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Can “talking therapy” prevent chronic pain taking hold?

Published on 11 March 2016
Source: Arthritis Today

Arthritis Today Spring 2016 Number 169

An older man talking on a mobileWe’re all too aware of the devastating impact chronic pain has on people’s lives. Chronic pain is the most common symptom of fibromyalgia, a condition which affects around 1 in every 25 people. Yet we still understand relatively little about its causes and how to help people suffering with it.

We believe that needs to change, so we’re investing heavily in innovative research to build our understanding of what’s behind chronic pain and develop new, improved treatments with the potential to transform quality of life for millions of people.

Just one of the many research studies we're funding in this area is exploring if cognitive behavioural therapy (CBT), also known as “talking therapy”, could be the answer to preventing chronic widespread pain. Scientists at the University of Aberdeen believe it could be after their breakthrough research found people living with chronic pain reported long-lasting improvements in their symptoms after receiving CBT.

The team is now taking its research one step further with a trial to test whether “talking therapy” can actually prevent the onset of chronic widespread pain in people identified as being at high risk of developing the condition.

Compelling evidence CBT improves quality of life

We asked Professor Gary Macfarlane, who's leading the study, to explain more:

"Scientific research tells us the brain plays a significant role in people’s experience of pain. Our work isn't suggesting pain is all in the mind, far from it. Fibromyalgia has been a major focus of my research for many years, so I've seen the negative impact it can have on family life, on careers and on physical and emotional health. But through our research we’ve found compelling evidence that CBT has hugely improved quality of life for many people with chronic widespread pain, by teaching them techniques to cope with what they're feeling.

"Our earlier findings were seen as a breakthrough as we got good results for people living with a painful condition which is notoriously difficult to treat. This led us to think "if we can treat this condition with CBT, can we prevent it?". So we’re now working to find out if early intervention can actually prevent or change the course of how pain symptoms develop in people at high risk of experiencing chronic widespread pain.”

The four-year study will involve 1,000 people from across Scotland. Each person will have visited their GP with musculoskeletal pain and reported additional symptoms indicating they may be at risk of chronic widespread pain. Half of those taking part in the trial will receive six CBT sessions on the phone with a trained therapist over a six-week period, plus booster sessions three and six months later. The half in the control arm of the trial will receive the care their doctor would normally provide.

The research team will then determine how many people have developed chronic widespread pain at key points during and after the trial, looking at any differences between the two treatment groups.

Breaking the vicious circle of symptoms and feelings

Professor Macfarlane says: "The CBT sessions address how people feel, both physically and emotionally. Chronic pain can make people feel anxious, stressed, lose their appetite or suffer from insomnia which can result in a vicious circle of symptoms and feelings.

"People who’ve received CBT tell us it's helped to change the way they feel about pain and allows them to take control over the impact it’s having on their quality of life.

"This research is happening alongside studies to try to understand the underlying biological factors in people developing chronic widespread pain and fibromyalgia. We’re researching genetic and hormonal factors, as well as how the body reacts to stressful situations, in a bid to understand more about this disease.

"But while we’re doing that we believe it’s vital, through pioneering research like this, to find ways to prevent people at risk from developing symptoms and to provide the best possible care for people living in pain right now.”

Read more about living with fibromyalgia.

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