Are psychological treatments effective for fibromyalgia pain?
Abstract
This article considers four broad classes of psychological techniques and their effects on fibromyalgia (FM) pain. A literature search identified 14 randomized controlled trials (RCTs) of cognitive-behavioral therapy (CBT) and operant-behavioral therapy (OBT), five relaxation RCTs, five biofeedback RCTs, five hypnotherapy RCTs, and two writing intervention RCTs. For psychoanalytic therapy in FM, no RCTs have been published. The highest effect sizes (r = 0.53-2.14) for pain reduction are found after CBT and OBT group treatments. Relaxation as a single treatment has not been proven useful. Hypnotherapy and writing intervention have demonstrated mild treatment effects, whereas psychological treatment is effective in FM pain. Considering the heterogeneity of FM, the promising effects of matched interventions such as CBT and OBT with pharmacotherapy, exercise, and other treatment domains require further research.
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Across different reviews, cognitive behavioural therapy effect sizes on key fibromyalgia symptoms and disability ranged from small to moderate.
“The magnitude of the effects sizes of CBTs on the key symptoms of FMS and on disability ranged between small and moderate in different reviews (Thieme and Gracely, 2009;Glombiewski et al., 2010;Bernardy et al., 2013).”
From Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome – A systematic review and meta-analysis of randomized controlled trials (2018) · cites this paper as Thieme and Gracely, 2009
Recent systematic reviews did not include acceptance-based studies.
“Recent systematic reviews did not include acceptance-based studies (Thieme and Gracely, 2009;Glombiewski et al., 2010;Bernardy et al., 2013).”
From Efficacy, acceptability and safety of cognitive behavioural therapies in fibromyalgia syndrome – A systematic review and meta-analysis of randomized controlled trials (2018) · cites this paper as Thieme and Gracely, 2009
CBT-CP is based on the principle that the experience of pain results in a complex interaction among biological, cognitive, affective and behavioral factors and that changing these factors should positively affect the painful experience.
“CBT for managing CP (CBT-CP) is based on the principle that the experience of pain results in a complex interaction among biological, cognitive, affective and behavioral factors and that changing these factors should positively affect the painful experience.”
From Effectiveness of a hybrid arts-based Cognitive Behavioral Therapy intervention for patients with non-malignant chronic pain (2022) · cites this paper as [10]
Evidence supporting the efficacy of non-pharmacological treatment in fibromyalgia is strong.
“Evidence supporting the efficacy of non-pharmacological treatment in FM is strong (e.g., [67; 61; 11; 12; 15; 62])”
From Internet-enhanced management of fibromyalgia: A randomized controlled trial (2010) · cites this paper as [62]
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- Authors
- Thieme, K., & Gracely, R. H.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Thieme, Kati
- ORCID
- Thieme, Kati
- Venue
- Current Rheumatology Reports
- Published
- 2009-11-29
- Volume
- 11
- Issue
- 6
- Pages
- 443-450
- ISSN
- 1523-3774 (ISSN-L)
- 1534-6307
- OpenAlex
- W1996185924
- Cited by
- 75
- References
- 61
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 3 · 2022: 2 · 2020: 2 · 2019: 1 · 2018: 1 · 2017: 5 · 2016: 4 · 2015: 4 · 2014: 2 · 2013: 13 · 2012: 12
- FWCI
- 1.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Rheumatology Reports (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- fibromyalgia, chronic pain, psychological intervention, cognitive behavioral therapy, relaxation training, biofeedback, hypnotherapy, writing intervention, psychoanalytic psychotherapy, treatment effectiveness
- MeSH terms
- Behavior Therapy, Fibromyalgia, Humans, Hypnosis, Pain, Randomized Controlled Trials as Topic, Treatment Outcome, Pain Management
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