APA Clinical Practice Guideline for Psychological and Other Nonpharmacological Treatment of Chronic Musculoskeletal Pain in Adults - guideline development panel

Sep 18, 2026

The American Psychological Association developed a clinical practice guideline offering recommendations for nonpharmacological treatment of chronic musculoskeletal pain in adults. The evidence base includes three systematic reviews and meta-analyses, supported by additional literature and real-world observations from practitioners and patients. The guideline development panel comprised health professionals across psychology and related fields, together with community members living with this condition. The work evaluates the efficacy of noninvasive, nonpharmacological and complementary/integrative approaches, and compares their effectiveness across treatment combinations and selected nonopioid pharmacologic options.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages146

Reading Time6 h 8 min

AccessFree to download

Abstract

Intended Use of Guidelines

Executive Summary

Treatment Recommendations

First-Line Recommendations

Second-Line Recommendations

Other Treatments Reviewed

Implementation Considerations

Recommendations for Research

Background and Justification: The Scope of the Problem

Process and Methods for the CPG

Discussion

Conclusion

Conflicts of Interest

Developer and Funding Source / Sponsor

Acknowledgements

References

Appendix A : Descriptions of Treatments

Appendix B: Definition of Key Terms

Appendix C: APA Declarations / Conflicts of Interest Form

APA CLINICAL PRACTICE GUIDELINE for Psychological and Other Nonpharmacological Treatment of Chronic Musculoskeletal Pain in Adults GUIDELINE DEVELOPMENT PANEL FOR THE TREATMENT OF CHRONIC MUSCULOSKELETAL PAIN IN ADULTS APPROVED BY APA COUNCIL OF REPRESENTATIVES AUGUST 2024 Copyright © 2024 by the American Psychological Association. This material may be reproduced and distributed without permission provided that acknowledgment is given to the American Psychological Association. This material may not be reprinted, translated, or distributed electronically without prior permission in writing from the publisher. For permission, contact APA, Rights and Permissions, 750 First Street, NE, Washington, DC 20002-4242. Suggested Citation American Psychological Association. (2024) . APA Clinical practice guideline for psychological and other nonpharmacological treatment of chronic musculoskeletal pain in adults. [https://www.apa.org/practice/guidelines/nonpharmacological-treatment-chronic-musculoskeletal-pain.pdf](https://www.apa.org/practice/guidelines/nonpharmacological-treatment-chronic-musculoskeletal-pain.pdf) This document was approved by the APA Council of Representatives over the course of its August 2024 meeting and is set to expire in approximately 2034. It is available online at [https://www.apa.org/practice/guidelines/nonpharmacological-treatment-chronic-musculoskeletal-pain.pdf](https://www.apa.org/practice/guidelines/nonpharmacological-treatment-chronic-musculoskeletal-pain.pdf) [Please refer to p. 41 of this guideline for a statement on conflicts of interest as well as p. 44 for acknowledgements.](Please refer to p. 41 of this guideline for a statement on conflicts of interest as well as p. 44 for acknowledgements.) Correspondence regarding this guideline should be addressed to Practice Directorate, American Psychological Association, 750 First Street, NE, Washington, DC, 20002-4242, United States. Email: [cpg@apa.org](cpg@apa.org) APA CLINICAL PRACTICE GUIDELINE for Psychological and Other Nonpharmacological Treatment of Chronic Musculoskeletal Pain in Adults GUIDELINE DEVELOPMENT PANEL FOR THE TREATMENT OF CHRONIC MUSCULOSKELETAL PAIN IN ADULTS Members of the Guideline Development Panel for the Treatment of Chronic Musculoskeletal Pain in Adults Ravi Prasad (chair) Department of Anesthesiology and Pain Medicine, University of California, Davis School of Medicine Kathryn L. Mueller (vice-chair) Department of Environmental & Occupational Health, University of Colorado School of Public Health Daniel Bruns Greeley Colorado, United States John G. Cagle University of Maryland, Baltimore School of Social Work Penney Cowan World Patients Alliance, Rocklin, California, United States Steven Z. George Department of Orthopaedic Surgery, Population Health Sciences, and Duke Clinical Research Institute, Duke University Geraldine Martorella College of Nursing, Florida State University Cindy A. McGeary Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center San Antonio Lt. Col. Joseph T. Norris, Jr., USAF, Ret. Los Angeles, California, United States Michael E. Schatman Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU Grossman School of Medicine. APA staff Raquel Halfond Practice Directorate JacobS. Marzalik Practice Directorate GUIDELINE FOR PSYCHOLOGICAL AND OTHER NONPHARMACOLOGICAL TREATMENT OF CHRONIC MUS CULO SKELETAL PAIN IN ADULTS AMERICAN PSYCHOLOGICAL ASSOCIATION I TABLE OF CONTENTS Abstract 1 Intended Use of Guidelines 2 Executive Summary 3 Treatment Recommendations 6 First-Line Recommendations 7 Second-Line Recommendations 8 Other Treatments Reviewed 9 Implementation Considerations 11 Recommendations for Research 12 Background and Justification: The Scope of the Problem 13 The APA Clinical Practice Guideline for the Treatment of the Problem 16 Process

FAQs

What is the document’s purpose?

It provides recommendations for nonpharmacological treatment of chronic musculoskeletal pain in adults.

What evidence informed the guideline?

Three systematic reviews and meta-analyses, along with other literature and observations from practitioners and patients, served as the basis.

Who participated in developing the guideline?

A guideline development panel included health professionals from multiple disciplines plus community members who self-identified as having chronic musculoskeletal pain.

Sep 18, 2026

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