Cognitive Behavioral Therapy for Chronic Pain

Psychotherapy strategies like CBT-CP are effective for pain management and opioid dose reduction within typical outpatient and surgical settings.

Cognitive Behavioral Therapy – Evidence Rating: Low to Moderate Quality

Evidence describing cognitive behavioral therapy for pain comes from multiple systematic reviews citing low to moderate quality evidence. These reviews draw from randomized control trials that sampled from populations with conditions including low back pain, fibromyalgia, and neck pain. Trials included in these systematic reviews generally had small sample sizes and did not report long-term outcomes, which limited the quality of their findings. Studies examining real-world application of CBT-CP have more consistently identified patient-level barriers to its uptake, but future research is needed to understand for whom CBT-CP is most efficacious, as well as provider- and system-level barriers to its use.

Evidence-based Scale

Psychotherapy interventions are effective for pain management and opioid dose reduction as part of typical outpatient pain care, inpatient, and pre-and postoperative care and during surgery.

CBT-CP-based interventions are often incorporated into multidisciplinary pain management and guided opioid tapering programs, combining CBT with other treatments and therapies. For instance, CBT-CP has been combined with physical exercise led by a fitness instructor. CBT-CP is generally compared to (and can be used alongside or in place of) other chronic pain treatments like drug therapy, physical therapy, nerve block injections or surgery.