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Treating pain in fibromyalgia

Issue 30 Synovium (Summer 2010)

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Although cognitive behavioural therapy (CBT) has been shown to be effective in treating patients with chronic pain syndromes, often it can be difficult for patients to engage in psychological treatments. Many patients cling to the notion of cure and continue to seek the investigation that will reveal the occult cause of their problem or the specialist who will have the definitive answer. They may perceive psychological treatments as substitutes for definitive treatments and hence value them less. A study published in Arthritis Care and Research1 may help change this perception. The study found that CBT administered to fibromyalgia patients can reduce nociceptor sensitivity as measured by electrophysiological techniques (far too complex to explain here!). Even more interestingly the CBT interventions were delivered by weekly telephone calls for a period of 6 weeks. This was a small study of only 32 patients but, if supported by further and larger studies, may help convince both physicians and patients that CBT is a ‘real’ treatment and targets the underlying disorder of nociceptor sensitivity.

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