Impact of physical therapy techniques and common interventions on sleep quality in patients with chronic pain: A systematic review

Santiago Navarro-Ledesma; Dina Hamed-Hamed; Ana Gonzalez-Muñoz; Leo Pruimboom

doi:10.1016/j.smrv.2024.101937

Impact of physical therapy techniques and common interventions on sleep quality in patients with chronic pain: A systematic review

Sleep Med Rev. 2024 Apr 15:76:101937. doi: 10.1016/j.smrv.2024.101937. Online ahead of print.

Authors

Santiago Navarro-Ledesma¹, Dina Hamed-Hamed², Ana Gonzalez-Muñoz³, Leo Pruimboom⁴

Affiliations

¹ Department of Physical Therapy, Faculty of Health Sciences, Campus of Melilla, University of Granada, Spain; University Chair in Clinical Psychoneuroimmunology (University of Granada and PNI Europe), Spain. Electronic address: snl@ugr.es.
² Clinical Medicine and Public Health PhD Program, Faculty of Health Sciences, University of Granada, Granada, Spain.
³ Clinical Medicine and Public Health PhD Program, Faculty of Health Sciences, University of Granada, Granada, Spain; Clinica Ana Gonzalez, Avenida Hernan Nuñez de Toledo 6, 29018, Malaga, Spain.
⁴ University Chair in Clinical Psychoneuroimmunology (University of Granada and PNI Europe), Spain.

PMID: 38669729
DOI: 10.1016/j.smrv.2024.101937

Abstract

This systematic review aims to find effectful healthcare strategies, with special focus on drug-free interventions and physical therapy, as part of the treatment for sleep in patients with chronic musculoskeletal pain. Data search was conducted across seven scientific databases. This review is deposited in the Prospero International prospective register of systematic reviews (CRD42023452574). Seventeen RCTs from different healthcare fields complied with our inclusion criteria. Two RCTs investigated manual therapy, five RCTs therapeutic exercise, one RCT Fu's subcutaneous needling, two RCTs physical agents (one on balneotherapy and one on cryo-stimulation), two RCTs cognitive-behavioral therapy, and four RCTs pharmacological therapy and their effect on sleep quality and/or quantity in patients suffering from chronic pain. We included the four RCT's in this systematic review with the purpose to be able to compare natural interventions with allopathic ones. As allopathic interventions are more prone to have secondary negative effects than physical therapy, compare the two types of interventions could be in favor of choosing the most effective treatment with the least secondary negative effects. Additionally, two RCTs on neurofeedback and limbic neuromodulation were also included. The results of the included studies suggest that strategies such as manual therapy, therapeutic exercise, Fu's subcutaneous needling, balneotherapy, cryo-stimulation, neurofeedback, limbic neuromodulation, cognitive-behavioral therapy, and pharmacological therapies have positive effects on patients suffering from chronic pain and sleep disturbances, especially when they suffer musculoskeletal pain. Secondary negative effects were found for the possible overuse of certain medicines such as morphine, a huge problem in the United States. Sleep deficiency is an independent risk factor for many diseases, including chronic pain syndrome and therefore more studies are needed to find non-toxic interventions for people suffering sleep disorders associated with systemic diseases and pain.

Keywords: Chronic musculoskeletal pain; Circadian rhythms; Physical therapy; Sleep; Sleep disturbances; Sleep medicine.

Publication types

Review