Counseling can improve arthritis pain, disability
Giving people with arthritis the tools to cope with pain can help them feel, and function, better, the authors of a new analysis of research on counseling for arthritis patients conclude.
However, just a session or two isn’t enough to truly help individuals with rheumatoid arthritis or osteoarthritis develop the coping skills they need, Dr. Francis J. Keefe of Duke University Medical Center in Durham, North Carolina, told Reuters Health. Learning these skills takes time and practice, he added. “It’s like riding a bike.”
People with arthritis can develop disabilities that may lead to psychological problems, creating a vicious cycle, Keefe and his team note in Health Psychology. With this in mind, experts have developed programs to help them cope with pain and disability using relaxation techniques, guided imagery, and strategies such as activity-rest cycling.
To evaluate the effectiveness of such programs, Keefe and his colleagues analyzed the results of 27 trials of psychological interventions for arthritis, which included a total of 3,409 participants.
People who underwent skills training reported a modest reduction in pain, better ability to cope with pain, reductions in anxiety and depression, less psychological and physical disability, and less joint swelling, the researchers found.
Pain may lead people with arthritis to give up pleasurable activities, Keefe noted. By using activity-rest cycling, which also involves recording activities and keeping track of when they overdo things, he added, many arthritis patients find they’re able to get more done, and even have the energy to return to recreational pursuits.
“People with arthritis benefit a lot from this, because overdoing is big problem for them,” Keefe said.
An effective program may include 12 to 14 sessions, he added. “Anything that’s providing just a session or two sessions is probably just providing educational information.” Teaching hospitals and Veterans Administration hospitals typically offer appropriate programs, which may be covered by insurance with a physician referral.
“By making these treatments available in a timely fashion to a wider range of patients, it may be possible to prevent and reduce unnecessary pain and suffering,” Keefe and his colleagues conclude.
SOURCE: Health Psychology, May 2007.
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