Washington – Talk Therapy by Phone May Ease Fibromyalgia: Study

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    Washington – Talk therapy done over the phone helped some people suffering chronic fibromyalgia-related pain to feel better in a study that looked at phone therapy as a potential cost-effective alternative to standard treatments.

    Researchers found that about one-third of people who had cognitive behavioral therapy, or CBT phone sessions felt “much better” or “very much better” after a few months, compared to less than one in ten who continued their usual treatment.

    “There’s no doubt that cognitive behavioral therapy can be very helpful in people managing chronic pain,” said Kevin Fontaine, a fibromyalgia researcher from the Johns Hopkins University School of Medicine in Baltimore, Maryland.

    However, “One of the difficulties with any sort of intervention with people that have fibromyalgia is sticking to it. This idea of delivering it via a phone call… has a lot of appeal to it,” Fontaine, who wasn’t involved in the new study, told Reuters Health.

    CBT helps patients understand how their thoughts and attitudes affect how they feel and how they respond to situations — then addresses practical steps they can take to improve negative thoughts and outcomes.

    While the technique has shown success in patients with fibromyalgia, as well as other types of chronic pain, depression and anxiety disorders, CBT isn’t available everywhere and can be expensive — starting at around $100 for an hour-long session.

    “One of the major, major problems with CBT is access to the therapists themselves,” said John McBeth from the University of Manchester in the UK, who worked on the study.

    Doing CBT over the phone would solve the problem of availability and sessions could be shorter and cheaper, researchers proposed.

    The current study involved 442 people in the UK with chronic widespread pain. Patients either had 10 telephone CBT sessions with a therapist, or were given free sessions with a fitness instructor and recommended to exercise regularly, or they did both CBT and the exercise program. A comparison group had no changes in their usual fibromyalgia treatment.

    Before and after six months of those programs, all the participants answered questions about their general health, quality of life and pain.

    By the end of the CBT and exercise sessions, about 33 percent of people who’d had one or both of the treatments said they were feeling at least “much better” than before the study started. That compared to only eight percent in the treatment-as-usual group.

    For the most part, those benefits held up for another three months after treatments ended. Only a quarter of people in the exercise-only group felt better at the nine-month, mark, though, and many are likely to have stopped exercising by that point, the researchers note.

    Despite the overall improvements in well-being some reported, participants didn’t get any added benefit from CBT or exercise for specific pain symptoms, McBeth and his colleagues write in the Archives of Internal Medicine. Most of the treatments’ benefits related to fatigue and how subjects coped with their pain.

    McBeth added that while a cost analysis found that talk therapy was “marginally more expensive than we would have hoped for” given its benefits, his team is planning to look into strategies to cut its costs.

    A few drugs are approved to treat fibromyalgia, including Cymbalta, Savella and Lyrica — but a combination of talk therapy and exercise remains the treatment of choice, McBeth said.

    Fibromyalgia “is primarily a pain condition, but it also has a lot of disorders that co-occur with it. There’s a lot of fatigue and gastrointestinal symptoms,” he told Reuters Health. “There isn’t one magic bullet that will target all those symptoms.”

    Fontaine said as far as he knows, telephone CBT is not currently available to most fibromyalgia patients outside of research studies. But that could change, he added.

    “If it’s demonstrated to work and demonstrated to be cost-effective, it would probably be something that would begin to be used quite regularly in the clinical setting,” Fontaine said.

    “This study certainly suggests that it could have a clinical value and it that it could be used more routinely with these types of patients.”

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    8 COMMENTS

    1. I, As a patient myself of a lot of suffering and pain, went to a lot of therapists and paidlots of dollars, but in the meantime I can understand why a person would feel its easier to talk on phone cuz its easier to talk ur heart out sometimes cuz u don’t see the therapist and u feel ur talking to a person that can’t see u, but again when u go to the therapist u feel he is listening to you and only focusing on u, the main thing is we should all end our worries and moshiach should come and we should go together with him to jerusalem…

      • Dear DarlingMommy,

        I completely know your pain! I was recently diagnosed with fibromyalgia not long ago myself!

        But only after going to multiple doctors, and spending 5 years trying to figure out what’s wrong with me! Multiple x-rays, cat-scans, & at least one MRI. 2 stints of physical therapy, and 3 procedures on my back later… all for nothing! Because other than just a bit of degenerative arthritis in my back, there’s NOTHING else wrong with me, other than the fibromyalgia!

        And look at all the money, time, wasted efforts, tears I cried trying to figure out why at 32 I hurt so bad all over my back & legs! I practically bankrupted my family just by myself trying to get to the bottom of all this stuff! It’s terrible!

        I can understand your sentiments, and I share them completely! I too cannot wait until the day the Moshiach arrives, and we *ALL* begin to feel much, much better! It’s going to be en everlasting day that won’t have even a MOMENT of pain in it!

        Praise G-d!

        (:-D

      • I hope you feel better and can find the right therapist for you! It is nothing against you or the therapist- there is a relationship that needs to be built. If you do not feel comfortable talking in person, odds are the therapist is not the correct one for you. Similar to shidduchim- both sides can be great people but they just don’t fit well together.

        • I personally feel great with therapists , very close and open with them, I’m just saying this fact about other people that sometimes think that its better talking on the phones,

    2. As 1 and 2 above demonstrate, frequently pain has a strong psychiatric component, which is why the study showed good results with CBT and the commenter #2 above had poor results with procedures and medications. Unfortunately, there is a stigma associated with considering something to have a psychiatric component, so patients are reluctant to seek the proper care, or even refuse to admit it to themselves (for example, “I’m not crazy, it really hurts, there’s something wrong”) and they go for test after test and treatment after treatment, without realizing that pain is itself a disorder, and not solely the sign of some other underlying problem.

      • You are correct that some types of pain have a strong psychiatric component, but you have no idea about what fibromyalgia (and many related ailments such as myofascial pain syndrome) are all about. Using a therapist as a treatment adjunct in fibro therapy does not mean that there are any psychiatric components to the disease – the therapist is used to allow the patient to learn methods of dealing with chronic (and often constant) pain. You are talking about something completely different.

      • Exactly Reb Yid! Excellent post!

        This is exactly what happened to me! I would swear up & down that I was in such agonizing pain… I couldn’t stand on a hard surface (ie: my kitchen, or the floor of a grocery store) for very long without needing to sit down, shift my position, etc. I was walking around w\the aches & pains of an 80 year old woman! But I’m only 32! (:-o

        And the medical costs of trying to find out what’s wrong with me have been staggering! We almost lost our home & finally had to file bankruptcy this year, just to be able to keep it, and get rid of all the medical debts that were starving us, cleaning our our savings, getting us into trouble (ie: people wanting to sue us, etc.), and nobody being able to treat me anymore because I owed them too much to begin with!

        My family was put through a nightmare trying to figure out my illness, and I’m not ashamed to talk about the bankruptcy & etc… because I know I am NOT alone in my story! There are literally millions of people in this country who are close to foreclosure JUST because of medical debts & no other reason, G-d forbid!

        Fibromyalgia is a very tricky disorder!

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