Promoting a foundation of resilience in older adults: pilot trial of a strengths-based positive psychology intervention for chronic low back pain.

Introduction: Chronic low back pain (cLBP) is a global public health problem and a leading cause of disability among older adults. Recent years have seen a burgeoning interest in promoting resilience in individuals with chronic pain; however, therapeutic strategies that focus on positive psychological resources and individual strengths are understudied among older adult populations. The aim of this study was to examine the feasibility and acceptability of a resilience-promoting intervention among older adults with cLBP, and to assess preliminary treatment effects on pain severity, pain interference, and quality of life.

Methods: Participants included 50 adults, ages ≥50 years, with back pain rated (at minimum) of moderate intensity and having a significant impact on daily activities. This single-arm trial included seven weekly group sessions targeting positive psychology concepts and techniques that have established benefits in pain management.

Results: Results suggest high credibility and engagement in the intervention program. Participants found the weekly session content to be beneficial and global treatment satisfaction was high. Pain intensity (-4.3 [-6.14, -2.54]), pain interference (-3.3 [-4.83, -1.80]), depression (-1.6 [-3.16, -0.04]) and QoL-health satisfaction (0.3 [0.01, 0.55]) improved from pre- to post-intervention. At the 3-month follow-up, improvements were also observed for pain intensity (-2.1 [-9.29, -5.04]), pain interference (-5.3 [-6.54, -2.86]), and QoL-physical health (0.9 [0.11, 1.74]).

Discussion: Results support the feasibility, acceptability, and potential efficacy of a resilience intervention for older adults with cLBP. These findings may be a step toward the advancement of therapeutic pain modalities and provide a foundation for future research on resilience-promoting interventions for aging populations with chronic pain.