The effect of cognitive behavioural therapy on pain and disability in chronic non-specific low back pain: An overview of systematic reviews

PMCID: PMC12173195

PMID: 40526738

DOI: 10.1371/journal.pone.0325122

Journal: PloS one

Publication Date: 2025-6-17

Authors: Leung T, Low MK, Yao PC, Pinho-Gomes AC

Key Points

• CBT provides statistically significant but modest improvements in pain intensity and disability for chronic low back pain patients
• Combination interventions (CBT + active treatments) showed more consistent positive outcomes compared to standalone CBT
• No standardized protocol exists for CBT delivery, suggesting a need for more rigorous, standardized research to optimize treatment protocols

Summary

This comprehensive overview of systematic reviews examined the efficacy of cognitive behavioral therapy (CBT) for chronic non-specific low back pain (CNSLBP), synthesizing evidence from 10 systematic reviews encompassing over 10,000 participants. The analysis revealed that CBT demonstrates moderate effectiveness in reducing pain and disability, particularly when compared to waiting list or usual care conditions, but shows variable results when compared to other active treatments.

The study highlighted significant methodological heterogeneity across reviews, with most demonstrating low to moderate quality of evidence. CBT showed consistent but modest improvements in pain intensity and functional disability, with the most promising outcomes observed when CBT was combined with other active treatments like exercise or physiotherapy. However, the authors caution against overstating CBT's effectiveness, noting that it may not be substantially superior to alternative interventions for managing chronic low back pain.