Telehealth Outreach for Chronic Back Pain (TELE)
Pain, Back Pain
About this trial
This is an interventional treatment trial for Pain focused on measuring pain, chronic pain, chronic back pain, randomized clinical trial
Eligibility Criteria
Inclusion Criteria:
- Ages 18-75 inclusive;
- chronic musculoskeletal low back pain (pain "on a daily basis" for at least six months) as the primary pain problem;
- not eligible for back surgery;
- presently lives in the San Diego area and will do so six months after baseline examination;
- English-speaking, literate, with stable residence and phone.
Exclusion Criteria:
- Major medical illness (e.g., insulin-dependent diabetes mellitus with neuropathy or "poor control", heart disease with New York Heart Association Functional Class III or IV, or chronic obstructive pulmonary disease requiring supplemental oxygen which might confound effects of pain on function);
- candidate for spine surgery;
- back pain associated with pregnancy, rheumatoid arthritis, neoplastic disease, osteomyelitis, or neural arch lesions, since their treatment and prognosis differs from the usual back pain population, or spinal stenosis, since increased physical activity would be contraindicated;
- history of Diagnostic and Statistical Manual (DSM)-IV bipolar disorder, dementia, or schizophrenia;
- current active DSM-IV diagnosed alcohol or non-prescribed substance dependence;
- current active DSM-IV major depressive episode or post-traumatic stress disorder since specialty mental health care would be indicated;
- non-opioid and opioid analgesics are permitted, except we will exclude patients on a hospital-initiated opioid treatment "contract," since at this medical center "contracting" identifies patients with history of opioid diversion, multiple VA and non-VA opioid prescribers, and repeated dose escalation in the absence of evidence of disease progression.
Sites / Locations
- VA San Diego Healthcare System, San Diego
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Active Comparator
Experimental
Active Comparator
Cognitive Behavioral Therapy-Psychologist-Delivered
Supportive Psychotherapy-Psychologist-Delivered
Cognitive Behavioral Therapy-Nurse-Delivered
Supportive Psychotherapy-Nurse-Delivered
10 hours of Cognitive Behavioral Training delivered by a psychologist over 8 weeks by telephone and face-to-face contact
10 hours of Rogerian Psychotherapy delivered by a psychologist over 8 weeks by telephone and face-to-face contact
10 hours of Cognitive Behavioral Training delivered by a primary care medical nurse over 8 weeks by telephone and face-to-face contact
10 hours of Rogerian Psychotherapy delivered by a primary care medical nurse over 8 weeks by telephone and face-to-face contact