Background: Psychological interventions are widely implemented for pain management and treatment, but their
reported effectiveness shows considerable variation and there is elevated likelihood for bias.
Methods: We summarized the strength of evidence and extent of potential biases in the published literature of
psychological interventions for pain treatment using a range of criteria, including the statistical significance of the
random effects summary estimate and of the largest study of each meta-analysis, number of participants, 95%
prediction intervals, between-study heterogeneity, small-study effects and excess significance bias.
Results: Thirty-eight publications were identified, investigating 150 associations between several psychological
interventions and 29 different types of pain. Of the 141 associations based on only randomized controlled trials,
none presented strong or highly suggestive evidence by satisfying all the aforementioned criteria. The effect of
psychological interventions on reducing cancer pain severity, pain in patients with arthritis, osteoarthritis, rheumatoid
arthritis, breast cancer, fibromyalgia, irritable bowel syndrome, self-reported needle-related pain in children/adolescents
or with chronic musculoskeletal pain, chronic non-headache pain and chronic pain in general were supported by
suggestive evidence.
Conclusions: The present findings reveal the lack of strong supporting empirical evidence for the effectiveness
of psychological treatments for pain management and highlight the need to further evaluate the established approach
of psychological interventions to ameliorate pain.