Self-management programs for chronic musculoskeletal pain conditions: a systematic review and meta-analysis.

OBJECTIVE To evaluate the effectiveness of self-management programs on pain and disability for chronic musculoskeletal pain conditions by systematic review. METHODS A search of randomized controlled trials was conducted in Medline and Embase from 1970s to 2010. Two reviewers independently selected trials, conducted critical appraisal of the methodological quality, and extracted the data. Meta-analyses were performed using all time-points meta-analysis (ATM). RESULTS Nineteen trials met inclusion criteria. For arthritis, the findings of this study showed that self-management programs have small to moderate effects in improving pain and disability at the long-term level, but the medium-term effect for disability is not significant. For chronic back pain, there is insufficient evidence to determine the effectiveness of self-management programs. CONCLUSION The encouraging evidence of this study indicates that it is recommended to provide self-management programs to adult patients with arthritis. Further research is needed on self-management for chronic back pain. PRACTICE IMPLICATIONS Self-management is a safe, community-based and effective way for patients with arthritis to manage pain and disability. Core skills of self-management should be delivered using multiple approaches.