Issues Magazine

Talking Therapy Improves Symptoms of Chronic Widespread Pain


Arthritis Research UK

Talking therapy provided over the phone can have a positive impact on people suffering from chronic widespread pain compared to usual care provided by their GP, research has shown.

Patients who received a short course of cognitive behavioural therapy (CBT) over the telephone from trained therapists reported that they felt “better” or “very much better” at the end of a six-month treatment period, and also three months after it ended.

The Arthritis Research UK-funded trial led by the University of Aberdeen working with the University of Manchester was the first-ever trial of telephone-delivered CBT for people with chronic widespread pain.

Cognitive behavioural therapy is a psychological method of helping people manage their pain by identifying and evaluating thoughts and behaviour.

Exercise was also shown to improve pain and disability and helped people manage their symptoms. However, the study showed there was no additional advantage of receiving both types of treatment over receiving just one.

The trial, involving 442 people with chronic widespread pain aged between 25 and 60 from GP surgeries in Cheshire and Aberdeen, aimed to develop more effective ways of reducing and/or coping with painful symptoms of chronic widespread pain.

The study was led by Professor Gary Macfarlane, professor of epidemiology at the University of Aberdeen and Dr John McBeth, reader in rheumatic disease epidemiology at the Arthritis Research UK Epidemiology Unit at The University of Manchester.

In the trial, patients were split into groups: one group doing exercise, a second receiving CBT, a third receiving a combination of both, and a fourth group who were given the “usual care” by their GP.

The exercise group was offered six fitness instructor-led monthly appointments and were recommended to exercise between 20 and 60 minutes per day with increasing intensity over the six-month period.

Outcomes were measured by self-completing postal questionnaires using a seven-point patient global assessment scale on patients’ health from the time of enrolling on the trial, ranging from “very much worse” to “very much better.” Assessments were made at six months, when treatment ended, and three months later. A positive outcome was defined as “much better” or “very much better”.

Telephone CBT and exercise were both associated with substantial, statistically significant, clinically meaningful improvements in self-rated global health.

The researchers also found that participants who expressed a preference for one or the other of the treatments did better if they got their preferred treatment.