Psychological therapies can be of benefit for chronic pain in adults

January 01, 0001

Psychological therapies can be of benefit for chronic pain in adults

Clinical Question:How effective are psychological therapies for management of chronic pain (excluding headache) in adults?

Bottom line: Cognitive behavioural therapy (CBT) and behavioural therapy (BT) have weak effects in improving pain. CBT and BT have minimal effects on disability associated with chronic pain. CBT and BT are effective in altering mood outcomes (depression and anxiety), and there is some evidence these changes are maintained at 6 months. The changes typically come to 0.5 or less on a 10-point scale. Guidance is still required on the best content, duration, intensity and format of treatment.

Caveat: An analysis of the quality rating scores showed the quality of the design and reporting of trials has clearly improved over the years. However, the quality of treatments, or of their reporting, or both, does not appear to have improved over time.

Context: Chronic pain is a common problem, causing significant distress and disability. Behavioural and cognitive treatments designed to ameliorate pain, distress and disability were first introduced over 40 years ago and are now well established.

Cochrane Systematic Review: Eccleston C et al. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Reviews 2009. Issue 2. Article No. CD007407. DOI: 10.1002/14651858. CD007407.pub2. This review contains 40 studies involving 4781 participants.

Cochrane PEARLS Practical Evidence About Real Life Situations. No. 197, September 2009.
Written by Brian R McAvoy. Published by the Cochrane Primary Care Group

Category: P. Psychological. Keywords: chronic pain, cognitive behavioral therapy, behavioral therapy, depression, anxiety
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 2 March 2010

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.