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Telephone CBT 'may be of benefit' for fibromyalgia

Short-term relief from chronic widespread pain - for instance in fibromyalgia - is associated with patients engaging in an exercise program and/or cognitive behavioural therapy (CBT) over the telephone.

Researchers in the UK randomised 442 patients with chronic widespread pain to receive either a six-month course of CBT by phone, graded exercise, a combination of both interventions, or usual care as control. Outcomes were self-rated on a seven-point scale.

After six months, the proportion of patients who felt 'much better' or 'very much better' was 30% per of the group receiving only telephone CBT, 35% of those on the exercise program and 37% of patients receiving both therapies. This compared with only 8% of controls.

The authors suggest these therapies may offer benefits to patients diagnosed with fibromyalgia.

'These results provide encouragement that short-term improvement is possible in a substantial proportion of patients with chronic widespread pain,' said lead author Dr John McBeth of the Arthritis Research UK Primary Care Centre at Keele University, Staffordshire.

In an accompanying editorial, Dr Seth Berkowitz and Dr Mitchell Katz of the Los Angeles County Department of Health Services, noted that exercise and CBT offer further advantages over usual pain management. ‘We welcome additional research that seeks to minimize the use of pharmacology, with its unclear efficacy and attendant consequences, in favour of a regimen that focuses on teaching skills for self-management of symptoms.'

Arch Intern Med. Published online 14 November 2011

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