Cognitive behavioural therapy and pain coping skills training for osteoarthritis knee pain management: a systematic review

[Purpose] To investigate the effectiveness of cognitive-behavioural therapy (CBT) and pain coping skills training (PCST) on pain level in adults with osteoarthritis of the knee (KOA) in comparison with usual care. [Subjects and Methods] Five databases were systematically searched for relevant randomised controlled trials (RCTs) according to the selected eligibility criteria (inception to June 7, 2016). PEDro scale was used to assess the validity of included studies. [Results] Four studies met the inclusion criteria and all studies had high methodological quality. The total number of participants was 665 across the four included studies. All participants had been diagnosed with KOA (clinical and radiographic evaluation). The majority of the population were female (71.13%). The interventions utilised were: CBT, CBT for insomnia (CBT-I), PCST, and PCST combined with behavioral weight management (BWM) in one study and with exercise in another study. The outcome measure for pain in KOA was the WOMAC scale. Overall, three studies have reported clinical improvement in KOA pain perception after 12-month follow-up time point. [Conclusion] This review has recognised the need for future studies that have rigorous methodological quality, and investigate the effect of mutual CBT and PCST protocols on KOA pain and pain-related functional and psychological abilities.