BACKGROUND & OBJECTIVE
The problem of chronic pain has yet to be solved. Current data has 28 million individuals in the UK affected by moderate to severe pain, at an annual incapacity benefit cost of 3.8 billion pounds. Current patterns of investigation, treatment, and expectations are failing to reduce pain overall. Psychologically informed treatment has been in practice for 40 years, yet the limited capacity of specialized clinics makes access difficult. Outpatient physiotherapy services can fill the need, but do we have the evidence to support including psychosocial approaches into practice as a cost-effective method for the treatment of pain? The authors of this study conducted a systematic review of the evidence for combining psychological approaches to musculoskeletal treatment in physiotherapy in improving physical function and quality of life compared to physiotherapy alone.
The review was registered on PROSPERO (International Prospective Register of Systematic Reviews) and followed PRISMA guidelines. Inclusion criteria limited papers to randomized controlled trials with comparable physiotherapy interventions in order to minimize the risk of differences in the physiotherapy component on the results. Cochrane Risk of Bias assessments were completed on all included studies.
8 studies met the inclusion criteria. Physiotherapy varied in the included studies among a general exercise protocol with strengthening, cardiovascular exercise, manual therapy, and postural control. The included studies were all based on a cognitive behavioral model for the psychological