[Efficacy of biofeedback in patients with chronic low back pain : Impact on pain intensity, psychological factors and stress markers].

BACKGROUND

The treatment of patients with chronic pain should be carried out in interdisciplinary multimodal pain programs of which relaxation methods represent an integral part. The German disease management guidelines (NDGM) on nonspecific low back pain currently do not recommend biofeedback as a relaxation technique for chronic low back pain due to inadequate data. Furthermore, health insurances do not cover the costs of this treatment.

METHODS

The efficacy of a 2-week biofeedback treatment was evaluated in a study of 10 patients with chronic nonspecific low back pain and 10 healthy, age and gender-matched subjects. The parameters "well-being", "depressive mood" and "pain-related disability" were assessed based on three psychometric tests (KAB, ADS and PDI). The pain intensity was measured using a numeric rating scale (NRS) and biofeedback measurement parameters themselves as well as stress markers in blood (noradrenaline, cortisol and MMP-2) were also measured.

RESULTS

The relaxation response was demonstrated by the biofeedback-parameters. The treatment led to an improvement in well-being, depressive mood and pain-related disability. These results correlated with a reduction of noradrenaline and MMP-2 blood levels, whereas cortisol concentrations showed no change.

CONCLUSION

Biofeedback relaxation is a suitable method in the treatment of chronic non-specific low back pain. Its use in interdisciplinary multimodal pain programs should be encouraged.