Effectiveness of motor imagery techniques in the treatment of chronic musculoskeletal pain: A scoping review

Recent neurophysiological studies provide evidence that motor imagery techniques, as a non-pharmacological intervention, reduce the perception of pain intensity at the cortical level and can therefore be used in clinical practice in patients with chronic musculoskeletal pain (CMP). The aim of this scoping review was to evaluate recent randomised controlled trials on the effect of motor imagery techniques for the relief of CMP. Four databases (PubMed, Scopus, Proquest, Cochrane Clinical Trials) were searched to identify randomised controlled trials on the effect of motor imagery techniques on the subjective intensity of musculoskeletal pain lasting for > 3 months in adults. Ten trials (349 participants) were identified for inclusion in this scoping review conducted following the PRISMA-ScR guidelines. The majority of the included studies showed that the motor imagery techniques reduced pain intensity in patients with CMP (namely in patients with post-traumatic phantom limb pain, adhesive capsulitis, impingement syndrome and non‑specific neck pain). immediately after therapeutic sessions, compared with control groups, and also in follow-up measurements up to a few months after baseline measurement. The motor imagery techniques used in the therapeutic sessions lasted more than four weeks, with at least three sessions of at least ten minutes each performed per week. The main limitations were the lack of high‑quality, double‑blind evidence with sufficient numbers of participants. This review summarises randomised controlled trials and shows that motor imagery techniques have considerable potential for the relief of CMP. High-quality evidence is needed to further support the use of motor imagery in clinical practice.