APS Press Room
News Highlights from The Journal of Pain • November 2006
The Peer Review Journal of the American Pain Society
| For immediate release | Contact: Chuck Weber (847) 705-1802 |
SEX HORMONES AND PAIN IN REGULARLY MENSTRUATING WOMEN WITH FIBROMYALGIA SYNDROME
Akiko Okifuji, PhD, Pain Research Center, University of Utah
Dennis Turk, PhD, Department of Anesthesiology, University of Washington
The prevalence of fibromyalgia syndrome (FMS) is greater in women, and the ratio of women to men treated for the disorder is 10:1. Despite extensive research, the pathopsysiology of fibromyalgia is unknown. Prevalence in women has prompted speculation that sex hormones might be involved. In this article, researchers sought to evaluate levels of sex hormones and pain sensitivity at various phases of the menstrual cycle in healthy women and in a group diagnosed with fibromyalgia.
The results of the study showed that levels of sex hormones for regularly menstruating women with FMS are comparable to pain-free women at different phases of the menstrual cycle. This suggests that higher prevalence of FMS in women is not likely to be associated with abnormal levels of sex hormones. The authors reported, however, there was some association between progesterone and ischemic pain sensitivity in general. They also noted that their findings are consistent with previous studies.
INTERDISCIPLINARY REHABILITATION IN FIBROMYALGIA AND CHRONIC BACK PAIN: A PROSPECTIVE OUTCOME STUDY
Felix Angst, Roberto Brioschi, Chris Main, Susanne Lehmann and Andre Aeschlimann
Zurzach Research Foundation, Switzerland and University of Manchester, England
The authors examined short-and-long-term biopsychosocial health and quality of life of fibromyalgia and low-back pain patients. Although diagnostics and therapy have made excellent progress in treating acute pain disorders, improvements in the management of chronic diseases have remained modest. Many studies, however, have demonstrated that interdisciplinary pain management programs were superior to uncoordinated therapies.
In this prospective cohort study, chronic-pain patients with fibromyalgia or low-back pain exhibited good response to a standardized inpatient interdisciplinary treatment program. Pain and most of the physical and affective dimensions, together with quality of life and coping performance, improved significantly in the short-term and mid-term. Researchers concluded that inpatient, structured interdisciplinary rehabilitation covering elements of behavioral therapy and graded activity exercises are effective.
EVIDENCE BASED SCIENTIFIC DATA DOCUMENTING THE TREATMENT AND COST EFFECTIVENESS OF COMPREHENSIVE PAIN PROGRAMS FOR CHRONIC NONMALIGNANT PAIN
Robert J. Gatchel and Akiko Okifuji
American Pain Society Task Force on Comprehensive Pain Rehabilitation
Studies have shown that traditional medical approaches to treating chronic pain have not been consistently efficacious or cost-effective. Conversely, newer comprehensive, multidisciplinary pain care programs (CPPs) have proven to be both efficacious and cost-effective. This study examines available evidence comparing traditional and comprehensive pain-care approaches. When available, conventional medical treatments were used as the benchmark to evaluate comprehensive pain-care programs.
The authors concluded their review clearly demonstrates that CCPs offer the most efficacious and cost-effective, evidenced-based treatment for chronic pain. Based on the growing number of randomized, controlled trials from different clinical-research centers, there is unequivocal evidence for the effectiveness and cost benefits of CPPs. However, the authors also concluded that a major obstacle to effective CPPs is the lack of understanding by third-party payers who still refuse to cover such programs.
USE OF THE CHRONIC PAIN COPING INVENTORY TO ASSESS OLDER ADULTS’ PAIN COPING STRATEGIES
Mary Ersek, Judith A Turner and Carol A. Kemp
University of Washington School of Medicine
Little is known about how older adults cope with persistent pain. The intent of this study was to describe strategies employed by older adults to cope with chronic non-cancer pain, as measured by the Chronic Pain Coping Inventory (CPCI). Two hundred residents of 43 retirement communities in the Pacific Northwest were studied.
The authors reported that the most frequently used coping strategies were task persistence, activity pacing, and coping self statements. They noted that frequent use of strategies on the task-persistence scale is consistent with previous findings that many older adults try to ignore their pain and not let it interfere with activities. Exercise and rest also were found to be frequently used pain-coping strategies for the older adults evaluated in the study.
The authors concluded their findings support using the CPCI for assessing pain-coping strategies of older adults in settings other than multidisciplinary pain clinics. However, they did not analyze taking pain medication as a coping strategy and recommend that measures of pain medication be developed and incorporated in future studies of pain coping.