Effectiveness of motivational interviewing on pain-related outcomes in patients with musculoskeletal pain: a systematic review and meta-analysis

PurposeTo determine the effectiveness of motivational interviewing (MI) in the treatment of adult patients with musculoskeletal (MSK) pain.Materials and methodsA comprehensive search strategy without date or language restrictions was performed in five scientific databases. Manual searches and reference tracking were also carried out. Two reviewers independently performed title and abstract as well as full-text screening, data extraction, assessment of risk of bias, and evaluation of overall certainty with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Where possible, a meta-analysis was performed to identify effects across multiple studies.ResultsTen studies reported in 16 manuscripts met the previously defined eligibility criteria. Many outcomes could be extracted and analyzed. Nine of the ten studies were considered to have a high risk of bias according to the revised Cochrane RoB 2.0. The majority of comparisons were based on low to very low overall certainty of the evidence.ConclusionsThe existing literature did not allow a reliable statement about the effectiveness of MI on pain-related outcomes in people with MSK pain. Only tendencies towards a positive influence of MI were recognisable. However, this must be confirmed by high-quality randomized controlled trials in the future.IMPLICATIONS FOR REHABILITATIONMotivational interviewing appears to be an option for patients with chronic musculoskeletal pain which presumably has few to no adverse effects.Motivational interviewing could represent an opportunity, particularly for patients for whom other treatment strategies have been ineffective so far.Motivational interviewing can safely be combined with other forms of treatment such as an active exercise therapy.