(PS12-C52) Effectiveness of Body-image Based Interventions in Chronic Pain for Reducing Pain, Interference and Emotional Distress: A Systematic Review

Title: "Effectiveness of body-image based interventions in chronic pain for reducing pain, interference and emotional distress: a systematic review"

Chronic pain is a significant public health problem affecting a large percentage of the population in United States (18%-34,5%) and Europe (27%). Nowadays, there is a broad consensus on the need to address chronic pain from a biopsychosocial perspective, including both pharmacological and non-pharmacological strategies which have shown moderate to good results (Park & Moon, 2010; Skelly et al., 2020). Even though there is still room for improvement. One promising avenue for intervention involves addressing body image concerns, which have been shown to be prevalent among people with chronic pain and can exacerbate pain and relate symptoms. Therefore, targeting body image modification as part of the treatment for patients with chronic pain may be beneficial in reducing pain, interference and emotional distress.

The aim of this study is to conduct a systematic review to gather evidence on the effect of non-pharmacological strategies (such as psychotherapy, physiotherapy) in reducing pain, interference and emotional distress by modifying body image related variables.

The study followed PRISMA guidelines and Cochrane Risk of Bias tool. The search was conducted on PubMed, PsycINFO and WebOfScience using keywords related to chronic pain, body image, intervention, pain interference and emotional distress. Two independent groups of reviewers reviewed the papers, and a third researcher acted as a judge in case of disagreement. The following inclusion criteria were followed: 1. Articles in English/Spanish/Italian/Portuguese; 2. Full text available; 3. Body Image-based intervention; 4. Chronic pain patients; 5. Non-pharmacological interventions. The study was registered on PROSPERO: CRD42022370718.

The database search identified 2592 papers. After removing duplicates, and articles that did not meet the criteria, 194 full-text articles were included. Most of the interventions were in the field of physiotherapy, although there were also other types of interventions like psychological intervention (such as CBT, positive body image, mindfulness), and other interventions (such as dance, yoga, and Pilates). Overall, the findings suggest that these interventions were effective in modifying body image and reducing pain intensity, interference, and emotional distress.

These findings show the broad variety of non-pharmacological strategies for chronic pain that positively modify Body Image and also have a positive impact on pain, interference and emotional distress.