Multidisciplinary rehabilitation for chronic low back pain: systematic review
Open accessAbstract
Objective: To assess the effect of multidisciplinary biopsychosocial rehabilitation on clinically relevant outcomes in patients with chronic low back pain. Design: Systematic literature review of randomised controlled trials. Participants: A total of 1964 patients with disabling low back pain for more than three months. Main outcome measures: Pain, function, employment, quality of life, and global assessments. Results: Ten trials reported on a total of 12 randomised comparisons of multidisciplinary treatment and a control condition. There was strong evidence that intensive multidisciplinary biopsychosocial rehabilitation with functional restoration improves function when compared with inpatient or outpatient non-multidisciplinary treatments. There was moderate evidence that intensive multidisciplinary biopsychosocial rehabilitation with functional restoration reduces pain when compared with outpatient non-multidisciplinary rehabilitation or usual care. There was contradictory evidence regarding vocational outcomes of intensive multidisciplinary biopsychosocial intervention. Some trials reported improvements in work readiness, but others showed no significant reduction in sickness leaves. Less intensive outpatient psychophysical treatments did not improve pain, function, or vocational outcomes when compared with non-multidisciplinary outpatient therapy or usual care. Few trials reported effects on quality of life or global assessments. Conclusions: The reviewed trials provide evidence that intensive multidisciplinary biopsychosocial rehabilitation with functional restoration reduces pain and improves function in patients with chronic low back pain. Less intensive interventions did not show improvements in clinically relevant outcomes. What is already known on this topic: Disabling chronic pain is regarded as the result of interrelating physical, psychological, and social or occupational factors requiring multidisciplinary intervention Two previous systematic reviews of multidisciplinary rehabilitation for chronic pain were open to bias and did not include any of the randomised controlled trials now available What this study adds: Intensive, daily biopsychosocial rehabilitation with a functional restoration approach improves pain and function in chronic low back pain Less intensive interventions did not show improvements in clinically relevant outcomes It is unclear whether the improvements are worth the cost of these intensive treatments
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The effect of a multidisciplinary rehabilitation program observed in RCT would be generalizable to real-world practice, including to typical patients attending a rehabilitation program at an outpatient setting.
“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 [8]
The Discussion (page unavailable) cautions that the trials involved selected patients with severe disabling low back pain in well-established programmes, and that their results might not apply to most primary-care patients or less-established programmes. The review therefore does not endorse the claimed generalizability of RCT effects to typical real-world practice. (LLM, conf=0.87)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredA 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).
“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 [8]
The Results and Conclusion support improvements in pain and function compared with non-multidisciplinary rehabilitation or usual care, but only for intensive programmes with functional restoration in patients with chronic low back pain. They do not establish superiority for multidisciplinary rehabilitation generally or for all chronic pain, and do not report improvement in pain interference or the claimed effect-size range of d=0.20–0.36. Page numbers were not available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA meta-analysis reveals that multidisciplinary programs with a functional restoration approach produce greater improvement in function for patients with disabling chronic pain than usual care.
“A meta-analysis reveals that multidisciplinary programs with functional restoration approach produce greater improvement in function for patients with disabling chronic pain than usual care [8].”
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 [8]
The Conclusion reports greater improvement in function than usual care, but specifies intensive programmes (>100 hours) for patients with disabling chronic low back pain. The claim omits the intensity requirement and broadens the population to disabling chronic pain generally; the Results also say less intensive programmes did not improve function. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThe reduction or relief of pain is not a primary aim of treatment, although improvements in pain are often reported.
“The reduction or relief of pain is not a primary aim of treatment, although improvements in pain are often reported [22, 23].”
From A Consideration of the Psychological Aspects to Managing Patients with Painful Diabetic Neuropathy: An Insight into Pain Management Services at a Tertiary Centre in the UK (2021) · cites this paper as [23]
The Results and Conclusions report that intensive multidisciplinary rehabilitation improves pain in patients with chronic low back pain, supporting the improvement portion of the claim. The paper does not say that pain reduction or relief is not a primary treatment aim; it also finds that less intensive interventions did not improve pain. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPrevious systematic reviews have mainly focused on a small selection of psychological approaches for chronic low back pain (cognitive behavioural therapy and behavioural therapies), neglecting more recently developed psychological interventions (cognitive functional therapy and acceptance and commitment therapy).
“Yet, previous reviews have mainly focused on a small selection of psychological approaches for chronic LBP (that is, cognitive behavioural therapy and behavioural therapies), neglecting more recently developed psychological interventions (that is, cognitive functional therapy and acceptance and commitment therapy).”
From Psychological interventions for chronic, non-specific low back pain: systematic review with network meta-analysis (2022) · cites this paper as [11]
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Cites
Systematic Reviews: Synthesis of Best Evidence for Clinical Decisions
Cook, D. J., Mulrow, C. D., & Haynes, R. B. (1997) · Annals of Internal Medicine · doi:10.7326/0003-4819-126-5-199703010-00006 · Cited by 2,184 · see citing works
The Hazards of Scoring the Quality of Clinical Trials for Meta-analysis
Jüni, P. (1999) · JAMA · doi:10.1001/jama.282.11.1054 · Cited by 1,981 · see citing works
Outcome Measures for Low Back Pain Research: A Proposal for Standardized Use
Deyo, R. A., Battie, M., Beurskens, A. J. H. M., Bombardier, C., Croft, P., Koes, B., Malmivaara, A., Roland, M., Von Korff, M., & Waddell, G. (1998) · Spine · doi:10.1097/00007632-199809150-00018 · Cited by 1,229 · see citing works
Self-citationEfficacy 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 · see citing works
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 · see citing works
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 · see citing works
van Tulder, M. W., Assendelft, W. J., Koes, B. W., & Bouter, L. M. (1997) · Spine · doi:10.1097/00007632-199710150-00001 · Cited by 727 · see citing works
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 · see citing works
Low Back Pain: A Twentieth Century Health Care Enigma
Waddell, G. (1996) · Spine · doi:10.1097/00007632-199612150-00002 · Cited by 546 · see citing works
Mayer, T. G. (1987) · JAMA · doi:10.1001/jama.258.13.1763 · Cited by 482 · see citing works
The Promise and Problems of Meta-Analysis
Bailar, J. C. (1997) · New England Journal of Medicine · doi:10.1056/nejm199708213370810 · Cited by 407 · see citing works
Badley, E. M., Rasooly, I. R., & Webster, G. (1994) · PubMed · Cited by 387 · see citing works
Nicholas, M. K., Wilson, P. H., & Goyen, J. (1992) · Pain · doi:10.1016/0304-3959(92)90082-m · Cited by 271 · see citing works
Clinically useful measures of effect in binary analyses of randomized trials
Sinclair, J. C., & Bracken, M. B. (1994) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(94)90191-0 · Cited by 271 · see citing works
Towards a comprehensive assessment of chronic pain patients
Turk, D. C., & Rudy, T. E. (1987) · Behaviour Research and Therapy · doi:10.1016/0005-7967(87)90002-7 · Cited by 246 · see citing works
Alaranta, H., Rytökoski, U., Rissanen, A., Talo, S., Rönnemaa, T., Puukka, P. J., Karppi, S. ‐., Videman, T., Kallio, V., & SLÄTIS, P. (1994) · Spine · doi:10.1097/00007632-199406000-00007 · Cited by 202 · see citing works
Acute Low Back Problems in Adults
U.S. Department of Health and Human Services Public Health Service Agency for Health Care Policy and Research (1997) · Journal of Dance Medicine & Science · doi:10.1177/1089313x9700100208 · Cited by 191 · see citing works
Triano, J. J. (1998) · Spine · doi:10.1097/00007632-199806010-00024 · Cited by 170 · see citing works
Does Nonsurgical Pain Center Treatment of Chronic Pain Return Patients to Work?
Cutler, R. B., Fishbain, D. A., Rosomoff, H. L., Abdel-Moty, E., Khalil, T. M., & Rosomoff, R. S. (1994) · Spine · doi:10.1097/00007632-199403001-00002 · Cited by 160 · see citing works
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 · see citing works
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 · see citing works
Bendix, A. F., Bendix, T., Hæstrup, C., & Busch, E. A. V. (1998) · European Spine Journal · doi:10.1007/s005860050040 · Cited by 131 · see citing works
Basler, H.-D., Jäkle, C., & Kröner‐Herwig, B. (1997) · Patient Education and Counseling · doi:10.1016/s0738-3991(97)00996-8 · Cited by 128 · see citing works
Bendix, A. F., Bendix, T., Ostenfeld, S., Bush, E., & Andersen, A. (1995) · European Spine Journal · doi:10.1007/bf00298239 · Cited by 125 · see citing works
Hutubessy, R. C. W., van Tulder, M. W., Vondeling, H., & Bouter, L. M. (1999) · Pain · doi:10.1016/s0304-3959(98)00204-8 · Cited by 121 · see citing works
Mitchell, R. I., & Carmen, G. M. (1994) · Spine · doi:10.1097/00007632-199403001-00001 · Cited by 120 · see citing works
Bendix, A., Bendix, T., Lund, C., Kirkbak, S., & Ostenfeld, S. (1997) · Journal of Rehabilitation Medicine · doi:10.2340/1650197719978189 · Cited by 118 · see citing works
Härkäpää, K., Järvikoski, A., Mellin, G. P., & Hurri, H. (1989) · Journal of Rehabilitation Medicine · doi:10.2340/1650197719898189 · Cited by 111 · see citing works
Härkäpää, K., Mellin, G. P., Järvikoski, A., & Hurri, H. (2020) · Journal of Rehabilitation Medicine · doi:10.2340/165019779022181188 · Cited by 93 · see citing works
A limited functional restoration program for injured workers: A randomized trial
Corey, D. T., Koepfler, L. E., Etlin, D., & Day, H. I. (1996) · Journal of Occupational Rehabilitation · doi:10.1007/bf02110886 · Cited by 67 · see citing works
Mellin, G. P., Hurri, H., Härkäpää, K., & Järvikoski, A. (2020) · Journal of Rehabilitation Medicine · doi:10.2340/1650197789219195 · Cited by 50 · see citing works
Behavioural treatment for chronic low-back pain
van Tulder, M. W., Ostelo, R., Vlaeyen, J. W. S., Linton, S. J., Morley, S., & Assendelft, W. J. (2000) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002014 · Cited by 50 · see citing works
Mellin, G. P., Härkäpää, K., Hurri, H., & Järvikoski, A. (2020) · Journal of Rehabilitation Medicine · doi:10.2340/165019779022189194 · Cited by 46 · see citing works
Evaluation of an Advanced Back Pain Rehabilitation Program
Åberg, J. (1984) · Spine · doi:10.1097/00007632-198404000-00018 · Cited by 37 · see citing works
Types of pain treatment facilities and referral selection criteria. A review
Fisbain, D. A. (1995) · Archives of Family Medicine · doi:10.1001/archfami.4.1.58 · Cited by 17 · see citing works
Härkäpää, K., Mellin, G. P., Järvikoski, A., & Hurri, H. (1989) · Journal of Rehabilitation Medicine · doi:10.2340/165020051990181188 · Cited by 17 · see citing works
Wh, J., Cziske, R., Gerdes, N., & Jacobi, E. (1990) · PubMed · Cited by 15 · see citing works
Mellin, G. P., Härkäpää, K., Hurri, H., & Järvikoski, A. (1989) · Journal of Rehabilitation Medicine · doi:10.2340/165020061990189194 · Cited by 11 · see citing works
Mellin, G. P., Hurri, H., Härkäpää, K., & Järvikoski, A. (1989) · Journal of Rehabilitation Medicine · doi:10.2340/1650197719899195 · Cited by 10 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Chou, R., Qaseem, A., Snow, V., Casey, D., Cross, J. T., Shekelle, P., Owens, D. K., & for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians and the American College of Physicians/American Pain Society Low Back Pain Guidelines Panel* (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-147-7-200710020-00006 · Cited by 2,718 · see citing works
Chapter 4 European guidelines for the management of chronic nonspecific low back pain
Airaksinen, O., Brox, J. I., Cedraschi, C., Hildebrandt, J., Klaber-Moffett, J., Kovacs, F., Mannion, A. F., Reis, S., Staal, J. B., Ursin, H., et al. (2006) · European Spine Journal · doi:10.1007/s00586-006-1072-1 · Cited by 2,594 · see citing works
The fear-avoidance model of musculoskeletal pain: Current state of scientific evidence
Leeuw, M., Goossens, M. E. J. B., Linton, S. J., Crombez, G., Boersma, K., & Vlaeyen, J. W. S. (2007) · Journal of Behavioral Medicine · doi:10.1007/s10865-006-9085-0 · Cited by 2,261 · see citing works
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 · see citing works
Self-citationClinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain
Chou, R., Fanciullo, G. J., Fine, P. G., Adler, J. A., Ballantyne, J. C., Davies, P., Donovan, M. I., Fishbain, D. A., Foley, K. M., Fudin, J., et al. (2009) · The Journal of Pain · doi:10.1016/j.jpain.2008.10.008 · Cited by 2,192 · see citing works
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 · see citing works
Kamper, S. J., Apeldoorn, A. T., Chiarotto, A., Smeets, R. J. E. M., Ostelo, R. W. J. G., Guzman, J., & van Tulder, M. W. (2015) · BMJ · doi:10.1136/bmj.h444 · Cited by 1,092 · see citing works
Chou, R., & Huffman, L. H. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-147-7-200710020-00007 · Cited by 1,045 · see citing works
Meta-analysis of psychological interventions for chronic low back pain
Hoffman, B. M., Papas, R. K., Chatkoff, D. K., & Kerns, R. D. (2007) · Health Psychology · doi:10.1037/0278-6133.26.1.1 · Cited by 844 · see citing works
Treatment of chronic non-cancer pain
Turk, D. C., Wilson, H. D., & Cahana, A. (2011) · The Lancet · doi:10.1016/s0140-6736(11)60402-9 · Cited by 716 · see citing works
Krismer, M., & van Tulder, M. (2007) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2006.08.004 · Cited by 694 · see citing works
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 · see citing works
Chou, R., Loeser, J. D., Owens, D. K., Rosenquist, R. W., Atlas, S. J., Baisden, J., Carragee, E. J., Grabois, M., Murphy, D. R., Resnick, D. K., et al. (2009) · Spine · doi:10.1097/brs.0b013e3181a1390d · Cited by 581 · see citing works
Complex Regional Pain Syndrome: Practical Diagnostic and Treatment Guidelines, 4th Edition
Harden, R. N., Oaklander, A. L., Burton, A. W., Perez, R. S. G. M., Richardson, K., Swan, M., Barthel, J., Costa, B., Graciosa, J. R., & Bruehl, S. (2013) · Pain Medicine · doi:10.1111/pme.12033 · Cited by 534 · see citing works
Fairbank, J., Frost, H., Wilson-MacDonald, J., Yu, L.-M., Barker, K., & Collins, R. (2005) · BMJ · doi:10.1136/bmj.38441.620417.8f · Cited by 514 · see citing works
Combined physiotherapy and education is efficacious for chronic low back pain
Moseley, L. (2002) · Australian Journal of Physiotherapy · doi:10.1016/s0004-9514(14)60169-0 · Cited by 472 · see citing works
Loisel, P., Buchbinder, R., Hazard, R., Keller, R., Scheel, I., van Tulder, M., & Webster, B. (2005) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-005-8031-2 · Cited by 403 · see citing works
Häuser, W., Bernardy, K., Arnold, B., Offenbächer, M., & Schiltenwolf, M. (2009) · Arthritis Care & Research · doi:10.1002/art.24276 · Cited by 378 · see citing works
Turk, D. C., Swanson, K. S., & Tunks, E. R. (2008) · The Canadian Journal of Psychiatry · doi:10.1177/070674370805300402 · Cited by 298 · see citing works
Lambeek, L. C., van Mechelen, W., Knol, D. L., Loisel, P., & Anema, J. R. (2010) · BMJ · doi:10.1136/bmj.c1035 · Cited by 293 · see citing works
Wicksell, R. K., Olsson, G. L., & Hayes, S. C. (2010) · European Journal of Pain · doi:10.1016/j.ejpain.2010.05.001 · Cited by 259 · see citing works
Psychological therapies for the management of chronic pain (excluding headache) in adults
Eccleston, C., Williams, A. C. D. C., & Morley, S. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007407.pub2 · Cited by 247 · see citing works
Ho, E. K.-Y., Chen, L., Simic, M., Ashton-James, C. E., Comachio, J., Wang, D. X. M., Hayden, J. A., Ferreira, M. L., & Ferreira, P. H. (2022) · BMJ · doi:10.1136/bmj-2021-067718 · Cited by 220 · see citing works
Carroll, C., Rick, J., Pilgrim, H., Cameron, J., & Hillage, J. (2010) · Disability and Rehabilitation · doi:10.3109/09638280903186301 · Cited by 214 · see citing works
Self-management program for chronic low back pain: A systematic review and meta-analysis
Du, S., Hu, L., Dong, J., Xu, G., Chen, X., Jin, S., Zhang, H., & Yin, H. (2017) · Patient Education and Counseling · doi:10.1016/j.pec.2016.07.029 · Cited by 199 · see citing works
Psychological Interventions for the Treatment of Chronic Pain in Adults
Driscoll, M. A., Edwards, R. R., Becker, W. C., Kaptchuk, T. J., & Kerns, R. D. (2021) · Psychological Science in the Public Interest · doi:10.1177/15291006211008157 · Cited by 176 · see citing works
Bell, J. A., & Burnett, A. (2009) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-009-9164-5 · Cited by 159 · see citing works
A scale for rating the quality of psychological trials for pain
Yates, S. L., Morley, S., Eccleston, C., & de C. Williams, A. C. (2005) · Pain · doi:10.1016/j.pain.2005.06.018 · Cited by 150 · see citing works
Psychological factors and treatment opportunities in low back pain
Pincus, T., & McCracken, L. M. (2013) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2013.09.010 · Cited by 144 · see citing works
Economic burden of chronic pain
Phillips, C. J. (2006) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1586/14737167.6.5.591 · Cited by 139 · see citing works
Archer, K. R., Seebach, C. L., Mathis, S. L., Riley, L. H., & Wegener, S. T. (2014) · The Spine Journal · doi:10.1016/j.spinee.2013.06.087 · Cited by 118 · see citing works
Web-Based Interventions for Chronic Back Pain: A Systematic Review
Garg, S., Garg, D., Turin, T. C., & Chowdhury, M. F. U. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.4932 · Cited by 115 · see citing works
Silva Guerrero, A. V., Maujean, A., Campbell, L., & Sterling, M. (2018) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000601 · Cited by 116 · see citing works
The Long-term Effect of Multidisciplinary Back Training: A Systematic Review
van Geen, J.-W., Edelaar, M. J. A., Janssen, M., & van Eijk, J. T. M. (2007) · Spine · doi:10.1097/01.brs.0000251745.00674.08 · Cited by 104 · see citing works
A meta-ethnography of patients’ experience of chronic non-malignant musculoskeletal pain
Toye, F., Seers, K., Allcock, N., Briggs, M., Carr, E., Andrews, J., & Barker, K. (2013) · Health Services and Delivery Research · doi:10.3310/hsdr01120 · Cited by 98 · see citing works
Archer, K. R., Wegener, S. T., Seebach, C., Song, Y., Skolasky, R. L., Thornton, C., Khanna, A. J., & Riley, L. H. (2011) · Spine · doi:10.1097/brs.0b013e3181f8c6f4 · Cited by 95 · see citing works
Are self-management strategies effective in chronic pain treatment?
Nicholas, M. K., & Blyth, F. M. (2016) · Pain Management · doi:10.2217/pmt.15.57 · Cited by 89 · see citing works
Thompson, E. L., Broadbent, J., Bertino, M. D., & Staiger, P. K. (2016) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000235 · Cited by 84 · see citing works
Gilpin, H. R., Keyes, A., Stahl, D. R., Greig, R., & McCracken, L. M. (2017) · The Journal of Pain · doi:10.1016/j.jpain.2017.04.003 · Cited by 81 · see citing works
Opioid Cessation and Multidimensional Outcomes After Interdisciplinary Chronic Pain Treatment
Murphy, J. L., Clark, M. E., & Banou, E. (2013) · The Clinical Journal of Pain · doi:10.1097/ajp.0b013e3182579935 · Cited by 81 · see citing works
Perry, K. N., Nicholas, M. K., & Middleton, J. W. (2010) · The Clinical Journal of Pain · doi:10.1097/ajp.0b013e3181bff8f3 · Cited by 80 · see citing works
Mangels, M., Schwarz, S., Worringen, U., Holme, M., & Rief, W. (2009) · The Clinical Journal of Pain · doi:10.1097/ajp.0b013e3181925791 · Cited by 74 · see citing works
Management of chronic pain in primary care
Smith, B. H., & Torrance, N. (2011) · Current Opinion in Supportive & Palliative Care · doi:10.1097/spc.0b013e328345a3ec · Cited by 63 · see citing works
Turk, D. C., & Burwinkle, T. M. (2005) · Professional Psychology: Research and Practice · doi:10.1037/0735-7028.36.6.602 · Cited by 57 · see citing works
Effectiveness of multidisciplinary programmes for clinical pain conditions: an umbrella review.
Dragioti, E., Evangelou, E., Larsson, B., & Gerdle, B. (2018) · Journal of Rehabilitation Medicine · doi:10.2340/16501977-2377 · Cited by 53 · see citing works
Williams, N. H., Hendry, M., Lewis, R., Russell, I., Westmoreland, A., & Wilkinson, C. (2007) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2007.01.008 · Cited by 54 · see citing works
Murphy, J. L., Palyo, S. A., Schmidt, Z. S., Hollrah, L. N., Banou, E., Van Keuren, C. P., & Strigo, I. A. (2021) · Pain Medicine · doi:10.1093/pm/pnaa417 · Cited by 54 · see citing works
Treatment of provoked vulvodynia: a systematic review
Bohm-Starke, N., Ramsay, K. W., Lytsy, P., Nordgren, B., Sjöberg, I., Moberg, K., & Flink, I. (2022) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2022.02.008 · Cited by 51 · see citing works
Schlicker, S., Baumeister, H., Buntrock, C., Sander, L., Paganini, S., Lin, J., Berking, M., Lehr, D., & Ebert, D. D. (2020) · JMIR Mental Health · doi:10.2196/16398 · Cited by 46 · see citing works
Kitselaar, W. M., van der Vaart, R., Perschl, J., Numans, M. E., & Evers, A. W. M. (2023) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001145 · Cited by 45 · see citing works
“This corroborates conclusions from other research, which demonstrate that PSS requires a multidomain classification and treatment (48,49,53,54).”
ResultScriven, H., Doherty, D., & Ward, E. (2019) · Rural and Remote Health · doi:10.22605/rrh4710 · Cited by 41 · see citing works
Nordin, C. A., Michaelson, P., Gard, G., & Eriksson, M. K. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5634 · Cited by 38 · see citing works
Kaiser, U., Kopkow, C., Deckert, S., Sabatowski, R., & Schmitt, J. (2015) · BMJ Open · doi:10.1136/bmjopen-2015-008146 · Cited by 34 · see citing works
Management of chronic pain through pain management programmes
Wilson, I. R. (2017) · British Medical Bulletin · doi:10.1093/bmb/ldx032 · Cited by 36 · see citing works
Internet-Based Aftercare for Patients with Back Pain—A Pilot Study
Moessner, M., Schiltenwolf, M., & Neubauer, E. (2012) · Telemedicine and e-Health · doi:10.1089/tmj.2011.0221 · Cited by 33 · see citing works
Pain management in musculoskeletal conditions
Nicholas, M. K. (2008) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2007.11.008 · Cited by 34 · see citing works
Penney, L. S., & Haro, E. (2019) · Journal of Pain Research · doi:10.2147/jpr.s185652 · Cited by 32 · see citing works
Psychotherapeutic interventions for chronic pain: Evidence, rationale, and advantages
Majeed, M. H., Ali, A. A., & Sudak, D. M. (2019) · The International Journal of Psychiatry in Medicine · doi:10.1177/0091217418791447 · Cited by 32 · see citing works
McCracken, L. M., Sato, A., Wainwright, D., House, W., & Taylor, G. J. (2014) · Primary Health Care Research & Development · doi:10.1017/s1463423613000273 · Cited by 27 · see citing works
Ahlgren, C., Fjellman-Wiklund, A., Hamberg, K., Johansson, E. E., & Stålnacke, B.-M. (2016) · Disability and Rehabilitation · doi:10.3109/09638288.2015.1127435 · Cited by 26 · see citing works
Richards, M. C., Ford, J. J., Slater, S. L., Hahne, A. J., Surkitt, L. D., Davidson, M., & McMeeken, J. M. (2013) · Manual Therapy · doi:10.1016/j.math.2012.06.005 · Cited by 24 · see citing works
You, D. S., Ziadni, M. S., Cooley, C. E., Talavera, D. C., Mackey, S. C., & Poupore-King, H. (2021) · Journal of Back and Musculoskeletal Rehabilitation · doi:10.3233/bmr-200305 · Cited by 19 · see citing works
“Our 278 results are consistent with a meta-analysis showing 279 that multidisciplinary programs with functional restora- 280 tion approach produce greater improvement in func- 281 tion for patients with disabling chronic pain than usual 282 care [8,10], but inconsistent with a RCT showing that 283 both CBT alone and C…”
MethodResultCampello, M., Ziemke, G., Hiebert, R., Weiser, S., Brinkmeyer, M., Fox, B., Dail, J., Kerr, S., Hinnant, I., & Nordin, M. (2012) · Military Medicine · doi:10.7205/milmed-d-12-00118 · Cited by 20 · see citing works
Twiddy, H., Frank, B., & Alam, U. (2021) · Diabetes Therapy · doi:10.1007/s13300-020-00983-y · Cited by 15 · see citing works
“The reduction or relief of pain is not a primary aim of treatment, although improvements in pain are often reported [22, 23].”
BackgroundOptimising the psychological benefits of osteopathy
Williams, N. H. (2007) · International Journal of Osteopathic Medicine · doi:10.1016/j.ijosm.2007.05.002 · Cited by 15 · see citing works
Björnsdóttir, S. V., Triebel, J., Arnljótsdóttir, M., Tómasson, G., & Valdimarsdóttir, U. A. (2018) · Disability and Rehabilitation · doi:10.1080/09638288.2017.1312565 · Cited by 14 · see citing works
- Authors
- Guzmán, J., Esmail, R., Karjalainen, K., Malmivaara, A., Irvin, E., & Bombardier, C.
- Affiliations
- Institute for Work & Health (CA)
- Corresponding author
- Guzmán, Jaime
- ORCID
- Guzmán, Jaime
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2001-06-23
- Volume
- 322
- Issue
- 7301
- Pages
- 1511-1516
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC33389
- OpenAlex
- W2035540128
- Cited by
- 941
- References
- 39
- Citations by year
- 2026: 11 · 2025: 14 · 2024: 20 · 2023: 16 · 2022: 21 · 2021: 23 · 2020: 30 · 2019: 24 · 2018: 22 · 2017: 35 · 2016: 38 · 2015: 37 · 2014: 52 · 2013: 51 · 2012: 64
- FWCI
- 3.48
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Funders
- Workplace Safety and Insurance Board
- Topics
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- chronic low back pain, multidisciplinary rehabilitation, biopsychosocial rehabilitation, functional restoration, pain intensity, functional capacity, career readiness, sick leave, quality of life, outpatient rehabilitation
- MeSH terms
- Chronic Disease, Combined Modality Therapy, Humans, Quality of Life, Randomized Controlled Trials as Topic, Treatment Outcome, Low Back Pain
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