Effects of Multidisciplinary Biopsychosocial Rehabilitation on Short-Term Pain and Disability in Chronic Low Back Pain: A Systematic Review with Network Meta-Analysis

Abstract

Chronic low back pain (CLBP) is a significant public health issue, with prevalence intensifying due to an ageing global population, amassing approximately 619 million cases in 2020 and projected to escalate to 843 million by 2050. In this study, we analyzed the effects of multidisciplinary biopsychosocial rehabilitation (MBR) on pain and disability. To address this question, we conducted a PRISMA-guided systematic review and random-effect network meta-analysis on studies collected from six electronic databases. The network comprised diverse MBR modalities (behavioral, educational, and work conditioning) alongside exercise therapy (ET), minimal intervention, and usual care, with pain and disability as outcomes. Ninety-three studies were included, encompassing a total of 8059 participants. The NMA substantiated that both ET and MBR modalities were effective in alleviating CLBP, with education-oriented MBR emerging as the most efficacious for pain mitigation (MD = 18.29; 95% CI = 13.70; 22.89) and behavior-focused MBR being the most efficacious for disability reduction (SMD = 0.88; 95% CI = 0.46; 1.30). Nevertheless, the discerned differences amongst the treatments were minimal and uncertain, highlighting that no modality was definitively superior to the others. Given the intricate nature of CLBP, embodying various facets, our findings advocate for a combined therapeutic approach to optimize treatment efficacy.

Failed back surgery syndrome—terminology, etiology, prevention, evaluation, and management: a narrative review

“…This comprehensive FBSS care pathway can help improve decision-making, minimize practice variation, and optimize outcomes. However, the implementation of multidisciplinary care is frequently hindered by limited access to specialized centers and higher costs owing to the involvement of multiple professionals [ 98 ].…”

“…However, a network meta-analysis indicated that MBR demonstrates only minimal differences in effectiveness when compared to minimal intervention and usual care in the treatment of chronic LBP, with no single treatment approach exhibiting clear superiority. Therefore, a thorough cost-benefit analysis is warranted to determine the most economically viable and clinically effective treatment modality among multidisciplinary approaches [ 98 ].…”