Pain-catastrophizing and the Effect of Tai Chi for Low Back Pain
 
April 21, 2016 - There is evidence to support the effectiveness of Tai Chi for reducing pain-related symptoms across multiple musculoskeletal conditions, however, the mechanism(s) are unclear. Researchers from the University of Oxford, the University of Sydney and the University of Manchester collaborated on a study to explore the role of pain-catastrophizing as a possible mediator in the relationship between practicing Tai chi and back pain symptoms.

Adults with persistent low back pain were recruited via community advertisement in Sydney, Australia. They were randomly assigned to the group for a 10-week Tai Chi intervention or to a wait-list control group.

Patients completed self-assessments of pain intensity and bothersome-ness using 0-10 numerical rating scales, disability using the Roland Morris Disability Questionnaire and pain catastrophizing using the Pain Coping Strategies Questionnaire pre and post intervention.

The results suggest partial mediation, by which a reduction in catastrophizing explained approximately 1/3 of the effect on pain intensity and bothersome-ness and 2/3 of the effect on disability.

As the first known mediation analysis of Tai Chi for reducing low back pain-symptoms, it provides initial evidence that it may do so by having an effect on cognitive appraisal outcomes such as pain-catastrophizing and information for choosing appropriate process measures for future studies. As Tai Chi is growing in popularity as an alternative treatment for patients with chronic musculoskeletal conditions, it is important to gain a better understanding of how it might work using confirmatory mediation analysis alongside future clinical trials.