“…These comorbidities are frequently associated with higher pain and physical limitation,18,19,26,31,32,38,43,45,46,48,50,55 poor outcomes to both conservative and surgical interventions,20,30,31,34,35,37,44,47,56 and increased pharmacotherapy and health care utilization 23,48. Our results indicate that standardized interventions to manage these comorbidities are lacking as a number of different self-care management programs, telephone support programs, video information support programs, and new drug treatments were reported in the literature with varied success 21–23,28,33,36,39,40,42,47,49,51,54.…”