the Coping Strategies Questionnaire. RESULTS There were statistically significant reductions from pre- to post-treatment in catastrophizing in the treatment group, and an improvement in quality of life for the treatment group. However, most outcome measures did not indicate a positive treatment outcome. On a scale measuring pain catastrophizing, 58% (15/26) of the treated participants showed reliable improvement, compared with 18% (5/28) of the control group. CONCLUSION Internet-based cognitive behavioural therapy can serve as a complement for individuals with chronic pain who prefer this treatment and have difficulties accessing specialist treatment facilities.