Bio-psychosocial Effectiveness of Holistic Psychotherapeutic Nursing Interventions for Chronic Low Back Pain

Abstract

Chronic low back pain (CLBP) is one of the most disabling global health problems, affecting more than 20% of adults. Traditional biomedical management often emphasizes pharmacological and physical interventions, which yield only partial or temporary relief. Emerging evidence highlights the need for biopsychosocial interventions that address the interplay of biological, psychological, and social factors influencing pain. This study evaluates the effectiveness of a holistic psychotherapeutic nursing intervention that integrates physiotherapy and psychotherapy compared with single-modality treatments.

A randomized controlled trial was conducted among 60 patients with CLBP of ≥6 months’ duration. Participants were assigned to physiotherapy (n=20), psychotherapy (n=20), or holistic therapy (n=20). Each group underwent 15 sessions across 30 days, followed by 11 months of structured follow-up. Outcomes included pain intensity (VAS), anxiety (STAI), and self-esteem (Self-Esteem Inventory).

Findings revealed that physiotherapy offered significant short-term relief (P1–P3) but diminished sustainability. Psychotherapy demonstrated slower yet lasting improvements after P6. Holistic therapy provided both immediate and sustained benefits across all 12 follow-up phases, with substantial improvements in family esteem, body esteem, and reductions in state and trait anxiety. Regression analysis confirmed self-esteem particularly family esteem as a strong predictor of pain reduction (R²=0.674).

The results support the superiority of holistic psychotherapeutic nursing interventions in CLBP management, aligning with global calls for biopsychosocial care. Nurses, as primary providers, are uniquely positioned to deliver such integrative interventions, reducing reliance on pharmacological therapies while promoting resilience and quality of life.