scholarly journals Efficacy of Cognitive Behavioral Therapy in Managing Chronic Pain of Degenerative Conditions: An Overview of Randomized Clinical Trials and Meta-Analysis Studies

2020 ◽  
Vol 2 (1) ◽  
pp. 27-31
Author(s):  
Nchawanangwa Kaonga ◽  
◽  
Charity Kapenda ◽  
James Mwanza ◽  
Brian Chanda Chiluba ◽  
...  

Background:Cognitive behavioral therapy is a goal-oriented psychotherapy treatment that takes a hands-on, practical approach to problem-solving. It has been documented in various studies to have an impact when used in the management of chronic pain. It has been shown to lack the drawbacks of pharmacological and surgical treatments such as addiction and toxicity; and cost and recovery time, respectively. Cognitive behavioral therapy has also been shown to target cognitive distortions such as pain catastrophizing among other things. The objective of the review is to evaluate the effectiveness of cognitive behavioral therapy in the management of chronic pain of degenerative conditions. Methods:This review article was conducted basing on the previous studies published from 2009-2019 and data analyzed was retrieved from Google Scholar, Elsevier and Science Direct. Only the articles that looked at effectiveness of cognitive behavioral therapy in the management of chronic pain from a physiotherapists point were included. Results:The outcomes of the studies used varied and included reduction in pain intensity, pain disability, fear avoidance, catastrophizing and kinesophobia. The CBT approaches used across the studies also varied and included operant conditioning, biofeedback, relaxation techniques, pacing, cognitive coping techniques, graded activity and graded exposure.Conclusion:Published randomized controlled trials provide good evidence for the effectiveness of cognitive behavioral therapy and how specific approaches may vary in effectiveness depending on the desired outcomes

Pain Medicine ◽  
2021 ◽  
Author(s):  
Matthew E Schumann ◽  
Brandon J Coombes ◽  
Keith E Gascho ◽  
Jennifer R Geske ◽  
Mary C McDermott ◽  
...  

Abstract Background Decreasing pain catastrophizing and improving self-efficacy to self-manage chronic pain symptoms are important treatment targets in the context of interdisciplinary cognitive behavioral therapy for chronic pain. Greater pain catastrophizing has been shown to be associated with greater impact of pain symptoms on functioning, while conversely, greater pain self-efficacy has been associated with lower pain intensity and lower levels of disability. Objective To prospectively evaluate interdisciplinary cognitive behavioral therapy for pain outcomes, as well as to the mediating effects of both pain catastrophizing and pain self-efficacy on outcome. Methods Participants were 315 patients with chronic pain between April 2017 and April 2018 who completed a three-week interdisciplinary pain rehabilitation program. Pain severity, pain interference, pain catastrophizing, pain self-efficacy, quality of life, and depressive symptom questionnaires, and measures of physical performance were assessed at pre- and posttreatment. Follow-up questionnaires were returned by 163 participants. Effect size and reliable change analyses were conducted from pre- to posttreatment and pretreatment to 6-month follow-up. Mediation analyses were conducted to determine the mediating effect of pain catastrophizing and pain self-efficacy on pain outcome. Results Significant improvements from pre- to posttreatment in pain outcomes were observed, and over 80% evidenced reliable change in at least one pain-relevant measure. Pain catastrophizing and pain self-efficacy mediated the relationship between changes in pain outcomes. Conclusions Interdisciplinary pain rehabilitation is an effective treatment and decreasing pain catastrophizing and increasing pain self-efficacy can influence maintenance of treatment gains.


Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1209
Author(s):  
Shinji Kimura ◽  
Masako Hosoi ◽  
Naofumi Otsuru ◽  
Madoka Iwasaki ◽  
Takako Matsubara ◽  
...  

Recent clinical practice guidelines for chronic pain indicate, with a high evidence level, that the combination of exercise and cognitive behavioral therapy (CBT) is effective. The purpose of this study was to evaluate the effectiveness of an exercise facilitation method in combination with CBT using the “Ikiiki Rehabilitation Notebook” for patients with intractable chronic pain. “Ikiiki” means active in Japanese. A total of 22 cases with chronic low back (n = 13), lower extremity (n = 8), or neck (n = 1) pain were treated using this notebook. Two cases dropped out, leaving 22 cases. Each case was evaluated in terms of the numerical rating scale (NRS) of the pain, activities of daily living (ADL), pain catastrophizing scale (PCS), and quality of life (QOL) at pretreatment and post-treatment. The endpoint of the method was to achieve the long-term goals set by the patients. The mean treatment period was 11.2 months. The outcomes were as follows: improvement of presenteeism: nine cases; enhanced participation in hobbies: seven cases; improved school attendance: two cases; return to work: one case; improvement of self-care and/or self-efficacy: three cases. The NRS, ADL, PCS, and QOL were significantly improved after the treatment. This method is possibly valuable for educating patients about the cause and treatment of chronic pain and actively facilitating exercise and social participation. Further studies are needed to investigate the effectiveness of using this notebook for the patient with intractable chronic pain.


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