Chronic Pain and Cognitive Behavioral Therapy

Knoerl, Robert; Smith, Ellen M. Lavoie; Weisberg, James N.

doi:10.1177/0193945915615869

Cited by 151 publications

(119 citation statements)

References 92 publications

(153 reference statements)

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…38 Although none of our patients were receiving cognitive behavioral therapy for pain reduction, complementary and alternative medicine including psychological interventions, such as cognitive behavioral therapy and self-regulatory treatments, have been found to be efficacious in decreasing pain intensity and improving physical functioning although military veterans are underrepresented in these studies. 39 Fourth, we were not able to assess the use of illicit opioid because of the retrospective design of our study; however, our institutional policy prohibits the prescription of any opioids for patients who are actively using illicit drugs or who tested positive on routine urine drug testing.…”

Section: Discussionmentioning

confidence: 99%

Pain Intensity and Opioid Utilization in Response to CPAP Therapy in Veterans with Obstructive Sleep Apnea on Chronic Opioid Treatment

Jaoude

Lal

Vermont

et al. 2016

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

Study Objectives: Sleep fragmentation has been linked to poor pain tolerance and lowered pain threshold. Little evidence exists on whether continuous positive airway pressure (CPAP) adherence in veterans with obstructive sleep apnea (OSA) who are taking opioids for non-malignant pain would ameliorate pain and reduce consumption of opioids. Methods: A retrospective case-control study was performed at a VA sleep center. Pain intensity was assessed using the Numerical Categorical Scale prior to CPAP treatment and 12-mo follow-up. Opioids intake was assessed using the morphine equivalent daily dose (MEDD). Adherence to CPAP was evaluated with the built-in meter. Results: We reviewed 113 patients with OSA (apnea-hypopnea index [AHI] 35.9 ± 29.5) using a MEDD of 61.6 mg (range 5-980 mg) and a control group of 113 veterans with OSA (AHI 33.4 ± 27.3) on no opioids treatment. CPAP adherence was significantly lower at 12 mo in opioid-treated patients compared to controls (37% versus 55%; p = 0.01). Greater pain intensity was the only independent variable associated with CPAP non-adherence at 12-mo follow-up (p = 0.03). Compared to baseline, no significant difference was observed in pain intensity or consumption of opioids in CPAP adherent patients. I NTRO DUCTI O NChronic pain is a serious and highly prevalent condition among service members. Although the prevalence of chronic pain and opioid use associated with deployment is not well known, a recent report indicated that nearly half of a group of infantry soldiers who had seen combat in Afghanistan have reported experiencing chronic pain.1 The better body armor combined with advanced medical care on the battlefield had led to improved survival rates following serious residual injuries (such as limb amputations and severe nerve and musculoskeletal damage) caused by blasts or projectiles. The multiplicity of these wounds in soldiers, coupled with cognitive impairments associated with traumatic brain injury and mental health morbidity has caused an increase in dependency on opioids to suppress these ailments.The use of opioids has been associated with development of sleep-disordered breathing, including central apneas, ataxic breathing, and nocturnal hypoxemia.2-4 However, obstructive sleep apnea (OSA) is considered the predominant form of sleep-disordered breathing among veterans receiving chronic opioid therapy.5 However, this reduced pain sensitivity has been reported in healthy volunteers with induced rather than preexisting pain. It is speculated that the sleep disruption resulting from repeated arousals alters the nociceptive system, rendering it more susceptible to maladaptive plasticity. Preliminary investigations in healthy volunteers have suggested that although pain sensitivity is increased following sleep restriction, restoring sleep architecture ameliorates pain thresholds. 6,7 Further, treatment of underlying sleep apnea with continuous positive airway pressure (CPAP) has been associated with reduced hyperalgesia in patients with sleep-disordered breathing. ...

show abstract

Section: Discussionmentioning

confidence: 99%

Pain Intensity and Opioid Utilization in Response to CPAP Therapy in Veterans with Obstructive Sleep Apnea on Chronic Opioid Treatment

Jaoude

Lal

Vermont

et al. 2016

Journal of Clinical Sleep Medicine

View full text Add to dashboard Cite

show abstract

“…Cognitive restructuring has been demonstrated to be a key component of previous self-guided cognitive behavioural pain management interventions. Of the seven-self-guided cognitive behavioural pain management trials reviewed by Knoerl, Lavoie Smith, & Weisberg (2015), four had positive effects on anxiety/ depression. These four trials placed a specific emphasis on cognitive restructuring by providing participants with access to modules containing this strategy for multiple weeks.…”

Section: Discussionmentioning

confidence: 99%

“…Less is known regarding the efficacy of cognitive behavioral pain management for pain-related fatigue and sleep-related impairment in individuals with chronic pain (Knoerl, Lavoie Smith, & Weisberg, 2015). However, there is considerable evidence supporting the use of cognitive behavioral therapy for insomnia and fatigue (Price, Mitchell, Tidy, & Hunot, 2008;Zachariae, Lyby, Ritterband, & O'Toole, 2016).…”

Section: Discussionmentioning

confidence: 99%

Potential mediators of improvement in painful chemotherapy-induced peripheral neuropathy via a web-based cognitive behavioural intervention

Knoerl

Barton

Holden

et al. 2018

CONJ

Self Cite

View full text Add to dashboard Cite

“…Yeni bir meta analizde, 35 çalışma IMMPACT kılavuzla-rında önerilen kriterlere göre incelenmiş (Knoerl, Lavoie Smith, & Weisberg, 2016) ve en sık uygulanan tedavi sü-resinin 6-10 hafta olduğu, etkinliğinin ise geniş dağılımlı olduğu izlenmiştir. Örneğin, 1-5 haftalık tedavinin etkisinin %0 olduğu izlenirken, 20 hafta üstü tedavini etkinliği %75 bulunmuştur.…”

Section: Bi̇li̇şsel Davranişçi Terapi̇ni̇n Etki̇nli̇ği̇unclassified

Cognitive Bahavioral Therapy In The Chronic Pain Management

Babaoğlu¹,

İnan²,

Özdel³

2017

JCBPR

View full text Add to dashboard Cite

Cognitive Bahavioral Therapy in The Chronic Pain ManagementPain is a complex experience that is influenced by neurological processes and psychosocial factors, and an important health problem that affects the individual, society, and work force, leading to reduced quality of life and physical activity, and impaired social relations. Many studies have demonstrated the efficacy of cognitive behavioral therapy (CBT) in reducing the severity and frequency of pain, improving pain-induced negative mood, and improving quality of life. The patient's cognitive coping, cognitive restructuring, problem solving and relaxation skills are improved with CBT. Considering the biopsychosocial pain model and other literature information, chronic pain management should be organized in a multidisciplinary approach.Keywords: Chronic pain, cognitive behavioral therapy, chronic pain management ÖzAğrı, nörolojik süreçler ve psikososyal faktörlerden etkilenen karmaşık bir deneyim olup, yaşam kalitesi ile fiziksel aktivitede azalma ve sosyal ilişkilerde bozulmaya neden olan, bireyi, toplumu ve iş gücünü etkileyen önemli bir sağlık problemidir. Ağrının şiddetini ve sıklığını azaltma, ağrı kaynaklı negatif ruh halinin iyileşmesi ve yaşam kalitesinin yükseltilmesi konusunda bilişsel davranışçı terapinin (BDT) etkinliği birçok çalışma ile gösterilmiştir. BDT ile hastanın bilişsel başa çıkma, bilişsel yeniden yapılandırma, problem çözme ve gevşeme becerileri geliştirilir. Biyopsikososyal ağrı modeli ve diğer literatür bilgileri göz önünde bulundurularak, kronik ağrı tedavisi multidisipliner bir yaklaşımla düzenlenmelidir.

show abstract

Chronic Pain and Cognitive Behavioral Therapy

Cited by 151 publications

References 92 publications

Pain Intensity and Opioid Utilization in Response to CPAP Therapy in Veterans with Obstructive Sleep Apnea on Chronic Opioid Treatment

Pain Intensity and Opioid Utilization in Response to CPAP Therapy in Veterans with Obstructive Sleep Apnea on Chronic Opioid Treatment

Potential mediators of improvement in painful chemotherapy-induced peripheral neuropathy via a web-based cognitive behavioural intervention

Cognitive Bahavioral Therapy In The Chronic Pain Management

Contact Info

Product

Resources

About