Fibromyalgia & musculoskeletal pain
Long-term effectiveness of non-surgical interventions for chronic low back pain: a systematic review and meta-analysis
Authors' conclusion
Some interventions, including cognitive behavioural therapy, mindfulness, exercise, and multidisciplinary care could produce the long-term benefits required to reduce the global burden due to non-specific chronic low back pain; however, the effects are mostly small, and the strength of evidence is relatively uncertain.
Study context
- Population
- Adults with chronic low back pain (non-specific for the main findings), RCTs searched in MEDLINE, EMBASE, CINAHL to May 22, 2024
- Participants
- 15,395 adults75 trials
- Comparison
- Non-surgical interventions vs placebo, adjuvant intervention, no intervention or usual care
- Outcome
- Pain intensity and disability at long-term (1-2 years) and very long-term (≥2 years) follow-up
- Follow-up
- 1-2 years; ≥2 years
Methodological detailsrandom effects meta-analysis, prospectively registered protocol, patient and clinician involvement, Risk of bias high in 51 [68%] of 75 studies
- Random effects meta-analysis
- Prospectively registered protocol
- Patient and clinician involvement
- Risk of bias high in 51 [68%] of 75 studies
Pooled result
As reported in the abstract
Pain intensity, non-specific chronic low back pain (moderate certainty) · long-term (1-2 years)
Mean difference (95% CI)
CBTvs ComparatorI2 =0.0
−7.2(−9.8 to −4.6)
Mindfulnessvs ComparatorI2 =0.1
−10.0(−14.4 to −5.6)
Further pooled results
| Outcome | Mean difference (95% CI) | |
|---|---|---|
| Disability (moderate certainty) · long-term (1-2 years)CBTvs ComparatorI2 =0.0 | −5.7 (−7.7 to −3.7) | |
| Disability (moderate certainty) · long-term (1-2 years)Mindfulnessvs ComparatorI2 =11.1 | −9.3 (−14.4 to −4.1) | |
| Disability (moderate certainty) · long-term (1-2 years)Goal settingvs ComparatorI2 =4.8 | −8.3 (−12.8 to −3.9) | |
| Disability (moderate certainty) · long-term (1-2 years)Needlingvs ComparatorI2 =0.0 | −4.8 (−8.1 to −1.5) | |
| Pain intensity (low certainty) · very long-term (≥2 years)Multidisciplinary carevs ComparatorI2 =0.0 · low certainty evidence | −10.1 (−16.6 to −3.7) | |
| Disability (low certainty) · very long-term (≥2 years)Exercisevs ComparatorI2 =33.5 · low certainty evidence | −10.2 (−17.5 to −2.9) | |
| −20−10010Difference (linear scale) |
Original publication
Long-term effectiveness of non-surgical interventions for chronic low back pain: a systematic review and meta-analysis. Lancet Rheumatol. Published 28 May 2025. doi:10.
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