Aabedi Andre, Wang Vera, Fraix Marcel P, Agrawal Devendra K
Departments of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California 91766 USA.
J Orthop Sports Med. 2025;7(1):162-168. doi: 10.26502/josm.511500191. Epub 2025 Mar 31.
Musculoskeletal injuries are a leading cause of pain and disability, with many patients developing chronic pain. While traditional management focuses on physical treatments, psychological interventions have emerged as a complementary approach. This study examines the role of psychological treatments in pain management after musculoskeletal injury, their efficacy, and their integration with existing treatment strategies. A review of literature, including systematic reviews and meta-analyses, was conducted to assess the effectiveness of psychological treatments such as cognitive-behavioral therapy (CBT), mindfulness-based stress reduction (MBSR), and pain neuroscience education (PNE). Studies on the impact of psychological distress on pain perception, circulating inflammatory biomarkers, and neuromuscular exercises were analyzed. Research indicates that psychological elements, particularly pain catastrophizing, anxiety, and depression, play crucial roles in determining both pain intensity and disability levels. Short-term improvements in pain intensity, functional capacity, and psychological well-being have been documented with CBT, MBSR, and PNE interventions. The integration of psychological approaches with physiotherapy demonstrates enhanced patient outcomes. Biological markers of inflammation, specifically CRP and IL-6, show potential as indicators of pain severity and treatment effectiveness. Notably, neuromuscular exercises have shown pain-reducing effects comparable to pharmaceutical interventions, though long-term efficacy data for psychological treatments remains variable. The integration of psychological interventions represents a significant advancement in musculoskeletal pain management, particularly in addressing the mental and emotional dimensions of pain experience. While current research supports their immediate benefits, additional investigation is necessary to determine long-term effectiveness and refine treatment approaches. Future research should emphasize individualized treatment protocols, technological integration, and robust longitudinal studies to maximize therapeutic outcomes.
肌肉骨骼损伤是疼痛和残疾的主要原因,许多患者会发展为慢性疼痛。虽然传统治疗侧重于物理治疗,但心理干预已成为一种补充方法。本研究探讨了心理治疗在肌肉骨骼损伤后疼痛管理中的作用、疗效以及它们与现有治疗策略的整合。通过对文献进行综述,包括系统评价和荟萃分析,以评估认知行为疗法(CBT)、基于正念的减压疗法(MBSR)和疼痛神经科学教育(PNE)等心理治疗的有效性。分析了关于心理困扰对疼痛感知、循环炎症生物标志物和神经肌肉锻炼影响的研究。研究表明,心理因素,特别是疼痛灾难化、焦虑和抑郁,在决定疼痛强度和残疾程度方面起着关键作用。CBT、MBSR和PNE干预已记录了疼痛强度、功能能力和心理健康的短期改善。心理方法与物理治疗的整合显示出更好的患者治疗效果。炎症生物标志物,特别是C反应蛋白(CRP)和白细胞介素-6(IL-6),显示出作为疼痛严重程度和治疗效果指标的潜力。值得注意的是,神经肌肉锻炼已显示出与药物干预相当的止痛效果,尽管心理治疗的长期疗效数据仍然存在差异。心理干预的整合代表了肌肉骨骼疼痛管理的重大进展,特别是在解决疼痛体验的心理和情感层面方面。虽然目前的研究支持它们的直接益处,但需要进一步研究以确定长期有效性并完善治疗方法。未来的研究应强调个性化治疗方案、技术整合和有力的纵向研究,以最大限度地提高治疗效果。