{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T09:15:31Z","timestamp":1793438131587,"version":"4.5.0"},"reference-count":63,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,2,7]],"date-time":"2019-02-07T00:00:00Z","timestamp":1549497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Psychosocial risk factors associated with chronic orofacial pain are amenable to self\u2010management. However, current management involves invasive therapies which lack an evidence base and has the potential to cause iatrogenic harm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine: (a) whether self\u2010management is more effective than usual care in improving pain intensity and psychosocial well\u2010being and (b) optimal components of self\u2010management interventions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Databases and data treatment<\/jats:title><jats:p>Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycINFO, WHO International Clinical Trials Registry Platform and Clinical Trials.gov were searched. Meta\u2010analysis was used to determine effectiveness, and GRADE was used to rate quality, certainty and applicability of evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fourteen trials were included. Meta\u2010analyses showed self\u2010management was effective for long\u2010term pain intensity (standardized mean difference [SMD] \u22120.32, 95% confidence interval [CI] \u22120.47 to \u22120.17) and depression (SMD \u22120.32, 95% CI \u22120.50 to \u22120.15). GRADE analysis showed a high score for certainty of evidence for these outcomes and significant effects for additional outcomes of activity interference (\u22120.29 95% CI \u22120.47 to \u22120.11) and muscle palpation pain (SMD \u22120.58 95% CI \u22120.92 to \u22120.24). Meta\u2010regression showed nonsignificant effects for biofeedback on long\u2010term pain (\u22120.16, 95% CI \u22120.48 to 0.17, <jats:italic>p<\/jats:italic>\u2010value\u00a0=\u00a00.360) and depression (\u22120.13, 95% CI \u22120.50 to 0.23, <jats:italic>p<\/jats:italic>\u2010value\u00a0=\u00a00.475).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Self\u2010management interventions are effective for patients with chronic orofacial pain. Packages of physical and psychosocial self\u2010regulation and education appear beneficial. Early self\u2010management of chronic orofacial pain should be a priority for future testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>This systematic review provides clear evidence for effectiveness of combined biomedical and psychological interventions (incorporating self\u2010management approaches) on long\u2010term outcomes in the management of chronic orofacial (principally TMD) pain. Self\u2010management should be a priority for early intervention in primary care in preference to invasive, irreversible and costly therapies. Further research is needed firstly to clarify the relative effectiveness of specific components of self\u2010management, both individually and in conjunction, and secondly on outcomes in other types of chronic orofacial pains.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.1358","type":"journal-article","created":{"date-parts":[[2019,1,9]],"date-time":"2019-01-09T06:11:38Z","timestamp":1547014298000},"page":"849-865","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["The effectiveness of self\u2010management interventions in adults with chronic orofacial pain: A systematic review, meta\u2010analysis and meta\u2010regression"],"prefix":"10.1002","volume":"23","author":[{"given":"Vishal R.","family":"Aggarwal","sequence":"first","affiliation":[{"name":"Faculty of Medicine &amp; Health, School of Dentistry University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Fu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine &amp; Health, School of Healthcare University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris J.","family":"Main","sequence":"additional","affiliation":[{"name":"Research Institute for Primary Care &amp; Health Keele University Keele UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhua","family":"Wu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine &amp; Health, School of Dentistry University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"crossref","unstructured":"Aggarwal V. 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