Exercise, talk therapy and mixed programmes gave small early gains in pain confidence.

The review

1. 01

   Who took part

   The 60 studies had 12,415 adults with long-lasting pain in muscles, bones or joints. Women made up 73% of them, and average ages in the studies ranged from 38 to 78.

2. 02

   What they did

   The studies tested exercise, therapy that challenges unhelpful thoughts, self-management teaching, or a mix of these. They compared them with usual care, people who were still waiting for treatment, a fake treatment, or nothing. How often and how long they ran varied a lot between studies.

3. 03

   What happened

   In the first three months, mixed programmes, therapy and exercise each gave small gains in pain confidence. Exercise and mixed programmes still helped at four to six months, and only mixed programmes helped at seven to twelve months. Self-management teaching gave no clear gain at any time, nothing helped after a year, and the evidence was weak.

What the review found

1. Helped

   In the first three months, mixed programmes made people a bit more confident about pain than the other groups.

   Pooled analysis of 0 studies · vs usual care, the waiting group, a fake treatment, or nothing · they rated themselves · the authors rated their certainty low · ⚠ most studies had serious flaws; signs that small negative studies went unpublished

2. Helped

   In the first three months, therapy on unhelpful thoughts made people a bit more confident than the other groups.

   • Action: Challenge unhelpful thoughtstested

   Pooled analysis of 0 studies · vs usual care, the waiting group, a fake treatment, or nothing · they rated themselves · the authors rated their certainty low · ⚠ most studies had serious flaws; signs that small negative studies went unpublished; the studies disagreed a lot

3. Helped

   In the first three months, exercise left people a little more confident than the other groups.

   Pooled analysis of 0 studies · vs usual care, the waiting group, a fake treatment, or nothing · they rated themselves · the authors rated their certainty low · ⚠ most studies had serious flaws; signs that small negative studies went unpublished

4. No difference

   Self-management teaching made no clear difference in the first three months or at any later time.

   Pooled analysis of 0 studies · vs usual care, the waiting group, a fake treatment, or nothing · they rated themselves · the authors rated their certainty low · ⚠ most studies had serious flaws; signs that small negative studies went unpublished

Source