Eye Movement Desensitization and Reprocessing (EMDR) Versus Treatment as Usual for Non-Specific Chronic Back Pain Patients with Psychological Trauma: A Randomized Controlled Pilot Study

Objective: Eye-Movement-Desensitization and Reprocessing (EMDR) – an evidence-based approach to eliminate emotional distress from traumatic experiences – was recently suggested for the treatment of chronic pain. Aim of this study was to estimate preliminary efficacy of a pain-focused EMDR interventi...

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Main Authors: Andreas Gerhardt, Sabine Leisner, Mechthild Hartmann, Susanne Janke, Günther H Seidler, Wolfgang Eich, Jonas Tesarz
Format: Article
Language:English
Published: Frontiers Media S.A. 2016-12-01
Series:Frontiers in Psychiatry
Subjects:
Online Access:http://journal.frontiersin.org/Journal/10.3389/fpsyt.2016.00201/full
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author Andreas Gerhardt
Sabine Leisner
Mechthild Hartmann
Susanne Janke
Günther H Seidler
Wolfgang Eich
Jonas Tesarz
author_facet Andreas Gerhardt
Sabine Leisner
Mechthild Hartmann
Susanne Janke
Günther H Seidler
Wolfgang Eich
Jonas Tesarz
author_sort Andreas Gerhardt
collection DOAJ
description Objective: Eye-Movement-Desensitization and Reprocessing (EMDR) – an evidence-based approach to eliminate emotional distress from traumatic experiences – was recently suggested for the treatment of chronic pain. Aim of this study was to estimate preliminary efficacy of a pain-focused EMDR intervention for the treatment of non-specific chronic back pain.Design: Randomized controlled pilot study.Methods: Forty non-specific chronic back pain patients reporting previous experiences of psychological trauma were consecutively recruited from outpatient tertiary-care pain centers. After baseline assessment, patients were randomized to intervention or control group (1:1). The intervention group received ten sessions standardized pain-focused EMDR in addition to treatment-as-usual. The control group received treatment-as-usual alone.The primary outcome was preliminary efficacy, measured by pain intensity, disability, and treatment satisfaction from the patients' perspective. Clinical relevance of changes was determined according to established recommendations. Assessments were conducted at the baseline, post-treatment, and at a 6-month follow-up. Intention-to-treat-analysis with last-observation-carried-forward method was used. Registered with ClinicalTrials.gov (NCT01850875).Results: Estimated effect sizes (between-group, pooled standard deviation) for pain intensity and disability were d=0.79 (CI95%: 0.13, 1.42) and d=0.39 (CI95%: -0.24, 1.01) post-treatment, and d=0.50 (CI95%: 0.14, 1.12) and d=0.14 (CI95%: -0.48, 0.76) at 6-month follow-up. Evaluation on individual patient basis showed that about 50% of the patients in the intervention group improved clinically relevant and also rated their situation as clinically satisfactory improved, compared to zero patients in the control group.Conclusions: There is preliminary evidence that pain-focused EMDR might be useful for non-specific chronic back pain patients with previous experiences of psychological trauma, with benefits for pain intensity maintained over six months.
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spelling doaj.art-3edfb34449704d0ab0c29f578ed575462022-12-21T18:13:54ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402016-12-01710.3389/fpsyt.2016.00201227282Eye Movement Desensitization and Reprocessing (EMDR) Versus Treatment as Usual for Non-Specific Chronic Back Pain Patients with Psychological Trauma: A Randomized Controlled Pilot StudyAndreas Gerhardt0Sabine Leisner1Mechthild Hartmann2Susanne Janke3Günther H Seidler4Wolfgang Eich5Jonas Tesarz6University Hospital HeidelbergBerufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Ruhr-University BochumUniversity Hospital HeidelbergUniversity Hospital HeidelbergUniversity Hospital HeidelbergUniversity Hospital HeidelbergUniversity Hospital HeidelbergObjective: Eye-Movement-Desensitization and Reprocessing (EMDR) – an evidence-based approach to eliminate emotional distress from traumatic experiences – was recently suggested for the treatment of chronic pain. Aim of this study was to estimate preliminary efficacy of a pain-focused EMDR intervention for the treatment of non-specific chronic back pain.Design: Randomized controlled pilot study.Methods: Forty non-specific chronic back pain patients reporting previous experiences of psychological trauma were consecutively recruited from outpatient tertiary-care pain centers. After baseline assessment, patients were randomized to intervention or control group (1:1). The intervention group received ten sessions standardized pain-focused EMDR in addition to treatment-as-usual. The control group received treatment-as-usual alone.The primary outcome was preliminary efficacy, measured by pain intensity, disability, and treatment satisfaction from the patients' perspective. Clinical relevance of changes was determined according to established recommendations. Assessments were conducted at the baseline, post-treatment, and at a 6-month follow-up. Intention-to-treat-analysis with last-observation-carried-forward method was used. Registered with ClinicalTrials.gov (NCT01850875).Results: Estimated effect sizes (between-group, pooled standard deviation) for pain intensity and disability were d=0.79 (CI95%: 0.13, 1.42) and d=0.39 (CI95%: -0.24, 1.01) post-treatment, and d=0.50 (CI95%: 0.14, 1.12) and d=0.14 (CI95%: -0.48, 0.76) at 6-month follow-up. Evaluation on individual patient basis showed that about 50% of the patients in the intervention group improved clinically relevant and also rated their situation as clinically satisfactory improved, compared to zero patients in the control group.Conclusions: There is preliminary evidence that pain-focused EMDR might be useful for non-specific chronic back pain patients with previous experiences of psychological trauma, with benefits for pain intensity maintained over six months.http://journal.frontiersin.org/Journal/10.3389/fpsyt.2016.00201/fullTreatmentEMDRPsychological traumaEye Movement Desensitization and Reprocessing (EMDR)Chronic back pain
spellingShingle Andreas Gerhardt
Sabine Leisner
Mechthild Hartmann
Susanne Janke
Günther H Seidler
Wolfgang Eich
Jonas Tesarz
Eye Movement Desensitization and Reprocessing (EMDR) Versus Treatment as Usual for Non-Specific Chronic Back Pain Patients with Psychological Trauma: A Randomized Controlled Pilot Study
Frontiers in Psychiatry
Treatment
EMDR
Psychological trauma
Eye Movement Desensitization and Reprocessing (EMDR)
Chronic back pain
title Eye Movement Desensitization and Reprocessing (EMDR) Versus Treatment as Usual for Non-Specific Chronic Back Pain Patients with Psychological Trauma: A Randomized Controlled Pilot Study
title_full Eye Movement Desensitization and Reprocessing (EMDR) Versus Treatment as Usual for Non-Specific Chronic Back Pain Patients with Psychological Trauma: A Randomized Controlled Pilot Study
title_fullStr Eye Movement Desensitization and Reprocessing (EMDR) Versus Treatment as Usual for Non-Specific Chronic Back Pain Patients with Psychological Trauma: A Randomized Controlled Pilot Study
title_full_unstemmed Eye Movement Desensitization and Reprocessing (EMDR) Versus Treatment as Usual for Non-Specific Chronic Back Pain Patients with Psychological Trauma: A Randomized Controlled Pilot Study
title_short Eye Movement Desensitization and Reprocessing (EMDR) Versus Treatment as Usual for Non-Specific Chronic Back Pain Patients with Psychological Trauma: A Randomized Controlled Pilot Study
title_sort eye movement desensitization and reprocessing emdr versus treatment as usual for non specific chronic back pain patients with psychological trauma a randomized controlled pilot study
topic Treatment
EMDR
Psychological trauma
Eye Movement Desensitization and Reprocessing (EMDR)
Chronic back pain
url http://journal.frontiersin.org/Journal/10.3389/fpsyt.2016.00201/full
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