The DOI matches its Crossref record; 65 of the 65 references it cites were found in a registry or an index.
Multidisciplinary treatment for chronic pain: a systematic review of interventions and outcomes
Open accessAbstract
OBJECTIVES: To provide an overview of the effectiveness of multidisciplinary treatments of chronic pain and investigate about their differential effects on outcome in various pain conditions and of different multidisciplinary treatments, settings or durations. METHODS: In this article, the authors performed a systematic review of all currently available randomized controlled trials (RCTs) fulfilling the inclusion criteria, by using a recently developed rating system aimed to assess the strength of evidence with regard to the methodological quality of the trials. RESULTS: Compared with other non-disciplinary treatments, moderate evidence of higher effectiveness for multidisciplinary interventions was shown. In contrast to no treatment or standard medical treatment, strong evidence was detected in favour of multidisciplinary treatments. The evidence that comprehensive inpatient programmes were more beneficial that outpatient programmes was moderate. Fibromyalgia and chronic back pain patients tended to profit more substantially than patients with diverse origins or chronic pain diagnoses. No evidence was found that treatment variables, such as duration or programme components, were influential for the success of the intervention. CONCLUSION: A standard of multidisciplinary programmes should be internationally established to guarantee generally good outcomes in the treatment of chronic pain. Our results highlight the lack of quality of design, execution or reporting of many of the RCTs included in this article. Future studies should more specifically focus on differential effects of treatment components and patient variables, allowing the identification of subgroups, which most probably would profit from multidisciplinary pain programmes.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The effect of a multidisciplinary rehabilitation program observed in RCT would be generalizable to real-world practice.”
From Effectiveness of a multidisciplinary rehabilitation program in real-world patients with chronic back pain: A pilot cohort data analysis (2021) · cites this paper as [7]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Randomized clinical trials (RCT) suggest a multidisciplinary approach to pain rehabilitation is superior to other active treatments in improving pain intensity, function, disability, and pain interference for patients with chronic pain, with small effect size (ds= 0.20–0.36) but its effectiveness remains unknown in real-world practice.”
From Effectiveness of a multidisciplinary rehabilitation program in real-world patients with chronic back pain: A pilot cohort data analysis (2021) · cites this paper as [7]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Interdisciplinary pain rehabilitation (IPR) programmes have been reported to show positive long-term results.”
The cited source says what the claim attributes to it.
In the citing paper
“Two systematic reviews found that IPR produces better results than less extensive treatment or no treatment at all,5,6 and the effect appears to be stable over time.”
The cited source says what the claim attributes to it.
In the citing paper
“Two systematic reviews found that IPR produces better results than less extensive treatment or no treatment at all,5,6 and the effect appears to be stable over time.”
In the citing paper
“The size of effects -small to moderate -is similar to other systematic reviews in this field: of mixed chronic pain (Scascighini 2008), low back pain (Henschke 2010a; Hoffman 2007), fibromyalgia (Bernady 2010;Glombiewski 2010;Häuser 2009) and arthritis (Dixon 2007).”
From Psychological therapies for the management of chronic pain (excluding headache) in adults (2012) · cites this paper as Scascighini 2008
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Grading quality of evidence and strength of recommendations
(2004) · BMJ · doi:10.1136/bmj.328.7454.1490 · Cited by 8,477
Updated Method Guidelines for Systematic Reviews in the Cochrane Collaboration Back Review Group
van Tulder, M., Furlan, A., Bombardier, C., & Bouter, L. (2003) · Spine · doi:10.1097/01.brs.0000065484.95996.af · Cited by 2,180
Morley, S., Eccleston, C., & Williams, A. (1999) · Pain · doi:10.1016/s0304-3959(98)00255-3 · Cited by 1,597
Efficacy of multidisciplinary pain treatment centers: a meta-analytic review.
Flor, H., Fydrich, T., & Turk, D. C. (1992) · Pain · doi:10.1016/0304-3959(92)90145-2 · Cited by 1,227
Conservative Treatment of Acute and Chronic Nonspecific Low Back Pain
van Tulder, M. W., Koes, B. W., & Bouter, L. M. (1997) · Spine · doi:10.1097/00007632-199709150-00012 · Cited by 981
Coping with chronic pain: a critical review of the literature
Jensen, M. P., Turner, J. A., Romano, J. M., & Karoly, P. (1991) · Pain · doi:10.1016/0304-3959(91)90216-k · Cited by 835
A cost-of-illness study of back pain in The Netherlands
van Tulder, M. W., Koes, B. W., & Bouter, L. M. (1995) · Pain · doi:10.1016/0304-3959(94)00272-g · Cited by 760
van Tulder, M. W., Assendelft, W. J., Koes, B. W., & Bouter, L. M. (1997) · Spine · doi:10.1097/00007632-199710150-00001 · Cited by 727
Behavioural treatment for chronic low-back pain
Henschke, N., Ostelo, R. W., van Tulder, M. W., Vlaeyen, J. W., Morley, S., Assendelft, W. J., & Main, C. J. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002014.pub3 · Cited by 718
Gatchel, R. J., & Okifuji, A. (2006) · The Journal of Pain · doi:10.1016/j.jpain.2006.08.005 · Cited by 535
Jensen, M. P., Turner, J. A., & Romano, J. M. (2001) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.69.4.655 · Cited by 473
Behavioral Treatment for Chronic Low Back Pain
van Tulder, M. W., Ostelo, R., Vlaeyen, J. W. S., Linton, S. J., Morley, S., & Assendelft, W. J. (2001) · Spine · doi:10.1097/00007632-200102010-00012 · Cited by 456
Burckhardt, C. S., Mannerkorpi, K., Hedenberg, L., & BJELLE, A. O. (1994) · PubMed · Cited by 393
A meta-analysis of fibromyalgia treatment interventions
Rossy, L. A., Buckelew, S. P., Dorr, N., Hagglund, K. J., Thayer, J. F., McIntosh, M. J., Hewett, J. E., & Johnson, J. C. (1999) · Annals of Behavioral Medicine · doi:10.1007/bf02908299 · Cited by 390
Multidisciplinary bio-psycho-social rehabilitation for chronic low-back pain
Guzmán, J., Esmail, R., Karjalainen, K. A., Malmivaara, A. V., Irvin, E., & Bombardier, C. (2002) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000963 · Cited by 365
Cognitive-Behavioral Treatments for Chronic Pain: What Works for Whom?
Vlaeyen, J. W. S., & Morley, S. (2005) · The Clinical Journal of Pain · doi:10.1097/00002508-200501000-00001 · Cited by 350
BOUTRON, I., MOHER, D., TUGWELL, P., GIRAUDEAU, B., POIRAUDEAU, S., NIZARD, R., & RAVAUD, P. (2005) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2005.05.004 · Cited by 308
Spinhoven, P., ter Kuile, M., Kole‐Snijders, A. M. J., Mansfeld, M. H., den Ouden, D., & Vlaeyen, J. W. S. (2004) · European Journal of Pain · doi:10.1016/j.ejpain.2003.08.003 · Cited by 274
Nicholas, M. K., Wilson, P. H., & Goyen, J. (1992) · Pain · doi:10.1016/0304-3959(92)90082-m · Cited by 271
Sim, J., & Adams, N. (2002) · Clinical Journal of Pain · doi:10.1097/00002508-200209000-00008 · Cited by 252
(1996) · PubMed · Cited by 234
Fibromyalgia: a randomised, controlled trial of a treatment programme based on self management
Cedraschi, C., Desmeules, J., Rapiti, E., Baumgartner, E., Cohen, P., Finckh, A., Allaz, A. F., & Vischer, T. L. (2004) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2002.004945 · Cited by 216
Inpatient vs. outpatient pain management: results of a randomised controlled trial
de Williams, C. A. C., Richardson, P. H., Nicholas, M. K., Pither, C. E., Harding, V. R., Ridout, K. L., Ralphs, J. A., Richardson, I. H., Justins, D. M., & Chamberlain, J. H. (1996) · Pain · doi:10.1016/0304-3959(96)02996-x · Cited by 199
Inpatient vs outpatient pain management: Results of a randomised controlled trial
(1996) · Pain · Cited by 199
A 3-year follow-up of a multidisciplinary rehabilitation programme for back and neck pain
Jensen, I. B., Bergström, G., Ljungquist, T., & Bodin, L. (2005) · Pain · doi:10.1016/j.pain.2005.03.005 · Cited by 188
Behavioural treatment for chronic low-back pain
Ostelo, R., van Tulder, M. W., Vlaeyen, J. W. S., Linton, S. J., Morley, S., & Assendelft, W. J. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002014.pub2 · Cited by 187
Multidisciplinary rehabilitation for fibromyalgia and musculoskeletal pain in working age adults
Karjalainen, K. A., Malmivaara, A., van Tulder, M. W., Roine, R., Jauhiainen, M., Hurri, H., & Koes, B. W. (1999) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001984 · Cited by 180
Comparison of Integrated Group Therapy and Group Relaxation Training for Fibromyalgia
Keel, P., Bodoky, C., Gerhard, U., & Müller, W. (1998) · Clinical Journal of Pain · doi:10.1097/00002508-199809000-00010 · Cited by 176
Vlaeyen, J. W. S., Haazen, I. W. C. J., Schuerman, J. A., Kole-Snijders, A. M. J., & van Eek, H. (1995) · British Journal of Clinical Psychology · doi:10.1111/j.2044-8260.1995.tb01443.x · Cited by 170
Lemstra, M., & Olszynski, W. P. (2005) · The Clinical Journal of Pain · doi:10.1097/00002508-200503000-00008 · Cited by 166
Jensen, I. B., Bergström, G., Ljungquist, T., Bodin, L., & Nygren, Å. (2001) · Pain · doi:10.1016/s0304-3959(00)00420-6 · Cited by 162
Jousset, N., Fanello, S., Bontoux, L., Dubus, V., Billabert, C., Vielle, B., Roquelaure, Y., Penneau-Fontbonne, D., & Richard, I. (2004) · Spine · doi:10.1097/01.brs.0000102320.35490.43 · Cited by 160
Operant-behavioural and cognitive-behavioural treatment for chronic low back pain
Nicholas, M. K., Wilson, P. H., & Goyen, J. (1991) · Behaviour Research and Therapy · doi:10.1016/0005-7967(91)90112-g · Cited by 159
Kääpä, E., Frantsi, K., Sarna, S. J., & Malmivaara, A. V. (2006) · Spine · doi:10.1097/01.brs.0000200104.90759.8c · Cited by 150
(1997) · PubMed · Cited by 149
Multidisciplinary intensive treatment for chronic low back pain: a randomized, prospective study
Bendix, A. F., Bendix, T., VAeGTER, K., Lund, C., FRØLUND, L., & HOLM, L. (1996) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.63.1.62 · Cited by 148
Kole-Snijders, A. M. J., Vlaeyen, J. W. S., Goossens, M. E. J. B., Mölken, M. R., Heuts, P. H. T. G., van Breukelen, G., & von Eek, H. (1999) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.67.6.931 · Cited by 137
Jacquier, I., Boutron, I., Moher, D., Roy, C., & Ravaud, P. (2006) · Annals of Surgery · doi:10.1097/01.sla.0000242707.44007.80 · Cited by 136
Bendix, A. F., Bendix, T., Hæstrup, C., & Busch, E. A. V. (1998) · European Spine Journal · doi:10.1007/s005860050040 · Cited by 131
Basler, H.-D., Jäkle, C., & Kröner‐Herwig, B. (1997) · Patient Education and Counseling · doi:10.1016/s0738-3991(97)00996-8 · Cited by 128
Bendix, A. F., Bendix, T., Ostenfeld, S., Bush, E., & Andersen, A. (1995) · European Spine Journal · doi:10.1007/bf00298239 · Cited by 125
Bendix, A., Bendix, T., Lund, C., Kirkbak, S., & Ostenfeld, S. (1997) · Journal of Rehabilitation Medicine · doi:10.2340/1650197719978189 · Cited by 118
ALTMAIER, E. M., Lehmann, T. R., Russell, D. W., Weinstein, J. N., & Kao, C. F. (1992) · Pain · doi:10.1016/0304-3959(92)90240-c · Cited by 116
Bendix, A. F., Bendix, T., Labriola, M., & Bœkgaard, P. (1998) · Spine · doi:10.1097/00007632-199803150-00013 · Cited by 113
Functional Restoration versus Outpatient Physical Training in Chronic Low Back Pain
Bendix, T., Bendix, A. F., Labriola, M., Hæstrup, C., & Ebbehøj, N. E. (2000) · Spine · doi:10.1097/00007632-200010010-00012 · Cited by 109
Long-term Outcomes in Multidisciplinary Treatment of Chronic Low Back Pain
Patrick, L. E., ALTMAIER, E. M., & Found, E. M. (2004) · Spine · doi:10.1097/00007632-200404150-00006 · Cited by 107
Baker, A. D. L. (2013) · Springer eBooks · doi:10.1007/978-1-4471-5451-8_65 · Cited by 104
Which resources should be used to identify RCT/CCTs for systematic reviews: a systematic review
Crumley, E. T., Wiebe, N., Cramer, K., Klassen, T. P., & Hartling, L. (2005) · BMC Medical Research Methodology · doi:10.1186/1471-2288-5-24 · Cited by 95
Peters, J. L., Large, R. G., & Elkind, G. S. (1992) · Pain · doi:10.1016/0304-3959(92)90110-w · Cited by 90
Linton, S. J., & Götestam, K. G. (1984) · British Journal of Clinical Psychology · doi:10.1111/j.2044-8260.1984.tb01303.x · Cited by 86
Turner-Stokes (2003) · doi:10.1016/s0003-9993(03)00015-7 · Cited by 72
Chronic Low Back Pain Rehabilitation Programs
Rose, M. J., Reilly, J. P., Pennie, B. H., Bowen‐Jones, K., Stanley, I. M., & Slade, P. D. (1997) · Spine · doi:10.1097/00007632-199710010-00009 · Cited by 71
Applicability and Clinical Relevance of Results in Randomized Controlled Trials
Malmivaara, A. V., Koes, B. W., Bouter, L. M., & van Tulder, M. W. (2006) · Spine · doi:10.1097/01.brs.0000219868.30427.66 · Cited by 56
A randomised control trial evaluating in- and outpatient pain management programmes
Peters, J. L., & Large, R. G. (1990) · Pain · doi:10.1016/0304-3959(90)90005-x · Cited by 51
Soares, J. J. F., & Grossi, G. (2002) · Scandinavian Journal of Occupational Therapy · doi:10.1080/110381202753505845 · Cited by 50 · cited 6×
“Biofeedback training was performed in six studies [24, 38, 44, 46 , 48, 49].”
BackgroundMethodResultInfluentialEvaluation of a Swedish version of the arthritis self-efficacy scale in people with fibromyalgia.
Lomi, C., Burckhardt, C., Nordholm, L., Bjelle, A., & Ekdahl, C. (1995) · Scandinavian Journal of Rheumatology · doi:10.3109/03009749509095164 · Cited by 47
Functional restoration in chronic low back pain
Bendix, T., Bendix, A. F., Busch, E. A. V., Jordan, A., & Bendix, T. (1996) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/j.1600-0838.1996.tb00076.x · Cited by 39
Keller, S., Ehrhardt‐Schmelzer, S., Herda, C. A., Schmid, S., & Basler, H. ‐. (1997) · European Journal of Pain · doi:10.1016/s1090-3801(97)90037-9 · Cited by 31
A review of cognitive-behavioural methods for the treatment of chronic pain
Pearce, S. (1983) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(83)90082-x · Cited by 31
A Review of Multidisciplinary Interventions for Fibromyalgia Patients: Where Do We Go from Here?
Oliver, K. A., Cronan, T. A., & Walen, H. R. (2001) · Journal of Musculoskeletal Pain · doi:10.1300/j094v09n04_07 · Cited by 29
Jensen, I. B., Dahlquist, C., Nygren, Å., Royen, E., & Stenberg, M. (1997) · Journal of Occupational Rehabilitation · doi:10.1023/b:joor.0000010858.70743.21 · Cited by 26
Increasing Activity and Improving Function in Chronic Pain Management
Harding, V. R., & Watson, P. (2000) · Physiotherapy · doi:10.1016/s0031-9406(05)61298-9 · Cited by 21
Ravaud, P., & Boutron, I. (2006) · Nature Clinical Practice Rheumatology · doi:10.1038/ncprheum0194 · Cited by 10
Malmivaara, A., Koes, B. W., Bouter, L. M., & van Tulder, M. W. (2006) · Digital Academic REpository of VU University Amsterdam (Vrije Universiteit Amsterdam) · Cited by 3
Keefe (1999) · doi:10.1002/1529-0131(199904)12:2
Research works printed but not linked: 3
- Keefe FJ. Behavioural assessment and treatment of chronic pain: current status and future directions. J Consult Clin Psychol 1982;50:896-911.
- Gowans SE, deHueck A, Voss S, Richardson M. A randomized, controlled trial of exercise and education for individuals with fibromyalgia. Arthritis Care Res 1999;12:120-8.
- Schultz J. Das autogenen training: Konzentrative Selbsentspannung. 19th edn. Stuttgart (D): Thieme Verlag, 1991.
Cited by
Sorted by citations
EULAR revised recommendations for the management of fibromyalgia
Macfarlane, G. J., Kronisch, C., Dean, L. E., Atzeni, F., Häuser, W., Fluß, E., Choy, E., Kosek, E., Amris, K., Branco, J., et al. (2017) · Annals of the Rheumatic Diseases · doi:10.1136/annrheumdis-2016-209724 · Cited by 1,566
Psychological therapies for the management of chronic pain (excluding headache) in adults
Williams, A. C. D. C., Eccleston, C., & Morley, S. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007407.pub3 · Cited by 1,634
Interdisciplinary chronic pain management: Past, present, and future.
Gatchel, R. J., McGeary, D. D., McGeary, C. A., & Lippe, B. (2014) · American Psychologist · doi:10.1037/a0035514 · Cited by 856
Acceptance and commitment therapy and mindfulness for chronic pain: Model, process, and progress.
McCracken, L. M., & Vowles, K. E. (2014) · American Psychologist · doi:10.1037/a0035623 · Cited by 627
Owen, P. J., Miller, C. T., Mundell, N. L., Verswijveren, S. J. J. M., Tagliaferri, S. D., Brisby, H., Bowe, S. J., & Belavý, D. L. (2019) · British Journal of Sports Medicine · doi:10.1136/bjsports-2019-100886 · Cited by 613
Metadata
- Authors
- Scascighini, L., Toma, V., Dober-Spielmann, S., & Sprott, H.
- Affiliations
- University Hospital Zurich (CH)
- ORCID
- Sprott, H.
- Venue
- Rheumatology
- Publisher
- Oxford University Press (OUP)
- Published
- 2008-01-29
- Volume
- 47
- Issue
- 5
- Pages
- 670-678
- ISSN
- 1462-0324 (ISSN-L)
- 1462-0332
- OpenAlex
- W2119136552
- Cited by
- 613
- References
- 65
- Citations by year
- 2026: 21 · 2025: 25 · 2024: 27 · 2023: 34 · 2022: 38 · 2021: 49 · 2020: 38 · 2019: 41 · 2018: 45 · 2017: 54 · 2016: 50 · 2015: 38 · 2014: 36 · 2013: 34 · 2012: 28
- FWCI
- 1.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Lara D. Veeken (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, other-oa)
- reroDoc Digital Library (submittedVersion)
- Bern Open Repository and Information System (University of Bern) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, other-oa)
- Zurich Open Repository and Archive (University of Zurich)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- chronic pain, multidisciplinary pain management, pain management program, fibromyalgia, chronic back pain, treatment effectiveness, methodological quality of trials, treatment duration, treatment components
- MeSH terms
- Chronic Disease, Combined Modality Therapy, Exercise Therapy, Humans, Pain, Psychotherapy, Group, Quality of Life, Cognitive Behavioral Therapy, Case-Control Studies, Physical Therapy Modalities, Pain Management
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
