Pain in Arthritis and Musculoskeletal Disorders: The Role of Coping Skills Training and Exercise Interventions
Duke University Medical Center, Durham, NC 27710, USA.Journal of Orthopaedic and Sports Physical Therapy (Impact Factor: 3.01). 11/1996; 24(4):279-90. DOI: 10.2519/jospt.19126.96.36.1999
There is growing recognition of the limitations of conventional, biomedical approaches to the management of pain in individuals having arthritis and musculoskeletal disorders. This article provides an overview of newly developed biopsychosocial approaches to the management of pain in this population. The presentation is divided into three sections. In the first section, a biopsychosocial model of pain is presented. This model highlights the role that biological factors (eg., disease severity, comorbid conditions), cognitive-behavioral factors (eg., thoughts, emotions, and behaviors), and environmental factors (eg., spouse or family responses to pain behavior) can play in influencing the pain experience. In the second section, we provide an overview of two newly developed treatment protocols based on the biopsychosocial model of pain: a pain coping skills training protocol and an exercise training protocol. Practical aspects of implementing these protocols are illustrated by highlighting how they are applied in the management of patients having persistent osteoarthritic pain. In the final section of the article, we pinpoint several important future directions for research in this area. Future studies need to explore the utility of combining pain coping skills and exercise training protocols. In addition, there is a need to identify variables that predict patients' response to biopsychosocial treatments.
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ABSTRACT: Human rheumatoid factor administered to mice 24 hours after intraperitoneal injection of human IgC as antigen causes a 68 per cent reduction in the numbers of spleen cells capable of forming rosettes with IgG-coated sheep erythrocytes. Normal human macroglobulin does not cause such an inhibition of antibody-producing cells. The inhibitory effect of rheumatoid macroglobulin appears immunologically specific.Arthritis & Rheumatology 03/1969; 12(1):1-9. DOI:10.1002/1529-0131(199902)12:1<1::AID-ART1>3.0.CO;2-T · 7.76 Impact Factor
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ABSTRACT: Cognitive-behavioral approaches appear to offer a viable alternative for the management of arthritis pain. Controlled studies have documented the efficacy of CBT protocols for managing pain in individuals having OA and RA. Preliminary studies examining the efficacy of CBT for FM patients have also yielded encouraging results. A number of clinical and research issues need attention if CBT is to be incorporated into rheumatology practice settings. These issues include identifying the most important components of CBT, developing strategies for matching CBT interventions to patients' readiness for behavior change, testing the efficacy of different therapy formats (e.g., individual versus group), broadening the scope of CBT to address issues other than pain, and insurance reimbursement.Medical Clinics of North America 02/1997; 81(1):277-90. DOI:10.1016/S0025-7125(05)70515-0 · 2.61 Impact Factor
- Arthritis care and research: the official journal of the Arthritis Health Professions Association 02/1999; 12(1):1-2. DOI:10.1002/1529-0131(199902)12:13.0.CO;2-T
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