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Meta-Analysis
. 2021 Dec 22;19(1):60.
doi: 10.3390/ijerph19010060.

Psychological Approaches for the Integrative Care of Chronic Low Back Pain: A Systematic Review and Metanalysis

Giorgia Petrucci  1 , Giuseppe Francesco Papalia  1 , Fabrizio Russo  1 , Gianluca Vadalà  1 , Michela Piredda  2 , Maria Grazia De Marinis  2 , Rocco Papalia  1 , Vincenzo Denaro  1
Affiliations
Meta-Analysis

Psychological Approaches for the Integrative Care of Chronic Low Back Pain: A Systematic Review and Metanalysis

Giorgia Petrucci et al. Int J Environ Res Public Health. .

Abstract

Chronic low back pain (CLBP) is the most common cause of disability worldwide, affecting about 12% to 30% of the adult population. Psychological factors play an important role in the experience of pain, and may be predictive of pain persistence, disability, and long-term sick leave. The aim of this meta-analysis was to identify and to describe the most common psychological approaches used to treat patients who suffer from CLBP. A systematic search was performed on PubMed/MEDLINE and Cochrane Central. Overall, 16 studies with a total of 1058 patients were included in the analysis. Our results suggest that cognitive behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR) interventions are both associated with an improvement in terms of pain intensity and quality of life when singularly compared to usual care. Disability also improved in both groups when compared to usual care. Significant differences in fear-avoidance beliefs were noted in the CBT group compared to usual care. Therefore, psychological factors are related to and influence CLBP. It is crucial to develop curative approaches that take these variables into account. Our findings suggest that CBT and MBSR modify pain-related outcomes and that they could be implemented in clinical practice.

Keywords: cognitive behavioral therapy; depression; disability; fear-avoidance beliefs; low back pain; mindfulness-based stress reduction.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Preferred reporting items for systematic review and meta-analysis (PRISMA 2020).
Figure 2
Figure 2
Pain: CBT versus control.
Figure 3
Figure 3
Pain: MBSR versus control.
Figure 4
Figure 4
Pain: MBSR versus CBT.
Figure 5
Figure 5
Disability: CBT versus control.
Figure 6
Figure 6
Disability: MBSR versus control.
Figure 7
Figure 7
Quality of Life: CBT versus control.
Figure 8
Figure 8
Quality of Life: MBSR versus control.
Figure 9
Figure 9
Quality of Life: MBSR versus CBT.
Figure 10
Figure 10
Depression: CBT versus control.
Figure 11
Figure 11
Depression: MBSR versus control.
Figure 12
Figure 12
Depression: MBSR versus CBT.
Figure 13
Figure 13
Fear-Avoidance beliefs: CBT versus control.
Figure 14
Figure 14
Days without pain: CBT versus control.
See this image and copyright information in PMC

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