Abstract

Objectives: This literature review assesses the short and long term effectiveness for chronic pain management of single modality treatment approaches such as opioid use, non-steroidal anti-inflammatory drugs, massage therapy, manual therapy (soft tissue mobilization), instrument assisted soft tissue mobilization, myofascial release, acupuncture, soft tissue release, dry needle, trigger point injection, joint manipulation/joint mobilization, active release technique, strain counter strain, craniosacral therapy, stretching/exercise, McKenzie method, and kinesio taping in comparison to treatment methods that follow the biopsychosocial model such as the multidisciplinary approach, cognitive behavioral rehabilitation and Advanced Soft Tissue Release.

Methods: A comprehensive literature search was conducted in major search databases including Medline, ScienceDirect, Pubmed, Embase, Google Scholar, Cinahl, BioMed Central, and Cochrane. 16,145 articles were found. Studies that met the inclusion criteria included systematic reviews and metaanalyses evaluating the treatment options for musculoskeletal pain.

Results: 57 studies met the criteria of this study, with 50 being systematic reviews, 4 randomized controlled trials (RCT), 1 non-RCT, and 2 literature reviews. The single modality studies were 47 studies, totalled as 53 individual different findings because some studies evaluated several single modalities in the same study. The findings of the 47 studies were consistent regarding that the single modalities provided short term pain reduction or no pain reduction. The biopsychosocial model studies were 7 systematic reviews, 1 literature review, 1 cohort study that consistently showed long term pain reduction, improved range of motion, and improvement in functional activities.

Conclusion: Based on the studies evaluated, treatment methods following the biopsychosocial model seem to yield long term pain reduction, increased range of motion, and improvement in functional activities. On the other hand the single modality treatment methods seemed to yield either short term pain reduction or no pain reduction.

Abbreviations: ART: Active Release Technique; ASTR: Advanced Soft Tissue Release; IASTM: Instrument Assisted Soft Tissue Mobilization; IRB: Institutional Review Board; KT: Kinesio Tape; MCE: Motor Control Exercise; MTrP: Myofascial Trigger Points; NSAIDs: Non-Steroidal Anti-Inflammatory Drugs; NSCLBP: Non-Specific Chronic Low Back Pain; OT: Occupational Therapy; RCT: Randomized Control Trials; ROM: Range of Motion; SCS: Strain Counter Strain; SMFR: Self-Myofascial Release