Behavior Therapy Boosts Functioning in Fibromyalgia

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Behavior Therapy Boosts Functioning in Fibromyalgia

Wed Jul 10,10:43 AM ET

By Alison McCook

NEW YORK (Reuters Health) - Patients with fibromyalgia who received a short

program of cognitive behavioral therapy were more likely to show

improvements in functioning after the treatment than those who were not

given the therapy, according to new research.

However, patients who had the therapy reported no less pain than others, the

authors note.

Fibromyalgia is a chronic condition marked by widespread muscular and joint

pain, as well as specific " tender " points that typically occur in the neck,

spine, hips and shoulders. Other symptoms include sleep disturbances and

fatigue, depression and irritable bowel syndrome. The condition affects an

estimated 2% to 4% of the population, but is seen most often in women of

reproductive age.

Cognitive behavioral therapy seeks to help patients deal with problems by

focusing on self-control and coping strategies.

During the study, 145 patients with fibromyalgia were given standard

treatment for the condition, which included antidepressants, pain-relievers

and instructions about exercise. Half of the patients also enrolled in six

sessions of cognitive behavioral therapy, conducted over a 4-week period.

In this study, cognitive behavioral therapy consisted of six hour-long group

sessions with an experienced therapist that focused on teaching patients

skills to improve their physical functioning. During the sessions, the

therapist instructed patients on how to relax their muscles, increase their

functioning without increasing their pain, and manage the negative thoughts

and beliefs that can affect their functioning.

One year after the treatment ended, patients reported how much pain they

were experiencing and their levels of physical functioning.

The investigators found that 25% of patients who had behavioral therapy

experienced a significant increase in physical functioning after the

treatment, an improvement seen in only 12% of patients who did not receive

it. Both groups of patients had the same pain levels one year after the

treatment, according to the report in the recent issue of the Journal of

Rheumatology.

In an interview with Reuters Health, lead author Dr. A. of

the University of Michigan in Ann Arbor--who was at town University in

Washington, DC at the time of the study--said that cognitive behavioral

therapy (CBT) may help some aspects of fibromyalgia, but not others.

Fibromyalgia " is thought to be the result of many bodily systems becoming

dysregulated, " explained. " Therefore, there are probably many

subtypes of (fibromyalgia) depending upon how the body has become

dysregulated. CBT may work better for some types of dysregulation than for

others, " he added.

Indeed, previous studies of CBT in fibromyalgia have shown mixed results,

perhaps due to changes in how the therapy was administered, noted.

For example, CBT can focus on functional status, pain, or psychological

well-being, he pointed out.

" Therefore, while all have been called CBT, each has actually been quite

different in terms of skills taught, length of treatment and focus of

treatment, " he said.

One of the next steps is to see whether longer periods of CBT produce better

results, added.

SOURCE: The Journal of Rheumatology 2002;29:1280-1286.