Leung Tiffany, Low Mei Ken, Yao Pei Chi, Pinho-Gomes Ana-Catarina
Institute of Epidemiology and Health Care, University College London, London, United Kingdom.
Institute of Ophthalmology, University College London, London, United Kingdom.
PLoS One. 2025 Jun 17;20(6):e0325122. doi: 10.1371/journal.pone.0325122. eCollection 2025.
Low back pain (LBP) is experienced by most people at least once in their lifetime and is the leading cause of disability worldwide. Cognitive behavioural therapy (CBT) is a non-invasive method used to manage chronic non-specific low back pain (CNSLBP) and contains less adverse effects than analgesic medications.
To determine the efficacy of interventions incorporating CBT on reducing pain intensity and physical disability in CNSLBP.
An overview of reviews without meta-analysis was conducted. Four electronic databases (MEDLINE, Embase, Cochrane Library and PsycINFO) were searched. Adults aged 18 or above with CNSLBP were included. AMSTAR 2 was used to assess risk of bias of included systematic reviews and data synthesis was conducted via vote counting methods.
Ten systematic reviews were included. Results showed that CBT is more effective in reducing pain and disability compared to waiting list/usual care (WL/UC). CBT in conjunction with other active treatments (AT) are also more effective than some standalone AT such as physiotherapy and exercise, but less effective than surgery.
CBT has some effect in reducing pain and disability, however, it may not be more effective than other treatments. The quality of evidence was low for most outcomes as there was high risk of bias and heterogeneity between studies. Future research could evaluate specific therapies such as acceptance and commitment therapy (ACT) and mindfulness-based cognitive therapy (MBCT), as these treatments lacked primary studies. There is no recognised standard for conducting CBT, and further research could determine the most effective duration, mode of delivery (e.g., online, group-based) and intensity of CBT.
大多数人一生中至少会经历一次腰痛，腰痛是全球致残的主要原因。认知行为疗法（CBT）是一种用于管理慢性非特异性腰痛（CNSLBP）的非侵入性方法，与止痛药物相比，其副作用更少。
确定采用CBT的干预措施对降低CNSLBP患者疼痛强度和身体残疾程度的疗效。
进行了一项不进行荟萃分析的综述概述。检索了四个电子数据库（MEDLINE、Embase、Cochrane图书馆和PsycINFO）。纳入18岁及以上患有CNSLBP的成年人。使用AMSTAR 2评估纳入的系统评价的偏倚风险，并通过投票计数法进行数据综合。
纳入了十项系统评价。结果表明，与等待名单/常规护理（WL/UC）相比，CBT在减轻疼痛和残疾方面更有效。CBT与其他积极治疗（AT）联合使用也比一些单独的AT（如物理治疗和运动）更有效，但比手术效果差。
CBT在减轻疼痛和残疾方面有一定效果，然而，它可能并不比其他治疗更有效。由于研究之间存在高偏倚风险和异质性，大多数结果的证据质量较低。未来的研究可以评估特定疗法，如接受与承诺疗法（ACT）和基于正念的认知疗法（MBCT），因为这些疗法缺乏初步研究。目前尚无进行CBT的公认标准，进一步的研究可以确定最有效的疗程、实施方式（如在线、基于小组）和CBT强度。
