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The Journal of Headache and Pain

Official Journal of the "European Headache Federation" and of "Lifting The Burden - The Global Campaign against Headache"

The Journal of Headache and Pain Cover Image

Volume 16 Supplement 1

1st Joint ANIRCEF-SISC Congress

Open Access

P004. Evidence based psychological treatments in pain management: a review of controlled and randomized trials about chronic headache, neuropathic pain and fibromyalgia

  • Amerigo Costa1,
  • Francesco Melina2,
  • Alessandra Sansalone1 and
  • Rosario Iannacchero1Email author
The Journal of Headache and Pain201516(Suppl 1):A151

Published: 28 September 2015


Chronic PainNeuropathic PainFibromyalgiaPain ManagementChronic Headache


Pain therapy settings often offer psychological interventions complementary to biomedical treatments [1]. While a large amount of scientific literature exists, there is relatively little experimental level evidence about the efficacy of psychotherapy in chronic pain. We reviewed randomized and controlled studies about the efficacy of psychotherapy in neuropathic pain conditions (NP), fibromyalgia (FM) and chronic headache (CH).

Materials and methods

In March 2015, we searched the Cochrane Central Register of Controlled Trials using the keywords “psychotherapy”, “chronic headache”, “neuropathic pain”, and “fibromyalgia”. We excluded non-randomized studies and identified works involving psychotherapeutic approaches showing evidence of efficacy. We performed descriptive statistics over quantitative and qualitative data.


Concerning neuropathic pain conditions, we found evidence for Cognitive-Behavioral Therapy (CBT) (2 studies), Psycho-education (PE) (2 studies) and Neuropsychological Rehabilitation (1 study). Regarding fibromyalgia, we found evidence for CBT (3 studies), PE (3 studies), Guided Imagery (GI) (3 studies), Strategic-Systems Therapy (Ericksonian) (2 studies), Brief Psychodynamic Therapy (1 study), Relaxation Training (RT) (1 study), Acceptance and Commitment Therapy (ACT) (1 study), Biofeedback (1 study), Mindfulness (1 study). We found evidence for CBT (4 studies), RT (3 studies), GI (2 studies), Biofeedback (1 study), ACT (1 study) in the treatment of chronic headache (Figure 1). It is noteworthy that CBT studies often involved informational group meetings; brief psychodynamic therapy was always carried out as a group intervention rather than individual sessions; strategic-systems therapy always involved hypnosis as elaborated in the Milton H. Erickson model of brief therapy.
Figure 1
Figure 1

Controlled and randomized studies about psychological treatments for chronic headache, neuropathic pain and fibromyalgia.


There is considerable terminological overlap between psychological approaches used in pain management. Many of the above-mentioned methods refer to similar practices under different names and therapists use them under different theoretical models. Our review supports the hypothesize that informative (psycho-education) and psycho-physiological interventions (biofeedback; relaxation training; guided imagery; mindfulness; ACT; neuropsychological rehabilitation) integrated with psychotherapy models (CBT; psychodynamic therapy; strategic-systems therapy) are useful in managing the considered forms of chronic pain.

Authors’ Affiliations

Centre for Headache and Adaptive Disorders, Unit of Neurology, Department of Neuroscience and Sense Organs, Azienda Ospedaliera “Pugliese-Ciaccio”, Catanzaro, Italy
Psychiatric Service for Diagnosis and Treatment, Department of Mental Health, Azienda Sanitaria Provinciale, Catanzaro, Italy


  1. Lee C, Crawford C, Hickey A, Active Self-Care Therapies for Pain (PACT) Working Group: Mind-body therapies for the self-management of chronic pain symptoms. Pain Med. 2014, 15 (Suppl 1): 21-39.View ArticleGoogle Scholar


© Costa et al. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.


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