Therapy Boosts Functioning in Fibromyalgia

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Therapy Boosts Functioning in Fibromyalgia

By Alison McCook

07/10/2002 — NEW YORK (Reuters) - 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.