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Chronic pain patients offered exercise on prescription in major new clinical trial

Published on 01 May 2007

Patients suffering from chronic pain are to be offered free exercise on prescription at their local gyms as part of a major new clinical trial aimed at developing more effective ways of reducing their painful symptoms.

More than 500 people suffering from chronic widespread pain, which currently affects ten per cent of the population and is extremely difficult to treat, will also be offered cognitive behavioural therapy (CBT) over the phone by trained therapists. CBT is a psychological method of helping people managing their pain by identifying and evaluating thoughts and behaviour.

Patients aged between 25 and 60 from GP practices in Macclesfield in Cheshire and Aberdeen will be recruited onto the trial, which is being run at the Universities of Aberdeen and Manchester and funded by a three-year £600,000 grant from the Arthritis Research UK.

Chronic widespread pain is the main symptom of fibromyalgia, which also causes tenderness around the body, extreme fatigue and sleep disturbance.

“Chronic widespread pain is one of the most common reasons for referral from the GP to the rheumatologist,” explained principal investigator Gary MacFarlane, Professor of Epidemiology at University of Aberdeen’s department of public health, who is heading a large team of doctors, physiotherapists and statisticians from both universities.

“Symptoms tend to be permanent, and GPs and rheumatologists struggle to manage and treat it. We think there is a real need to tackle this problem and to evaluate various types of treatment at primary care level that are potentially available to a large number of patients, and inexpensive to provide.”

Patients will be split into groups; one group doing exercise, a second receiving CBT, and a third group a combination of both. Their progress will be measured against another group who will be given the “usual care” from their GP, which may be painkillers.

Patients taking part in the exercise arm of the trial will be expected to attend the gym at least twice a week for up to nine months and will be assigned their own personal trainer to develop an exercise plan aimed at improving aerobic fitness by using a treadmill, exercise bike, rowing machine or cross-trainer. They will also be encouraged to try strength and flexibility training as well.

Those receiving CBT will have an initial hour-long assessment over the phone by a trained therapist, followed by seven weekly half hourly sessions and two further sessions at three months and six months. The therapy is being delivered over the phone as there is a shortage of trained therapists to undertake face-to-face work.

Before recruitment can start the team will survey 40,000 patients from GP practices in Macclesfield and Aberdeen to identify people with the condition, who will then be assessed for eligibility.

Yoga aids chronic back pain sufferers

Participants in the yoga trial

Yoga can provide more effective treatment for chronic lower back pain than more conventional methods, according to the UK’s largest ever study into the benefits of yoga.

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