A Low Back Pain Flare-Up Case Using a Cognitive Behavioral Approach

The case is a 50-year-old woman with subacute low back pain who had been making good progress and arrives tearful during a flare-up. Alison asks clinicians to treat the distress as a chance to build alliance, sit with it, and not change the subject or make light of it. Labeling the emotion is a safe first step, since a wrong guess still invites the patient to name what she feels, and labeling tends to calm the emotion. Validating the experience acknowledges that setbacks can feel like a return to square one. Open questions then bring out worries such as never improving, something being missed, or needing scans or injections. Reviewing what happened before the flare-up often finds a cause, such as doing too much too soon, and recalling how earlier flare-ups settled within a day or two gives her own evidence. Together they build a more helpful thought: this is a temporary flare-up linked to extra exercise, and sticking to the plan helps avoid the next one. Alliance built this way supports every other treatment.