What is known and what is still unknown within chronic musculoskeletal pain? A systematic evidence and gap map

Kristian D Lyng*, Chris Djurtoft, Malene K Bruun, Mads N Christensen, Rikke E Lauritsen, Jesper B Larsen, Kathryn A Birnie, Jennifer Stinson, Morten S Hoegh, Thorvaldur S Palsson, Anne E Olesen, Lars Arendt-Nielsen, Lars H Ehlers, Kirsten Fonager, Martin B Jensen, Hanne Würtzen, Patricia A Poulin, Gitte Handberg, Connie Ziegler, Lars B MoellerJudi Olsen, Lotte Heise, Michael S Rathleff

*Corresponding author for this work

Abstract

Evidence and gap maps (EGMs) can be used to identify gaps within specific research areas and help guide future research agendas and directions. Currently, there are no EGMs within the broad domain of chronic musculoskeletal (MSK) pain in adults. The aim of this study was to create a contemporary EGM of interventions and outcomes used for research investigating chronic MSK pain. This EGM was based on systematic reviews of interventions published in scientific journals within the past 20 years. Embase, PubMed, the Cochrane Library, and PsycINFO were used to retrieve studies for inclusion. The quality of the included reviews was assessed using AMSTAR-II. Interventions were categorised as either physical, psychological, pharmacological, education/advice, interdisciplinary, or others. Outcomes were categorised using the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) recommendations. Of 4299 systematic reviews, 457 were included. Of these, 50% were rated critically low quality, 25% low quality, 10% moderate quality, and 15% rated high quality. Physical interventions (eg, exercise therapy) and education were the most common interventions reported in 80% and 20% of the studies, respectively. Pain (97%) and physical functioning (87%) were the most reported outcomes in the systematic reviews. Few systematic reviews used interdisciplinary interventions (3%) and economic-related outcomes (2%). This contemporary EGM revealed a low proportion of high-quality evidence within chronic MSK pain. This EGM clearly outlines the lack of high-quality research and the need for increased focus on interventions encompassing the entire biopsychosocial perspective.

Original languageEnglish
JournalPain
Volume164
Issue number7
Pages (from-to)1406-1415
Number of pages10
ISSN0304-3959
DOIs
Publication statusPublished - 1 Jul 2023

Keywords

  • Adult
  • Chronic Pain/therapy
  • Exercise Therapy/methods
  • Humans
  • Musculoskeletal Pain/diagnosis
  • Pain Measurement
  • Review Literature as Topic
  • Evidence and gap map
  • Musculoskeletal pain
  • Evidence map
  • Adults
  • Chronic pain

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