Background: Blood flow restriction (BFR) is an effective clinical intervention used to increase strength in healthy individuals. However, its effects on pain and function in individuals with knee pain are unknown. Objective: To determine the effectiveness of adding BFR to resistance exercise for pain relief and improvement of function in patients with knee pain. Methods: Systematic review with meta-analysis of randomized clinical trials. Medline, Central, Embase, PEDro, Lilacs, CINAHL, SPORTDiscus, and Web of Science databases were searched from inception to May 2019. Randomized clinical trials that compared resistance exercise with or without BFR to treat knee pain and function in individuals older than 18 years of age with knee pain were included. Results: Eight randomized clinical trials met the eligibility criteria and for the quantitative synthesis, five studies were included. The pooled standardized mean difference (SMD) estimate showed that resistance exercises with BFR was not more effective than resistance exercises for reducing pain (SMD: −0.37 cm, 95% CI = −0.93, 0.19) and improving knee function (SMD = −0.23 points, 95% CI = −0.71, 0.26) in patients with knee pain.

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Musculoskeletal pain is a health problem that affects approximately 33 % of the adult population, of which 56 % corresponds to elderly people and 35% to people of working age. Some epidemiological investigations have shown that there are certain groups of people within the population most likely to develop chronic musculoskeletal pain, these studies have allowed to identify different weaknesses and needs in the interventions of health professionals in this problem. The data have shown that the prevalence of pain is higher in women, smokers, with incomplete education, with psychological or social risk, in this way the evidence has removed attention to the nociception of body structures as the only causal factor of pain musculoskeletal This has forced researchers to explore the influence of psychosocial factors in the experience of musculoskeletal pain, consider the integration of various factors and mechanisms to explain the development of the painful experience. The objective of this review is to describe the psychosocial factors that influence the experience of musculoskeletal pain in order to relate them to contemporary neuroscientific models.