Psychotherapy for Fibromyalgia

Various types of psychotherapy, such as cognitive and behavioral therapy and guided imagery, may help treat patients with fibromyalgia. Fibromyalgia is characterized by chronic, widespread pain in the muscles and soft tissues surrounding the joints, and it is accompanied by fatigue.

Researchers from the University of Heidelberg in Germany developed a guideline for the treatment and diagnostic procedures in fibromyalgia syndrome in cooperation with 10 German medical and psychological associations and two patient self-help groups.

A systematic literature search was performed in the Cochrane Collaboration Reviews (1993-12/2006), Medline (1980-12/2006), PsychInfo (1966-12/2006) and Scopus (1980-12/2006). Levels of evidence were assigned according to the classification system of the Oxford Centre for Evidence-Based Medicine.

Grading of the strengths of recommendations was done according to the German program for disease management guidelines. Standardized procedures to reach a consensus on recommendations were used.

The study found that cognitive and operant behavioral therapy is strongly recommended and guided imagery/hypnotherapy and written emotional disclosure are recommended.

The authors concluded that psychotherapeutic programs tailored to fibromyalgia subgroups should be developed and tested.

For more information about fibromyalgia, please visit Natural Standard’s Medical Conditions database.

Comments

[Graham]

Does this mean fibromyalgia might have psychological causes? In the past, it was once called psychogenic rheumatism. However, I thought researchers found that other factors, including sleep disturbances, injuries, abnormalities in the nervous system, and changes in the muscle metabolism, may lead to the development of fibromyalgia. So, it makes me wonder why psychotherapy might work.

[Julie]

I don't think that fibromyalgia has to have psychological causes for patients to benefit from therapy. I think that anyone who lives with pain on a daily basis can learn more helpful ways to cope through psychotherapy and just by knowing there is someone who will listen to their pain and suffering. I would think, assuming there is a good patient-counselor relationship, that the trust could be very healing. Also, I think that just having that time set aside each week to specifically address their daily suffering could relax them, making them better able to cope and overcome.

[Kara]

Julie,

You make a good point about stress. Many conditions are exacerbated by stress and anxiety. So, if you are able to participate in stress-relieving activities, such as therapy, it would make sense that your symptoms would improve.

[Lindsey]

Preliminary research suggests that therapeutic touch may be an effective treatment option for patients with fibromyalgia. During therapy, practitioners hold their hands a short distance away from patients without actually making physical contact. The purpose of this technique is to detect the patient's energy field, allowing the practitioner to correct any perceived imbalances.

Therapeutic touch consists of four steps: 1) centering (calming the mind and focusing attention on the patient), 2) assessing the patient's energy field for irregularities, 3) intervening to facilitate symmetrical flow of energy through the field, 4) evaluating the patient to verify the effects and conclude the treatment. Treatment sessions usually last from five to thirty minutes.

[Julie]

Thanks, Kara. Excellent point as well. I think that as a society, we need to get over the negative attitude we have towards therapy. Of course there are also a lot of unhealthy-minded therapists. However, I think that if we recognized the importance of "mental health" on overall health, our society would be a lot more "functional" and productive. Stress causes, aggravates and complicates health conditions.

[mo]

Interesting that the photo associated with this story depicts a man, since fibromyalgia is more common in women. I agree that the stigma of therapy needs to be removed. There also seems to be a trend toward recognizing some of the most basic things that affect quality of life: pain, sex, sleep and mood. I’m not sure if this is being driven by pharmaceutical companies and the drugs that they wish to market, but I’m thankful that these important issues are getting as much attention as the “big” diseases like cardiovascular disease, diabetes and cancer.

[Casey]

Fibromyalgia is a chronic condition, and many chronic conditions cause mental health complications, such as depression. So, I imagine psychotherapy would help relieve some of these symptoms.

[RS]

I agree, Casey. I bet depression and decreased quality of life are fairly common among people with fibromyalgia. Just imagine if you were always in pain (unless medicated) and unable to participate in certain physical activities. So, it makes sense that psychotherapy might help people cope with a diagnosis of a long-term illness like this.

[Larry]

I just read something interesting: "People with fibromyalgia have decreased activity in opioid receptors in parts of the brain that affect mood and the emotional aspect of pain, researchers have found. This might explain why fibromyalgia patients are likely to experience depression, and are not very responsive to opioid painkillers."

[Maria]

Thanks, Larry. That helps shed some light on this condition. I wonder if fibromyalgia patients have an increased risk of abusing their meds since they don't respond well to pain killers.

I recently saw an Intervention episode where a girl with severe rheumatoid arthritis became addicted to her pain killers. It's an awful situation because they really do need their medicine. So, it's a really difficult addiction to overcome.

[mo]

Other alternative therapies with good evidence for fibromyalgia include 5-HTP, acupuncture and chlorella. Each of these approaches shows promise in alleviating pain associated with fibromyalgia. Interestingly, they also appear to address other related issues, including quality of life, stress and depression.

[Leah Cohen]

This is really interesting and encouraging research because fibromyalgia may have many origins, and it often requires a multidisciplinary treatment approach. For many years fibromyalgia has been misdiagnosed and mistreated, so it is good news that research is underway to evaluate more CAM means of therapy.

[Leah Cohen]

I am wondering if there are any practitioners that can share their experience with use of acupuncture or acupressure for fibromyalgia? Some patients in the clinic have seen some positive results. This disease may have very complicated origins, and the right course of therapy varies widely among patients.

[Psychology psychotherapy online free]

Very interesting, your blog.

[SJ]

I am not surprised to learn that therapy helps healing fibromyalgia. All current evidence supports the mind-body connection. We don’t intentionally harm ourselves, but when a condition does occur, we can become more consciously connected to our bodies and trace the probable cause. Even without therapy, this can be possible.