Psychological Treatment in the Management of Pain following Musculoskeletal Injury

Author(s): Andre Aabedi, Vera Wang, Marcel P Fraix, Devendra K. Agrawal

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.