A Systematic Review of Self-Compassion in Chronic Pain: From Correlation to Efficacy

Abstract

Chronic pain (CP) is a common condition affecting millions of people worldwide. Compassion-related interventions are proving to be advantageous in CP, and self-compassion (SC) is hypothesized to be related with pain regulation physiological processes, as well as with psychological benefits in CP. We aimed to review scientific literature on: 1) Compassion-based psychological interventions and their changes in pain outcomes; and 2) associations between SC and pain-related outcomes. We performed a systematic research in four electronic databases: MEDLINE, EMBASE, PsycINFO and the Cochrane Library from inception until April 2020. In Question 1, we included studies involving adult patients with CP who participated in compassion-based psychological interventions. In Question 2, we included studies that examined the associations between SC and pain outcomes in adults with CP. We identified 16 studies. For Question 1, we included seven studies focused on different compassion-based interventions that assessed at least one pain outcome, in a total of 253 participants with CP associated with multiple conditions. For Question 2, we included nine studies, in a total of 1,430 participants, with eight different pain outcomes: Intensity, acceptance, catastrophizing, self-efficacy, disability, distress, pain related coping and anxiety. Considering the high heterogeneity between studies and the poor-quality assessment, we could not draw definitive conclusions on the efficacy of compassion-based interventions nor on the association between SC and pain outcomes. Studies are further discussed in detail. This review can be a starting point for large-scale and high-quality trials in this area as it provides an organized overview of the current literature on this topic.

Compassion focused therapy for pain management: ‘3 systems approach’ to understanding why striving and self-criticism are key psychological barriers to regulating activity and improving self-care for people living with persistent pain

“…23 A small reduction was also found for mean pain ratings (8%) although this is likely to be of questionable clinical significance. Broadly, these findings fit with those of the Lanzaro et al (2021) 17 systematic review of self-compassion pain management and also Austin et al (2020) 15 systematic review of compassion-based interventions for long term conditions.…”

“…The current authors suggest that this fits well with the proposal from Lanzaro et al regarding the benefits of understanding the relationship between self-compassion and pain management. 17…”

“…Whilst Lanzaro et al (2021) 17 found insufficient current evidence for the effectiveness of compassion-based treatment on pain outcomes, they have highlighted the importance of self-compassion in pain management. Further, they have proposed that understanding the relationship between self-compassion and persistent pain may lead to the development of more specific evidence-based compassion focused interventions for pain management.…”

“…Lanzaro et al ( 2021) 17 conducted a recent systematic review examining whether compassion-based interventions lead to improvement in pain-related outcomes. They identified 16 studies and found promising benefits in terms of reduction in pain intensity and pain interference, greater pain acceptance and pain self-efficacy, reduction in pain catastrophizing, pain anxiety and pain disability.…”

Self-compassion in Acceptance and Commitment Therapy for chronic pain: a pilot study

“…Self compassion, described as the sensitivity to personal suffering and the motivation to behave in a way that alleviates one's suffering [6,7], has been a recent topic of interest in CP research (see [8]) due to its potential physiological mechanisms of action (e.g., associated with oxytocin-endorphin pain regulation systems) [9,10], and to its protective role against depression [11] and pain disability [12] in CP. Indeed, compassion-based psychological interventions were found useful in effectively promoting CP management (see [13]).…”