Cognitive Behavior Therapy Helps Those With Chronic Pain

Chronic Pain Insomnia SartellResearch out of Europe suggests that cognitive behavior therapy (CBT) could help control or reduce chronic pain by helping patients sleep better.

We’ve discussed the link between poor sleep and chronic pain on the blog before, and while we’ve shared some tips for falling asleep and staying asleep, we’ve never examined CBT’s role in the equation. According to the University of Warwick, cognitive behavioral therapy was found to be moderately or strongly effective in the majority of chronic pain patients who suffered from insomnia. Lead research Nicole Tang, PhD, from the University’s Psychology department, said CBT is better alternative that long-term drug treatment for insomnia.

“This study is particularly important because the use of drugs to treat insomnia is not recommended over a long period of time therefore the condition needs to be addressed using a non-pharmacological treatment,” said Dr. Tang. “We believe that our results will be of particular interest to primary care physicians and allied health professionals who are taking up an increasingly important role in preventing and managing long-term conditions.”

CBT and Chronic Pain

For their study, researchers conducted a meta-analysis of 72 studies involving more than 1,000 chronic pain sufferers with insomnia. Treatments varied in the individual studies, but the most popular intervention strategies were education about sleep hygiene, stimulus control, sleep restriction and cognitive therapy. They also analyzed how these approaches were delivered to the subjects. Finally, researchers looked at documented pain levels before and after intervention techniques were administered.

After conducting the meta-analysis, researchers uncovered:

  • CBT was associated with a decrease in insomnia and mild to moderate decreases in pain levels.
  • Improved sleep was associated with a decrease in depressive feelings.
  • Chronic pain sufferers who received CBT experienced improved sleep and had a wider positive impact on pain, fatigue and depression feelings.

Interestingly, intervention techniques were less effective if they were delivered electronically, either by phone or the internet.

“We found little evidence that using therapies delivered either by phone or computer benefited insomniacs. The jury is still out on the effectiveness of using automated sleep treatments. We found that, at the moment at least, delivering therapies personally had the most positive effect on sleeplessness,” Dr. Tang said.

Dr. Tang said they want to pursue further research to establish if CBT is feasible and cost effective for treating chronic pain in the long run.

Related source: Sleep Review Magazine

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Thomas Cohn, MD

Interventional pain doctor helping Minnesotans manage back, neck, foot, and other pain. Board-certified in physical medicine and rehabilitation with additional board-certification in pain management from the American Board of Anesthesiology (ABA), the American Board of Interventional Pain Physicians (ABIPP) and the American Board of Pain Medicine (ABPM).

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