Nonsurgical interventions like cognitive-behavioral therapy and mindfulness may reduce pain and disability in nonspecific chronic low back pain at follow-up of 1 year or more, a meta-analysis shows.
In people with nonspecific chronic low back pain , nonsurgical interventions like cognitive-behavioral therapy and mindfulness possibly showed small-to-moderate long-term benefits in reducing pain intensity and disability.
However, the evidence was mostly of low-to-moderate certainty.Researchers conducted a systematic review and meta-analysis of 75 randomized or cluster randomized controlled trials involving 15,395 participants aged 16 years or older with chronic low back pain lasting at least 12 weeks. They assessed the effectiveness of nonsurgical interventions for chronic low back pain with a focus on long-term and very long-term outcomes. Psychological, physical, and combination nonsurgical interventions, including cognitive-behavioral therapy, mindfulness, and multidisciplinary care, were assessed, with exercise being the most frequently assessed intervention. Interventions were compared with placebo or sham, adjuvant interventions, no intervention, or usual care. Pain intensity and disability were assessed using scales like the Numerical Pain Rating Scale and Oswestry Disability Index, respectively, along with other measures, and the certainty of evidence was assessed.At long-term follow-up, small-to-moderate reductions in pain intensity and disability were possibly seen with cognitive-behavioral therapy and mindfulness in individuals with nonspecific chronic low back pain. The evidence was of moderate certainty. Goal setting and needling interventions probably resulted in small reductions in disability, with mean differences of -8.3 and -4.8, respectively. Multicomponent biopsychosocial care and behavioral therapy might have led to moderate and small reductions, respectively, in pain intensity in those with nonspecific chronic low back pain . Multidisciplinary care could have led to small reductions in disability . At very long-term follow-up, multidisciplinary care may have led to a moderate reduction in pain intensity , whereas exercise may have resulted in a moderate decrease in disability in those with nonspecific chronic low back pain. The evidence was mostly of low certainty.“Although we identified some interventions with long-term effects for people with chronic low back pain, the clinical importance of the effects is uncertain,” the study authors wrote. “Greater attention is needed on developing and testing interventions with long-term effects for chronic low back pain.”The certainty of the evidence was reduced for most comparisons because of the quality of the studies and inconsistencies in the results.The study reported receiving no specific funding. Some authors reported receiving grants, support for attending meetings, research fellowships, and serving as members of the executive board of the network and/or as members of associations outside the submitted work. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.All material on this website is protected by copyright, Copyright © 1994-2025 by WebMD LLC. This website also contains material copyrighted by 3rd parties.
Chronic Pain Of The Back Back Pain Pain Management Chronic Low Back Pain Chronic Pain Of The Low Back Pain Disability Cognitive-Behavior Therapy CBT Cognitive Behavioral Therapy Meta-Analysis Exercise Physical Activity
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