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Psychological therapies (Internet-delivered) for the management of chronic pain in adults

  1. Christopher Eccleston1,*,
  2. Emma Fisher2,
  3. Lorraine Craig3,
  4. Geoffrey B Duggan1,
  5. Benjamin A Rosser4,
  6. Edmund Keogh5

Editorial Group: Cochrane Pain, Palliative and Supportive Care Group

Published Online: 26 FEB 2014

Assessed as up-to-date: 13 NOV 2013

DOI: 10.1002/14651858.CD010152.pub2

How to Cite

Eccleston C, Fisher E, Craig L, Duggan GB, Rosser BA, Keogh E. Psychological therapies (Internet-delivered) for the management of chronic pain in adults. Cochrane Database of Systematic Reviews 2014, Issue 2. Art. No.: CD010152. DOI: 10.1002/14651858.CD010152.pub2.

Author Information

  1. 1

    University of Bath, Centre for Pain Research, Bath, UK

  2. 2

    Seattle Children’s Research Institute, Child Health, Behaviour, and Development, Seattle, USA

  3. 3

    University of Bath, Department of Health, Bath, UK

  4. 4

    University of Exeter, Exeter, UK

  5. 5

    University of Bath, Department of Psychology, Bath, UK

*Christopher Eccleston, Centre for Pain Research, University of Bath, Claverton Down, Bath, UK.

Publication History

  1. Publication Status: New
  2. Published Online: 26 FEB 2014



References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Berman 2009 {published data only}
Bromberg 2011 {published data only}
Buhrman 2004 {published data only}
Buhrman 2011 {published data only}
  • Buhrman M, Nilsson-Ihrfeldt E, Jannert M, Strom L, Andersson G. Guided internet-based cognitive behavioural treatment for chronic back pain reduces pain catastrophizing: a randomized controlled trial. Journal of Rehabilitation Medicine 2011;43(6):500-5.
Buhrman 2013 {published data only}
  • Buhrman M, Fredriksson A, Edstrom G, Shafiei D, Tarnqvist C, Ljotsson B, et al. Guided internet-delivered cognitive behavioural therapy for chronic pain patients who have residual symptoms after rehabilitation treatment: randomized controlled trial. European Journal of Pain 2013;17(5):753-65.
Buhrman 2013a {published data only}
  • Buhrman M, Skoglund A, Husell J, Bergstrom K, Gordh T, Hursti T, et al. Guided internet-delivered acceptance and commitment therapy for chronic pain patients: a randomized controlled trial. Behaviour Research and Therapy 2013;51(6):307-15.
Carpenter 2012 {published data only}
Chiauzzi 2010 {published data only}
Dear 2013 {published data only}
  • Dear BF, Titov N, Perry KN, Jonston L, Wootton BM, Terides MD, et al. The Pain Course: a randomised controlled trial of a clinician-guided internet-delivered cognitive behaviour therapy program for managing chronic pain and emotional well-being. Pain 2013;154(6):942-50.
Devineni 2005 {published data only}
Hedborg 2011 {published data only}
Lorig 2008 {published data only}
Ruehlman 2012 {published data only}
Strom 2000 {published data only}
Williams 2010 {published data only}

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Allen 2008 {published data only}
  • Allen M, Iezzoni LI, Huang A, Huang L, Leveille SG. Improving patient-clinician communication about chronic conditions: description of an internet-based nurse E-coach intervention. Nursing Research 2008;57(2):107-12.
Anderson 2006 {published data only}
Andersson 2002 {published data only}
Bieber 2006 {published data only}
  • Bieber C, Muller KG, Blumenstiel K, Schneider A, Richter A, Wilke S, et al. Long-term effects of a shared decision-making intervention on physician-patient interaction and outcome in fibromyalgia. A qualitative and quantitative 1 year follow-up of a randomized controlled trial. Patient Education and Counseling 2006;63(3):357-66.
Borckardt 2004 {published data only}
  • Borckardt JJ, Younger J, Winkel J, Nash MR, Shaw D. The computer-assisted cognitive/imagery system for use in the management of pain. Pain Research & Management 2004;9(3):157-62.
Brattberg 2006 {published data only}
Brattberg 2007 {published data only}
  • Brattberg G. Internet-based rehabilitation for individuals with chronic pain and burnout II: a long-term follow-up. International Journal of Rehabilitation Research 2007;30(3):231-4.
Bruce 2005 {published data only}
  • Bruce B, Lorig K, Laurent D, Ritter P. The impact of a moderated e-mail discussion group on use of complementary and alternative therapies in subjects with recurrent back pain. Patient Education and Counseling 2005;58(3):305-11.
Chambers 2006 {published data only}
  • Chambers A, Hennessy E, Powel-Tuck J. Longitudinal trends in quality of life after starting home parenteral nutrition: a randomised controlled study of telemedicine. Clinical Nutrition 2006;25(3):505-14.
Childs 2011 {published data only}
  • Childs JD, Teyhen DS, Van Wyngaarden JJ, Dougherty BF, Ladislas BJ, Helton GL, et al. Predictors of web-based follow-up response in the Prevention Of Low Back Pain In The Military Trial (POLM). BMC Musculoskeletal Disorders 2011;12(1):132.
Cleeland 2011 {published data only}
  • Cleeland CS, Wang XS, Shi Q, Mendoza TR, Wright SL, Berry MD, et al. Automated symptom alerts reduce postoperative symptom severity after cancer surgery: a randomized controlled clinical trial. Journal of Clinical Oncology 2011;29(8):994-1000.
de Bruijn-Kofman 1997 {published data only}
  • de Bruijn-Kofman AT, Van De Wiel H, Groenman NH, Sorbi MJ, Klip E. Effects of a mass media behavioral treatment for chronic headache: a pilot study. Headache 1997;37(7):415–20.
Everitt 2010 {published data only}
  • Everitt HA, Moss-Morris RE, Sibelli A, Tapp L, Coleman NS, Yardley L, et al. Management of irritable bowel syndrome in primary care: feasibility randomised controlled trial of mebeverine, methylcellulose, placebo and a patient self-management cognitive behavioural therapy website. (MIBS trial). BMC Gastroenterology 2010;10(1):136.
Everitt 2013 {published data only}
  • Everitt H, Moss-Morris R, Sibelli A, Tapp L, Coleman N, Yardley L, et al. Management of irritable bowel syndrome in primary care: the results of an exploratory randomised controlled trial of mebeverine, methylcellulose, placebo and a self-management website. BMC Gastroenterology 2013;13(1):68.
Fraenkel 2007 {published data only}
  • Fraenkel L, Rabidou N, Wittink D, Fried T. Improving informed decision-making for patients with knee pain. The Journal of Rheumatology 2007;34(9):1894-8.
Greco 2004 {published data only}
Hochlehnert 2006 {published data only}
  • Hochlehnert A, Richter A, Bludau HB, Bieber C, Blumenstiel K, Mueller K, et al. A computer-based information-tool for chronic pain patients. Computerized information to support the process of shared decision-making. Patient Education and Counseling 2006;61(1):92–8.
Huffstutter 2007 {published data only}
  • Huffstutter J, Craig WD, Schimizzi G, Harshbarger J, Lisse J, Kasle S, et al. A multicenter, randomized, open study to evaluate the impact of an electronic data capture system on the care of patients with rheumatoid arthritis. Current Medical Research and Opinion 2007;23(8):1967–79.
Jacobs 2013 {published data only}
  • Jacobs K, Foley G, Punnett L, Hall V, Gore R, Brownson E, et al. University students' notebook computer use: lessons learned using e-diaries to report musculoskeletal discomfort. Ergonomics 2013;54(2):206–19.
Jennings 2008 {published data only}
  • Jennings MB, Lesczczynski C, Goodwin S. The safety and efficacy of Pain Checker socks in the treatment of mild-to-moderate foot pain: a clinical trial. Journal of the American Podiatric Medical Association 2008;98(4):278-82.
Johns 2011 {published data only}
  • Johns SA, Kroenke K, Theobald DE, Wu J, Tu W. Telecare management of pain and depression in patients with cancer: patient satisfaction and predictors of use. The Journal of Ambulatory Care Management 2011;34(2):126–39.
Keulers 2007 {published data only}
  • Keulers BJ, Welters CFM, Spauwen PHM, Houpt P. Can face-to-face patient education be replaced by computer-based patient education? A randomised trial. Patient Education and Counseling 2007;67(1-2):176–82.
Kjeken 2011 {published data only}
  • Kjeken I, Darre S, Smedslund G, Hagen KB, Nossum R. Effect of assistive technology in hand osteoarthritis: a randomised controlled trial. Annals of the Rheumatic Diseases 2011;70(8):1447–52.
Kleiboer 2009 {published data only}
  • Kleiboer A, Sorbi M, Merelle S, Passchier J, van Doornen L. Utility and preliminary effects of online digital assistance (ODA) for behavioral attack prevention in migraine. Telemedicine Journal and e-Health 2009;15(7):682-90.
Kosterink 2010 {published data only}
  • Kosterink SM, Huis in 't Veld RM, Cagnie B, Hasenbring M, Vollenbroek-Hutten MM. The clinical effectiveness of a myofeedback-based teletreatment service in patients with non-specific neck and shoulder pain: a randomized controlled trial. Journal of Telemedicine and Telecare 2010;16(6):316-21.
Krein 2010 {published data only}
  • Krein S, Metreger T, Kadri R, Hughes M, Kerr EA, Piette JD, et al. Veterans walk to beat back pain: study rationale, design and protocol of a randomized trial of a pedometer-based internet mediated intervention for patients with chronic low back pain.. BMC Musculoskeletal Disorders 2010;11(1):205.
Kristjansdottir 2011 {published data only}
  • Kristjansdottir OB, Fors EA, Eide E, Finset A, Van Dulmen S, Wigers SH, et al. Written online situational feedback via mobile phone to support self-management of chronic widespread pain: a usability study of a Web-based intervention. BMC Musculoskeletal Disorders 2011;12(1):51.
Kristjansdottir 2013 {published data only}
  • Kristjansdottir OB, Fors EA, Eide E, Finset A, Stensrud T, van Dulmen S, et al. A smartphone-based intervention with diaries and therapist-feedback to reduce catastrophizing and increase functioning in women with chronic widespread pain: randomized controlled trial. Journal of Medical Internet Research 2013;15(1):e5.
  • Kristjansdottir OB, Fors EA, Eide E, Finset A, Stensrud TL, van Dulmen S, et al. A smartphone-based intervention with diaries and therapist feedback to reduce catastrophizing and increase functioning in women with chronic widespread pain. part 2: 11-month follow-up results of a randomized trial. Journal of Medical Internet Research 2013;15(3):e72.
Kroenke 2010 {published data only}
  • Kroenke K, Theobald D, Wu J, Norton K, Morrison G, Carpenter J, Tu W. Effect of telecare management on pain and depression in patients with cancer: a randomized trial. JAMA 2010;304(2):163-71.
Larsman 2010 {published data only}
  • Larsman P, Hasenbring M, Sandsjo L, Huis in 't Veld RM, Witvrouw E, Kosterink SM, et al. Prognostic factors for the effect of a myofeedback-based teletreatment service. Journal of Telemedicine and Telecare 2010;16(6):336-43.
Leboeuf-Yde 2012 {published data only}
  • Leboeuf-Yde C, Jensen RK, Axen I. Absence of low back pain in patients followed weekly over one year with automated text messages. Chiropractic & Manual Therapies 2012;20(9):1-7.
Leveille 2007 {published data only}
  • Leveille SG, Huang A, Tsai SB, Weingart SN, Iezzoni LI. Screening for chronic conditions using a patient internet portal: recruitment for an internet-based primary care intervention. Journal of General Internal Medicine 2007;23(4):472–5.
Leville 2009 {published data only}
  • Leveille SG, Huang A, Tsai SB, Allen M, Weingart SN, Iezzoni LI. Health coaching via an internet portal for primary care patients with chronic conditions: a randomized controlled trial. Medical Care 2009;47(1):41-7.
Lorig 2002 {published data only}
  • Lorig KR, Laurent DD, Deyo RA, Marnell ME, Minor MA, Ritter PL. Can a Back Pain E-mail Discussion Group improve health status and lower health care costs?: A randomized study. Archives of Internal Medicine 2002;162(7):792-6.
Lorig 2006 {published data only}
Macedo 2012 {published data only}
Miller 2010 {published data only}
  • Miller DM, Moore SM, Fox RJ, Atreja A, Fu AZ, Lee JC, et al. Web-based self-management for patients with multiple sclerosis: a practical, randomized trial. Telemedicine Journal and e-Health 2010;17(1):5-13.
Naylor 2008 {published data only}
Naylor 2010 {published data only}
  • Naylor MR, Naud S, Keefe FJ, Helzer JE. Therapeutic Interactive Voice Response (TIVR) to reduce analgesic medication use for chronic pain management. The Journal of Pain 2010;11(12):1410-9.
Oerlemans 2011 {published data only}
  • Oerlemans S, van Cranenburgh O, Herremans PJ, Spreeuwenberg P, van Dulmen S. Intervening on cognitions and behavior in irritable bowel syndrome: a feasibility trial using PDAs. Journal of Psychosomatic Research 2011;70(3):267-77.
Premi 1993 {published data only}
Russell 2011 {published data only}
  • Russell TG, Buttrum P, Wootton R, Jull GA. Internet-based outpatient telerehabilitation for patients following total knee arthroplasty: a randomized controlled trial. The Journal of Bone and Joint Surgery 2011;93(2):113-20.
Sandsjo 2010 {published data only}
  • Sandsjo L, Larsman P, Huis in 't Veld RM, Vollenbroek-Hutten MM. Clinical evaluation of a myofeedback-based teletreatment service applied in the workplace: a randomized controlled trial. Journal of Telemedicine and Telecare 2010;16(6):329-35.
Sciamanna 2006 {published data only}
Spunt 1996 {published data only}
Steel 2011 {published data only}
  • Steel J, Geller DA, Tsung A, Marsh JW, Dew MA, Spring M, et al. Randomized controlled trial of a collaborative care intervention to manage cancer-related symptoms: lessons learned. Clinical Trials 2011;8(3):298-310.
Taieb-Maimon 2012 {published data only}
  • Taieb-Maimon M, Cwikel J, Shapira B, Orenstein I. The effectiveness of a training method using self-modeling webcam photos for reducing musculoskeletal risk among office workers using computers. Applied Ergonomics 2012;43(2):376-85.
Vonk Noordegraaf 2012 {published data only}
  • Vonk Noordegraaf A, Huirne JA, Brolmann HA, Emanuel MH, van Kesteren PJ, Kleiverda G, et al. Effectiveness of a multidisciplinary care program on recovery and return to work of patients after gynaecological surgery; design of a randomized controlled trial. BMC Health Services Research 2012;12(1):29.
Weingart 2008 {published data only}
  • Weingart SN, Hamrick HE, Tutkus S, Carbo A, Sands DZ, Tess A, et al. Medication safety messages for patients via the web portal: the MedCheck intervention. International Journal of Medical Informatics 2008;77(3):161-8.

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. Additional references
Bailey 2010
Bender 2011
  • Bender JL, Radhakrishnan A, Diorio C, Englesakis M, Jadad AR. Can pain be managed through the Internet? A systematic review of randomized controlled trials. Pain 2011;152(8):1740-50.
Black 2011
Bodenheimer 2002
Breivik 2006
Civljak 2013
Cuijpers 2008
Currell 2000
  • Currell R, Urquhart C, Wainwright P, Lewis R. Telemedicine versus face to face patient care: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2000, Issue 2. [DOI: 10.1002/14651858.CD002098]
Dworkin 2005
  • Dworkin RH, Turk DC, Farrar JT, Haythornthwaite JA, Jensen MP, Katz NP, et al. Core outcome domains for chronic pain clinical trials: IMMPACT recommendations. Pain 2005;113(1-2):9-19.
Fu 2003
  • Fu D, Fu H, McGowan P, Sehn YE, Zhu L, Yang H, et al. Implementation and quantitative evaluation of chronic disease self-management programme in Shanghai, China: randomized controlled trial. Bulletin of the World Health Organization 2003;81(3):174-82.
Gatchel 2007
  • Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychological Bulletin 2007;133(4):581-624.
Griffiths 2010
  • Griffiths KM, Farrer L, Christensen H. The efficacy of internet interventions for depression and anxiety disorders: a review of randomised controlled trials. The Medical Journal of Australia 2010;192(11 (Suppl)):S4-11.
Hardiker 2011
Higgins 2011
  • Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from
Jennett 2003
  • Jennett PA, Affleck Hall L, Hailey D, Ohinmaa A, Anderson C, Thomas R, et al. The socio-economic impact of telehealth: a systematic review. Journal of Telemedicine and Telecare 2003;9(6):311-20.
Jordan 2007
Keogh 2010
King 2011
  • King S, Chambers CT, Huguet A, MacNevin RC, McGrath PJ, Parker L, et al. The epidemiology of chronic pain in children and adolescents revisited: a systematic review. Pain 2011;152(12):2729–38.
Lewis 2004
Macea 2010
  • Macea DD, Gajos K, Calil YAD, Fregni F. The efficacy of web-based cognitive behavioural interventions for chronic pain: a systematic review and meta-analysis. The Journal of Pain 2010;11(10):917-29.
Martin 2008
McLean 2010
McLean 2011
Pal 2013
Palermo 2009
  • Palermo TM, Wilson AC, Peters M, Lawandowski A, Somhegyi H. Randomized controlled trial of an internet-delivered family cognitive-behavioral therapy intervention for children and adolescents with chronic pain. Pain 2009;146(1-2):205-13.
RevMan 2011 [Computer program]
  • The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Sandgren 2000
  • Sandgren AK, McCaul KD, King B, O'Donnell S, Foreman G. Telephone therapy for patients with breast cancer. Oncology Nursing Forum 2000;27(4):683-8.
Spek 2007
  • Spek V, Cuijpers P, Nyklicek I, Riper H, Keyzer J, Pop V. Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychological Medicine 2007;37(3):319-28.
Standford 2008
Tuntland 2009
Velleman 2010
  • Velleman S, Stallard P, Richardson T. A review and meta-analysis of computerized cognitive behaviour therapy for the treatment of pain in children and adolescents. Child: Care, Health and Development 2010;36(4):465-72.
Whitten 2007
  • Whitten P, Johannessen LK, Soerensen T, Gammon D, Mackert M. A systematic review of research methodology in telemedicine studies. Journal of Telemedicine and Telecare 2007;13(5):230-5.
Williams 2012