Volume : 9, Issue : 1, JAN 2023




Background: Low Back Pain (LBP) is a major medical, social and economic problem in both developed and developing countries. It often affects all life domains & eventually has a profound impact on quality of life. Each year, 15–45% of adults suffer LBP and 1/20 people present to hospital with a new episode.

Aim of the study: The aim of the study is to find out the effectiveness of Cognitive Behavioral Therapy Vs Dialectical Behavioral Therapy along with Brunkow exercises & along with conventional therapy (Traction) to reduce pain and improve the quality of life by using VAS scale and Quality of life Questionnaire in Chronic Low Back patients.

Objectives of the study: To evaluate the effectiveness between Cognitive-Behavioral Therapy, Brunkow Exercises and Dialectical Behavioral Therapy, Brunkow Exercises along with Conventional therapy (Traction) for pain by using VAS and for Quality of life by using QOL Questionnaire on subjects with CLBP.

Methodology: 32 subjects who were clinically diagnosed of low back pain were assessed and 32 were recruited who are willing to be in the study and they were randomly allocated into 2 groups i.e Group A (n=16), Group B (n=16) . The outcome of this intervention was on Pain and Quality of life. This was recorded before and after the session of intervention.

Results: Statistical analysis of the data reveal that between the group comparison showed there is statistical significant difference in Visual Analogue Scale & Quality of life Questionnaire. Significant reductions (P < 0.01) in participants’ pain intensity, pain-related scores were found at the post treatment (vs pretreatment) assessment.

Conclusion: The Findings of the present study showed that both CBT & DBT along with Brunkow exercises were effective in reducing the intensity of Chronic Low Back Pain & improving the QOL but DBT were more effective when compared to CBT in reducing Pain and improving QOL.



Article : Download PDF

Cite This Article


Article No : 2

Number of Downloads : 185


1. Mary O‘Keeffe, Peter O‘Sullivan, Helen purtill, Norma Bargary, Kieran O‘Sullivan. Maher C, understood non-specific low back pain 2017; 389:736-47.

2. Burton AK. European guidelines for prevention in low back pain. COST B13 Working Group004: 1-53. Balagué, Federico, et al. ?Non-specific low back pain.? The Lancet 379.9814 (2012): 482-491. Level of evidence 1A

3. Haldeman S, dagenaisS.A supermarket approach to the evidence informed management of chronic LBP. Spine J 2008  8(1):1-7

4. Hanney WJ.Masaracchio M, kobler MJ. The influence of physical therapy. Guideline adherence on health care utilisation& costs among patients with LBP,a systemic review of literature, PLOS one 2016;24(6);769-81

5. Hoy D, Brooks P, Blyth F, BuchbinderR. The epidemiology of LBP. Best pract Res clin rheumatolol.2010;24 (6);769-81.

6. Meucci RD,Fassa AG, Faria NM . Prevalence of chronic LBP; systemic review, Revista de saude publica 2015 Oct 20;49:73

7. Damian Hoy, Lyn March, Peter Brooks, Fiona Blyth, Anthony Woolf, Christopher Bain, Gail Williams, Emma Smith, Theo Vos, Jan Barendregt, Chris Murray11, Roy Burstein11, Rachelle Buchbinder. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis 2014;73:968-974. Level of evidence 2A

8. Burton AK. European guidelines for prevention in low back pain. COST B13 Working Group004: 1-53.

9. Hoy D, Brooks P, Blyth F, Buchbinder R. The Epidemiology of low back pain. Best Pract Res Clin Rheumatol. 2010 Dec;24(6):769-81.

10. Jeffries LJ, Milanese SF, Grimmer-Somers KA. Epidemiology of adolescent spinal pain:  systematic overview of the research literature. Spine (Phila Pa 1976). 2007 Nov 01;32(23):2630-7.

11. Waxenbaum JA, Futterman B. Anatomy, back, lumbar vertebrae. InStatPearls [Internet] 2018 Dec 13. StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459278/ (last accessed 24.1.2020)

12. Musculoskeletal key Applied anatomy of the lumbar spine Available from:https://musculoskeletalkey.com/applied-anatomy-of-the-lumbar-spine/ (last accessed 24.1.2020)

13. ney.Biyani A, Andersson GB. Low back pain: pathophysiology and management. J Am Acad Orthop Surg. 2004 Mar-Apr;12(2):106-15. Doi: 10.5435/00124635-200403000-00006. PMID: 15089084.

14. khan I, Hargunani R, Saifuddin A. The lumbar high-intensity zone: 20 years on. Clinical radiology. 2014 Jun 1;69(6):551-8.

15. Chou R. Pharmacological management of low back pain. Drugs. 2010 Mar;70(4):387-402.Back pain https://www.mayoclinic.org/diseasesconditions/back-pain/diagnosis-treatment/drc-20369911

16. Kälin S, Rausch-Osthoff AK, Bauer CM. What is the effect of sensory discrimination training on chronic low back pain? A systematic review. BMC musculoskeletal disorders. 2016 Dec;17(1):1-9.

17. Akerblom S,PerrinS,Rivano Fischer M,Mccraken LM. The mediating role of acceptance in multidisciplinary CBT fir chronic pain J. Pain 16(7);606615{pubmed}

18. Chambless D,Ollendick TH.Empirically supported psychological interventions: controversies & evidence. Annu Rev psychol .2001;52:685716(pubmed){Google scholar}

19. Arch JJ, craskeMG. Firstline treatment; a critical appraisal of CBT developments & alternatives Psychiatr clin North Am ,2009;32:525-547(pubmed) {Google scholar}[Ref list].

20. Craske M. Cognitive behavioral therapy. New York, NY : APA books. 2010(Google scholar).

21. Linchan MM, skills training manual for treating borderline personality disorder. New York; Guilford press; 1993 (Google scholar).

22. Stoffers JM, Völlm BA, Rücker G, Trimmer A, Huband N, Lieb K. . Psychological therapies for people with borderline personality disorder (review). Cochrane Database Syst Rev. 2012; 8: CD005652 DOI:

23. Linehan M. Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York, NY: Guilford Press; 1993. [Google Scholar] [Ref list]

24. Bertolote,JM & Fleischmann ,A[2002] . Suicide &psychiatric diagnosis. A worldwide perspective. World psychiatry1(3),,DBT Mexico,[2018].Quienes somas ,DBT Mexico retrieved from https://dbt -mexico.mx/dbt. Mexico/

25. Linehan MM. Cognitive-behavioral treatment of borderline personality disorder. J Cur Psychiatry Rep 1993;6:225-31.

26. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001;16:606-13. [Crossref] [PubMed].

27. H. Richard Winn MD, in Youmans and Winn Neurological Surgery, 2017 https://www.sciencedirect.co m/topics/medicine-and-dentistry/lumbartraction

28. Kjaer P, Kongsted A, Ris I, Abbott A, Rasmussen CD, Roos EM, Skou ST, Andersen TE, Hartvigsen J. GLA: D® Back group-based patient education integrated with exercises to support self-management of back pain-development, theories and scientific evidence. BMC musculoskeletal disorders. 2018 Dec 1;19(1):418.

29. Alexander I: Electronic medical records for the orthopaedic practice. Clin Orthop Relat Res 2007; 457:114-119. [PubMed] [Google Scholar] [Ref list] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2902827/#!po=19.3182

30. Brunkow R, Stemmfuhrung nach R. Brunkow; Ferdinand Enke Verlag Stuttgart. 1978:1–9. 14-29, 47-92 [Google Scholar] [Ref list]