Cognitivebehavioral Therapy

Cognitive-behavioral therapy (CBT) and/or patient education may help improve pain and function in some individuals, either as sole therapy or in combination with exercise.497879 8081 [III] It may be particularly beneficial to provide CBT early after diagnosis to help patients understand FMS and learn how they themselves can be actively involved in its management. As FMS is a chronic condition without a permanent remedy, patient education is an important aspect of management as patients have to learn to manage their pain better even if they also receive other therapy. This therefore may help to improve their long-term prognosis by providing more realistic health beliefs. The quality of published trials in this area is relatively poor, but its use has been supported by previous

reviews , , and expert opinion supports its use.

With regard to the subgroups of FMS patients that have been proposed, the second group who experience the highest levels of distress may respond best to this approach,15 whereas the other two groups with moderate and low mood disturbances and distress are less likely to require CBT. Variation in trial reports and/or success may be compounded by this factor.

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