Cognitive Behavioral Therapy for Chronic Musculoskeletal Pain： Exercise Facilitation Method Based on the Cognitive Behavioral Therapy Using the Ikiiki Rehabilitaion Notebook

The extent of white matter (WM) and Grey matter (GM) structural neuroplasticity following cognitive behavioral therapy for chronic pain management remains undetermined. In the current study, we investigated structural alterations in GM morphometry, as well as WM complexity and connectivity, before and after an 11-week group CBT for the treatment of chronic musculoskeletal pain. We hypothesized that effective pain management would influence WM structural metrics indicative of brain plasticity, particularly within cognitive and limbic circuitry as well as GM volume within pain matrix structures. To determine this, patients were randomized into two groups: 1) CBT group that received CBT once-weekly for 11-weeks, or 2) EDU group consisting of an active patient control group that received educational materials by mail. All subjects completed behavioral assessments and underwent neuroimaging at: baseline prior to any intervention (TP1), 11-weeks following either CBT or EDU (TP2), and four months following completion of the intervention (TP3). CBT resulted in significant clinical improvements, assessed via behavioral self-reports, compared to EDU. Compared to EDU, region of interest WM analysis revealed several fiber tracts that had significantly increased WM complexity following CBT intervention, including the bilateral posterior internal capsule and the left cingulum within the temporal lobe. Conversely, several tracts exhibited a decrease in WM complexity including the right external capsule, the left posterior internal capsule, and the right cingulum within the temporal lobe. Changes in clinical outcomes were predictive of alterations in WM complexity metrics immediately following intervention and at long-term follow-up. No between-group differences were observed in either WM connectivity or GM volume. In conclusion, psychotherapeutic interventions such as group CBT influence coping strategies for effective pain relief that influence WM microstructure, however, the mechanisms of these changes remain undetermined. Future studies will be required to uncover the biological underpinnings of these alterations in pain populations.

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Exercise Facilitation Based on the Theory of Cognitive Behavioral Therapy for Chronic Musculoskeletal Pain

The Japanese Journal of Rehabilitation Medicine ◽

10.2490/jjrmc.55.206 ◽

2018 ◽

Vol 55 (3) ◽

pp. 206-214

Author(s):

Shinji Kimura ◽

Masako Hosoi ◽

Takako Matsubara ◽

Masahiko Shibata ◽

Yasuyuki Mizuno ◽

...

Keyword(s):

Cognitive Behavioral Therapy ◽

Musculoskeletal Pain ◽

Behavioral Therapy ◽

Chronic Musculoskeletal Pain ◽

Cognitive Behavioral

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The Effectiveness of Cognitive Behavioral Therapy in Patients with Chronic Musculoskeletal Pain

Pars of Jahrom University of Medical Sciences ◽

10.29252/jmj.10.2.73 ◽

2012 ◽

Vol 10 (2) ◽

pp. 73-82

Author(s):

S Rafiee ◽

F Sohrabi ◽

J Shams ◽

AA Forough

Keyword(s):

Cognitive Behavioral Therapy ◽

Musculoskeletal Pain ◽

Behavioral Therapy ◽

Chronic Musculoskeletal Pain ◽

Cognitive Behavioral

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Cognitive Behavioral Therapy in Pediatric Patients with Chronic Widespread Musculoskeletal Pain

Handbook of Cognitive Behavioral Therapy for Pediatric Medical Conditions - Autism and Child Psychopathology Series ◽

10.1007/978-3-030-21683-2_13 ◽

2019 ◽

pp. 185-199

Author(s):

Lauren M. Fussner ◽

Anne M. Lynch-Jordan

Keyword(s):

Cognitive Behavioral Therapy ◽

Musculoskeletal Pain ◽

Pediatric Patients ◽

Behavioral Therapy ◽

Cognitive Behavioral

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Emotional Awareness and Expression Therapy Achieves Greater Pain Reduction than Cognitive Behavioral Therapy in Older Adults with Chronic Musculoskeletal Pain: A Preliminary Randomized Comparison Trial

Pain Medicine ◽

10.1093/pm/pnaa145 ◽

2020 ◽

Vol 21 (11) ◽

pp. 2811-2822

Author(s):

Brandon C Yarns ◽

Mark A Lumley ◽

Justina T Cassidy ◽

W Neil Steers ◽

Sheryl Osato ◽

...

Keyword(s):

Cognitive Behavioral Therapy ◽

Musculoskeletal Pain ◽

Behavioral Therapy ◽

Emotional Awareness ◽

Pain Reduction ◽

Post Treatment ◽

Chronic Musculoskeletal Pain ◽

Comparison Trial ◽

Secondary Outcomes

Abstract Objective Emotional awareness and expression therapy (EAET) emphasizes the importance of the central nervous system and emotional processing in the etiology and treatment of chronic pain. Prior trials suggest EAET can substantially reduce pain; however, only one has compared EAET with an established alternative, demonstrating some small advantages over cognitive behavioral therapy (CBT) for fibromyalgia. The current trial compared EAET with CBT in older, predominately male, ethnically diverse veterans with chronic musculoskeletal pain. Design Randomized comparison trial. Setting Outpatient clinics at the West Los Angeles VA Medical Center. Subjects Fifty-three veterans (mean age = 73.5 years, 92.4% male) with chronic musculoskeletal pain. Methods Patients were randomized to EAET or CBT, each delivered as one 90-minute individual session and eight 90-minute group sessions. Pain severity (primary outcome), pain interference, anxiety, and other secondary outcomes were assessed at baseline, post-treatment, and three-month follow-up. Results EAET produced significantly lower pain severity than CBT at post-treatment and follow-up; differences were large (partial η2 = 0.129 and 0.157, respectively). At post-treatment, 41.7% of EAET patients had >30% pain reduction, one-third had >50%, and 12.5% had >70%. Only one CBT patient achieved at least 30% pain reduction. Secondary outcomes demonstrated small to medium effect size advantages of EAET over CBT, although only post-treatment anxiety reached statistical significance. Conclusions This trial, although preliminary, supports prior research suggesting that EAET may be a treatment of choice for many patients with chronic musculoskeletal pain. Psychotherapy may achieve substantial pain reduction if pain neuroscience principles are emphasized and avoided emotions are processed.

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