Comparative effectiveness of nonpharmacological interventions in reducing psychological symptoms among patients with chronic low back pain

International Journal of Surgery, 2024 · DOI: http://dx.doi.org/10.1097/JS9.0000000000000798 · Published: September 26, 2023

Mental Health Pain Management Rehabilitation

Simple Explanation

Chronic low back pain (CLBP) significantly impacts patients' quality of life and is linked with psychological issues, which can worsen CLBP symptoms. Treatments addressing psychological symptoms are important. This study compares different non-drug treatments to find the most effective ways to reduce depression, anxiety, and improve mental health in CLBP patients, aiming to guide clinical practice. The review found that mind-body therapies and biopsychosocial approaches show promise in reducing psychological symptoms associated with CLBP, with mind-body therapy being a priority for depression and anxiety.

Study Duration

Not specified

Participants

4806 patients with CLBP

Evidence Level

Systematic review and network meta-analysis

Key Findings

1
Mind body therapy, biopsychosocial approach, and physical therapy were effective in reducing depression compared to the control group.
2
For anxiety, mind body therapy, multicomponent intervention, and a biopsychosocial approach were superior to the control group.
3
Multicomponent intervention, exercise, and physical therapy demonstrated substantial effectiveness in improving mental health compared to the control group.

Research Summary

This systematic review and network meta-analysis evaluated the effectiveness of nonpharmacological interventions for reducing psychological symptoms in patients with chronic low back pain (CLBP). The study found that mind body therapy, biopsychosocial approaches, and physical therapy were effective in reducing depression, while mind body therapy, multicomponent intervention, and biopsychosocial approaches were effective in reducing anxiety. Mind body therapy is highlighted as a priority choice for reducing depression and anxiety in CLBP patients, aiding clinicians in treatment selection.

Practical Implications

Treatment Selection

Clinicians can use the findings to assess the potential risks and benefits of nonpharmacological treatments for CLBP patients with psychological symptoms.

Prioritize Mind-Body Therapy

Mind body therapy can be considered a priority choice in reducing depression and anxiety among patients with CLBP.

Future Research

More RCTs with rigorous methodology and adequate sample sizes are needed to further validate these findings.

Study Limitations

1
Most included RCTs exhibited concerns for risk of bias.
2
Loop inconsistency between direct and indirect sources of evidence was observed in some analyses.
3
Certainty of evidence varied from moderate to extremely low.

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