Self-management courses may raise confidence in long-lasting pain, most of all in groups

The review

1. 01

   Who took part

   8539 adults with long-lasting pain in muscles, bones or joints took part in 46 trials. Most trials studied arthritis of the knee or hip, back pain, fibromyalgia, or several kinds of pain together. The average age was about 55, and 72% of people were women.

2. 02

   What they did

   Each course had at least two parts, such as talk therapy, relaxing, exercise, or learning about pain. Most (57%) were group courses, and 78% were led by health professionals. Three in four (74%) lasted 8 weeks or less. The comparison groups got usual care or a waiting list.

3. 03

   What happened

   Group courses, courses led by health professionals and courses with a therapy part all raised confidence at every time measured. Effects on pain and physical ability were mixed. The paper calls its results for single course parts largely inconclusive.

What the review found

1. Helped

   In 46 trials, group courses raised confidence in managing pain more than usual care did, at all three times measured.

   • Rule: Practise with a groupused

   Pooled analysis of 0 studies · vs usual care or a waiting list · they rated themselves · ⚠ most studies had serious flaws; whole programmes were tested, so no single part can be credited

2. Helped

   In 46 trials, courses led by health professionals raised confidence in managing pain, at all three times measured.

   • Rule: With a coach or therapistused

   Pooled analysis of 0 studies · vs usual care or a waiting list · they rated themselves · ⚠ most studies had serious flaws; whole programmes were tested, so no single part can be credited

3. Helped

   In 46 trials, courses with a therapy part raised confidence in managing pain; courses without one did not clearly.

   • Action: Challenge unhelpful thoughtstested

   Pooled analysis of 0 studies · vs usual care or a waiting list · they rated themselves · ⚠ most studies had serious flaws; whole programmes were tested, so no single part can be credited

Source