Mind-based treatment may bring small gains in pain and confidence.

The review

1. 01

   Who took part

   1,307 adults with osteoarthritis took part in 12 studies, eight of them in the USA. The average age in each study was about 58 to 73.

2. 02

   What they did

   Each study compared a psychological programme with usual care, a waiting group or a placebo. Sessions were usually weekly and lasted 30 to 120 minutes.

3. 03

   What happened

   At the end of treatment, pain and tiredness were lower with treatment, and people rated themselves more confident. Physical function, anxiety and depression showed no clear difference, and the pain gain was not clear at later check-ups. The authors found signs that some weaker pain results may have gone unpublished.

What the review found

1. HelpedMotivation

   Across five studies, people given treatment rated themselves more confident at the end.

   • Action: Do a relaxation exercisetested
   • Action: Challenge unhelpful thoughtstested

   Pooled analysis of 5 studies with 528 people · vs usual care or no programme · they rated themselves

2. HelpedOther outcomes

   Across nine studies, pain was a little lower in the groups given treatment at the end.

   • Action: Do a relaxation exercisetested
   • Action: Challenge unhelpful thoughtstested

   Pooled analysis of 9 studies with 1,027 people · vs usual care, a placebo or no programme · they rated themselves · ⚠ signs that small negative studies went unpublished

3. HelpedOther outcomes

   Across three studies, tiredness was a little lower in the groups given treatment at the end.

   • Action: Do a relaxation exercisetested
   • Action: Challenge unhelpful thoughtstested

   Pooled analysis of 3 studies with 572 people · vs usual care or no programme · they rated themselves

4. No differenceOther outcomes

   Across six studies, physical function did not improve more with treatment than without it.

   • Action: Do a relaxation exercisetested
   • Action: Challenge unhelpful thoughtstested

   Pooled analysis of 6 studies with 658 people · vs usual care or no programme · they rated themselves

Source