Chronic musculoskeletal pain (CMSP) is one of the most pressing medical and social issues, leading to disability and a reduced quality of life. Given the limited efficacy and potential risks of side effects associated with traditional pharmacotherapy, psychological methods are becoming an essential component of multidisciplinary patient management.

Objective: To summarize and systematize current scientific data on psychological methods of CMSP therapy, taking into account modern neurobiological advances, clinical guidelines, and the evidence base. A review of publications in the PubMed, Scopus, Web of Science, and Google Scholar databases for the period of 2015-2026 was conducted.

Diagnostic approaches were examined, including the identification of "red flags" and psychological screening using validated scales such as PCS, HADS, TSK, GSE, and CSI. The critical role of the therapeutic alliance was emphasized. Cognitive-behavioral therapy (CBT) was analyzed in detail as the "gold standard" (level of evidence A), along with acceptance and commitment therapy (ACT), mindfulness practices (MBSR, MBCT), relaxation, behavioral activation, and selfmanagement strategies.

A comparative analysis of the methods was performed based on their level of evidence, mechanisms of action, and clinical efficacy. An original algorithm for selecting psychological interventions depending on the patient’s clinical and psychological profile was proposed. The potential of digital therapeutic solutions (telehealth, mobile applications, digital CBT) was outlined. It was demonstrated that combined programs pairing physical therapy with psychological methods significantly improve pain thresholds and reduce central sensitization.

Research gaps were identified, including the need to determine the optimal "dose" of psychotherapy, investigate long-term outcomes, and phenotype patients. The integration of psychological methods is a necessary component for the effective management of patients with CMSP.