Fibromyalgia

Posted on Fibromyalgia

2 types of cognitive behavioural therapy (CBT) are equally effective for treating fibromyalgia.

Maria Hedman-Lagerlöf

Maria Hedman-Lagerlöf CREDIT Andreas Beronius

A recent study led by researchers at Karolinska Institutet found that there are no significant differences between exposure-based CBT and traditional CBT when it comes to treating fibromyalgia. Both forms of treatment resulted in a noticeable reduction in symptoms for people affected by the disease. This study, published in the journal PAIN, is one of the largest to date to compare different treatment options for fibromyalgia.



Approximately 200,000 people in Sweden are currently living with fibromyalgia, a long-term pain syndrome that causes widespread pain, fatigue, and stiffness in the body, resulting in significant suffering for patients. There is currently no cure for fibromyalgia, and existing drugs often provide inadequate relief, highlighting the need for more effective treatment methods. While cognitive behavioural therapy (CBT) has shown some effectiveness, there is a shortage of trained CBT practitioners and a lack of knowledge about which CBT methods are most effective.


The study compared two different forms of internet-delivered cognitive behavioural therapy in terms of how effectively they reduce the symptoms and functional impact of fibromyalgia.

In short, exposure-based CBT entails the participant systematically and repeatedly confronting situations, activities, and stimuli that the patient has previously avoided due to the association with pain, psychological discomfort, or symptoms such as fatigue and cognitive problems.

In traditional CBT, participants are presented with various strategies to work on during treatment, such as relaxation techniques, activity planning, physical exercise, and methods for managing negative thoughts and improving sleep.

The study showed that traditional CBT was, in general, equivalent to the newer treatment form of exposure-based CBT. 

“Despite our hypothesis, our study shows that the traditional form can be equally effective,” says Maria Hedman-Lagerlöf, psychologist and researcher at Karolinska Institutet.

The randomized study involved 274 people with fibromyalgia, who were randomly assigned to be treated with traditional or exposure-based CBT. The treatments were delivered online, and all participants had regular contact with their therapist. 

Participants were asked to answer questions about their mood and symptoms before, during, and after treatment. Following the 10-week treatment, 60 percent of those who received exposure-based CBT and 59 percent of those who received traditional CBT reported that the treatment had helped them.

“The fact that both treatments were associated with a significant reduction in the participants’ symptoms and functional impairment and that the effects were sustained for 12 months after completion of the treatment, indicates that the internet, as a treatment format, can be of great clinical benefit for people with fibromyalgia,” says Maria Hedman-Lagerlöf. “This is good news because it enables more people to access treatment.”

The study is the second largest to compare different psychological treatment options for fibromyalgia, according to the researchers.

“Our study is also one of the first to compare with another active, established psychological treatment,” says Maria Hedman-Lagerlöf.

Leave a comment Posted on Fibromyalgia

Balneotherapy has been shown to reduce pain in patients with fibromyalgia, according to a trial.

Spa baths for fibromyalgia

Spa baths for fibromyalgia

A type of spa therapy known as balneotherapy has been shown to be both safe and effective in reducing pain in patients with primary fibromyalgia, as demonstrated by a clinical trial.

Findings were reported in the study “Is balneotherapy effective for fibromyalgia? Results from a 6-month double-blind randomized clinical trial,” published in the journal Clinical Rheumatology.

Fibromyalgia is linked to persistent widespread pain, fatigue, and tenderness in specific areas of the body known as tender points. The management of the condition typically involves a combination of approaches, including both pharmacological and nonpharmacological treatments. These may include hot and cold therapies, patient education, physical rehabilitation, and balneotherapy. Balneotherapy involves immersing the patient in mineralized and/or thermal waters from natural springs.

Previous clinical trials have indicated that balneotherapy can improve pain and tender point counts, with effects lasting three to six months. Researchers have also found that balneotherapy is well-tolerated and causes fewer side effects than pharmacological treatments. However, some aspects of these studies were limited and may have led to bias.

Conducted in Italy, this prospective, randomized, double-blind study investigated the effectiveness and tolerability of balneotherapy with highly mineralized sulfate water in primary fibromyalgia patients.Read more here

Posted on Fibromyalgia

Can cognitive-behavioral therapy reduce fibromyalgia pain?

Pain - what works best?
Pain – what works best?

In a recent randomized clinical trial of patients with fibromyalgia, cognitive-behavioral therapy (CBT), which uses structured techniques to alter distorted thoughts and negative moods, was found to be more effective than a matched education treatment in reducing the impact of pain and other aspects of fibromyalgia on daily living.

In the study published in Arthritis & Rheumatology, it was found that the group that received Cognitive Behavioral Therapy (CBT) experienced improvements. These improvements were partly due to reduced catastrophizing, which includes cognitive and emotional processes such as feelings of helplessness, rumination, and exaggeration of pain complaints.

Neuroimaging tests have shown that cognitive behavioral therapy (CBT) works by changing the connections between specific regions of the brain. This suggests that alterations in the brain circuitry associated with pain catastrophizing could be the reason why CBT is beneficial for fibromyalgia patients. Fibromyalgia is a condition marked by debilitating symptoms like widespread pain, fatigue, cognitive challenges, and psychosocial distress.

“According to corresponding author Jeungchan Lee, PhD, from Spaulding Rehabilitation Hospital and Harvard Medical School, these findings add to the growing body of research that emphasizes the benefits of non-pharmacologic treatments, such as CBT, for chronic pain conditions like fibromyalgia. Understanding the various biopsychosocial mechanisms through which these treatments reduce pain could help advance the practice of precision pain medicine and enhance treatment outcomes for the numerous patients affected by chronic pain.”

Posted on Fibromyalgia

Fibromyalgia! What Are The Symptoms Of Fibro Fog?

Image result for What Is "Fibro Fog?" What Are The Symptoms Of Fibro Fog? westwood

People suffering from fibromyalgia often experience “fibro fog,” a type of cognitive dysfunction also referred to as brain fog.

Posted on Fibromyalgia, Pain Management

CBT eases how fibromyalgia pain is experienced by the brain

A randomized, controlled trial led by Mass General Brigham researchers demonstrates that cognitive behavioral therapy can significantly reduce the impact of fibromyalgia pain
A randomized, controlled trial led by Mass General Brigham researchers demonstrates that cognitive behavioral therapy can significantly reduce the impact of fibromyalgia pain

Individuals with fibromyalgia often face limited treatment options and struggle to find explanations for their symptoms. Researchers at Mass General Brigham have discovered that cognitive behavioural therapy (CBT) can significantly alleviate the burden of fibromyalgia by reducing pain-catastrophizing, a negative cognitive and emotional response that can intensify pain. Neuroimaging data showing decreased connectivity between brain regions associated with self-awareness, pain, and emotional processing support this finding.

“In this study, we examined how psychological processes and the brain’s connectivity patterns respond to pain,” stated co-senior author Robert Edwards, PhD, a clinical psychologist in the Department of Anesthesiology, Perioperative & Pain Medicine at Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system. “We sought to investigate how cognitive behavioral therapy (CBT), a type of talk therapy aimed at addressing maladaptive thoughts, can improve daily functioning and change the brain’s processing of pain-related information.”

Edwards explains that cognitive behavioral therapy (CBT) can reduce negative cognitive and emotional responses to pain. He says that while these responses are normal, they can amplify the disabling effects of chronic pain and make conditions like fibromyalgia (FM) more burdensome.

The research team for the study included researchers from three members of Mass General Brigham: Spaulding Rehabilitation Hospital, Brigham and Women’s Hospital, and Massachusetts General Hospital. Mass General Brigham brings together 16 member institutions, including academic medical centres, top-tier speciality hospitals, community hospitals, and more. Research that involves multiple entities within Mass General Brigham provides unique insights and perspectives from different settings and areas of expertise, making it more impactful than individual research efforts.

:Researchers recruited 98 women, randomly assigning 64 to a treatment group receiving CBT and 34 to a control group that received education about FM and chronic pain but was not taught specific CBT techniques. All participants were between 18 and 75 years old and had a confirmed diagnosis of fibromyalgia for at least six months. To collect baseline data, all participants completed several validated pain and quality of life questionnaires.

During the study, each group took part in eight intervention sessions, which involved 60-75 minute visits with a licensed mental health provider. The participants were mainly evaluated based on their pain interference levels, which measures the extent to which their pain affected their daily activities, as well as their pain catastrophizing, pain severity, and the overall impact of fibromyalgia on their quality of life.

Results demonstrated that those who underwent CBT experienced significantly greater reductions in pain interference. CBT participants also exhibited significantly less pain catastrophizing and reported that their FM symptoms had significantly less impact on their daily lives.

The team saw evidence that after undergoing CBT, patients experienced changes in the activities of all three networks that suggested a diminished focus on pain.

“Before undergoing cognitive behavioral therapy (CBT), we observed strong connections in certain parts of the brain related to self-awareness and sensation, indicating that patients were highly attuned to the pain they were feeling and internalized these symptoms,” said co-first author Jeungchan Lee, PhD, an instructor in the Department of Physical Medicine and Rehabilitation at Spaulding Rehabilitation Hospital and the Athinoula A. Martinos Center for Biomedical Imaging at Massachusetts General Hospital. “After CBT, these connections were significantly weaker, suggesting that patients were better able to separate themselves from their pain after therapy.”

This study was limited to women, partly because of its high prevalence, and partly to eliminate confounding gender differences in brain activity. In the future, the researchers hope to collect data from men and non-binary patients with FM. Additionally, CBT includes several therapeutic components, and these results cannot be generalized to assess the impact across all forms of CBT on reducing FM chronic pain.

Both Lee and Edwards agree that these findings ultimately suggest that complex chronic pain conditions like fibromyalgia should be addressed with a multitude of pharmacological and cognitive therapies.

“I hope that these findings motivate healthcare providers to consider CBT as an effective treatment option to reduce the impact of pain patients experience,” explained Edwards. “Chronic pain conditions like fibromyalgia involve long-standing patterns of changes in the central nervous system, and CBT is one among many treatment options, such as medication and physical therapy, that we know can be beneficial for those living with FM.”