Biopsychosocial vs Multimodal Chronic Pain Management

Randomized Controlled Trial on the Effectiveness of a Multidisciplinary Biopsychosocial Program vs Multimodal Treatment in Patients With Chronic Low Back Pain

This study evaluated the effects of a multidisciplinary biopsychosocial program compared with standard multimodal care in patients with chronic low back pain treated at the University Hospital Osijek. Outcomes included pain intensity, disability, health-related quality of life, anxiety, depression, stress, and sleep quality. Data were collected using standardized self-assessment questionnaires and objective monitoring of sleep and physical activity during a four-week intervention period. The study was conducted as part of a doctoral dissertation.

This prospective, randomized, parallel-group study compared a multidisciplinary biopsychosocial treatment program with standard multimodal care in patients with chronic low back pain treated at the Department of Pain Management, University Hospital Osijek.

Participants were randomly assigned to one of two treatment groups using a random number generator. The multidisciplinary biopsychosocial group participated in a structured four-week program that included patient education, supervised exercise, individualized multidisciplinary care, pharmacotherapy, and acupuncture. The standard multimodal care group received conservative treatment, including pharmacotherapy, physical therapy modalities, and acupuncture.

Clinical and patient-reported outcomes were assessed using standardized self-report questionnaires measuring pain intensity, functional disability, health-related quality of life, anxiety, depression, stress, and sleep quality. In addition, objective data on sleep and physical activity were collected using a wearable smartwatch during the intervention period.

The study was conducted between November 2021 and May 2023 as part of a doctoral dissertation.

Inclusion Criteria:

• Age 18-65 years
• Chronic low back pain significantly affecting disability and/or emotional distress
• Active use of Croatian language
• Signed informed consent

Exclusion Criteria:

• Age <18 or >65
• Acute pain
• Previous participation in multidisciplinary program
• Pregnancy or cancer-related pain
• Psychotic disorders, moderate-severe cognitive impairment, urgent psychiatric conditions
• PTSD symptoms, extreme fatigue, low motivation, low literacy
• Allergic reactions to metal or silicone