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CBT for Chronic Musculoskeletal Pain

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Chronic musculoskeletal pain affects more than 1 in 5 American adults and costs the U.S. economy up to $630 billion annually. A new clinical practice guideline from the American Psychological Association highlights the critical role that psychological treatments can play in managing this pervasive condition. The guideline defined successful treatment based on functional outcomes that reflect meaningful change in patients’ lives rather than focusing solely on physical relief; their ability to participate in daily life, their mental health, and pain coping strategies.

Among evidence-based options, psychological treatments have emerged as the most promising. The guideline establishes Cognitive Behavioral Therapy (CBT) as a first-line recommendation for chronic musculoskeletal pain, showing strong evidence over treatment as usual or other active interventions. The panel also recommends multicomponent self-management interventions that combine patient education, physical components, and psychological strategies. For specific types of pain, such as chronic low back pain and osteoarthritis knee pain, the guideline recommends combinations of psychological treatments such as CBT alongside tailored exercise programs. Second-line recommendations are also provided for interventions with weaker but promising evidence.

However, many widely used interventions that have helped patients could not be included in the guideline due to research limitations. This gap underscores the need for more rigorous research as well as multidisciplinary collaboration in treatment planning and delivery to ensure that care leads to actual, meaningful improvements in patients’ functioning and quality of life.

Author: Devorah Rothman, MS
Editor: Nicholas Crimarco, Ph.D.

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What Is Cognitive Behavior Therapy?

Cognitive Behavioral Therapy is a type of treatment that is based firmly on research findings.  It places emphasis on changing your cognitions (thoughts) or behaviors (actions) in order to effect change in how you feel. These approaches help people in achieving specific changes or goals.

Changes or goals might involve:

A way of acting: like smoking less or being more outgoing;
A way of feeling: like helping a person to be less scared, less depressed, or less anxious;
A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts;
A way of dealing with physical or medical problems: like reducing back pain or helping a person stick to a doctor’s suggestions.

Cognitive behavioral therapists usually focus more on the current situation and its solution, rather than the past. They concentrate on a person’s views and beliefs about their life. CBT is an effective treatment for individuals, parents, children, couples, and families. The goal of CBT is to help people improve and gain more control over their lives by changing behaviors that don’t work well to ones that do.

How to Get Help

If you are looking for help, either for yourself or someone else, you may be tempted to call someone who advertises in a local publication or who comes up from a search of the Internet. You may, or may not, find a competent therapist in this manner. It is wise to check on the credentials of a psychotherapist. It is expected that competent therapists hold advanced academic degrees. They should be listed as members of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association. Of course, they should be licensed to practice in your state. You can find competent specialists who are affiliated with local universities or mental health facilities or who are listed on the websites of professional organizations. You may, of course, visit our website (www.abct.org) and click on “Find a CBT Therapist”

The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary organization committed to the advancement of a scientific approach to the understanding and amelioration of problems of the human condition. These aims are achieved through the investigation and application of behavioral, cognitive, and other evidence-based principles to assessment, prevention, and treatment.