Is Exercise Effective at Reducing Pain Catastrophizing in People With Chronic Nonspecific Spinal Pain? A Systematic Review and Meta-Analysis.
Cho W G Yu, Vishakha Bhatia, Sakshi Chandel et al.
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In 30 seconds
This systematic review and meta-analysis examined whether exercise reduces pain catastrophizing in people with chronic nonspecific spinal pain. It included eight studies with 1271 participants: seven studies of chronic low back pain and one of chronic neck pain. In the primary low-back-pain analyses, exercise was not significantly superior to control at short-term or intermediate-term follow-up (SMD=-0.4 to -0.32). An exploratory sensitivity analysis excluding one motor-control exercise study found greater reductions at both time points, but overall certainty was very low to low and all studies had some concerns or high risk of bias.
Key findings
- Primary analyses found no significant exercise advantage over control for low back pain at short-term (<3 mo) or intermediate-term (3 to 6 mo) follow-up (SMD=-0.4 to -0.32).
- After excluding one motor-control exercise study, sensitivity analyses favoured exercise at short-term follow-up (SMD=-0.49, 95% CI: -0.80 to -0.18) and intermediate-term follow-up (SMD=-0.67, 95% CI: -1.05 to -0.30).
- For chronic neck pain, low-certainty evidence supported neck and scapular muscle strengthening for reducing pain catastrophizing.
- All eight studies had some concerns or high risk of bias; overall evidence certainty was very low to low.
Why it matters
Pain catastrophizing is an outcome that exercise interventions may influence in chronic spinal pain, but the primary pooled findings do not establish a clear benefit for chronic low back pain. The differing results in exploratory analyses and the low certainty of the evidence mean that estimates remain uncertain. This review helps distinguish a possible signal of benefit from evidence strong enough to support firm conclusions.
What to keep in mind
The evidence base comprised eight studies, all with some concerns or high risk of bias; certainty was very low to low. The low-back-pain sensitivity findings were exploratory and followed exclusion of one study.