Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

ObjectivesThis systematic review examined studies that used mediation analysis to investigate the mechanisms of action of cognitive-behavioral, mind-body, and exercise-based interventions for pain and disability in people with chronic primary musculoskeletal pain.Materials and methodsWe searched 5 electronic databases for articles that conducted mediation analyses of randomized controlled trials to either test or estimate indirect effects.ResultsWe found 17 studies (n=4423), including 90 mediation models examining the role of 22 putative mediators on pain or disability, of which 4 had partially mediated treatment effect; 8 had mixed results, and 10 did not mediate treatment effect. The conditions studied were chronic whiplash-associated pain, chronic low back pain, chronic knee pain, and mixed group of chronic primary musculoskeletal pain.DiscussionWe observed that several of the studies included in our systematic review identified similar mechanisms of action, even between different interventions and conditions. However, methodological limitations were common. In conclusion, there are still substantial gaps with respect to understanding how cognitive-behavioral, mind-body, and exercise-based interventions work to reduce pain and disability in people with chronic primary musculoskeletal pain.

Original publication

DOI

10.1097/ajp.0000000000001047

Type

Journal article

Journal

The clinical journal of pain

Publication Date

07/2022

Volume

38

Pages

502 - 509

Addresses

Nucleus of Neuroscience and Behavior and Nucleus of Applied Neuroscience.

Keywords

Humans, Exercise Therapy, Cognition, Randomized Controlled Trials as Topic, Musculoskeletal Pain, Chronic Pain