Many people have pain that lasts for a long time, and pain that is not relieved or cured by physical therapy or medicines. The search for a diagnosis and for pain relief is often long, discouraging, and even damaging. For some people the pain leads to physical disability, changes in mood such as depression and anxiety, and social isolation. These are not inevitable and are thought to be reversible, at least to some extent, using a rehabilitation approach which aims to reduce disability and distress despite continuing pain. The treatments are based on robust psychological principles and practices and have been in use and developing for about 40 years.
The search found 52 trials of treatments, but only 40 provided data in a form that could be used. The two main types of psychological treatment were Cognitive Behavioural Therapy (CBT), and Behaviour Therapy (BT). Both focus on trying to help people change behaviour that makes pain, disability and distress worse. CBT also works directly on the thoughts and feelings that are a problem for people with persistent pain. The effects of these two treatments on pain, disability, and mood were tested immediately after the treatment, and six months later.
Psychological therapies can help people with chronic pain reduce negative mood (depression and anxiety), disability, and in some cases pain, but guidance is still required on the best content, duration, intensity, and format of treatment.