Patients who received psychological treatments also had significant reductions in physical disability and joint swelling, although there was no difference in levels of fatigue or stiffness.

More women (69 percent) participated than men did. The average age was nearly 59 years and 81 percent of the participants were white. Therefore, the results are not universally applicable to men, minority groups or people outside of middle age, the authors say.

The number of study patients that reported reduced pain was not statistically significant, but the authors say that although "the effect sizes for pain are smallfor the most part, these effects occur in addition to those produced by standard medical care." The non-drug methods studied "are presumed safer" than medications, they add, another plus for psychological treatments.

"The goal is rehabilitation to reduce disability not a cure for chronic pain," said Patricia Dobkin, Ph.D., an associate professor of medicine at McGill University in Montreal who was not involved with the review. "When working in pain clinics, one often notes that even when pain intensity is not reduced significantly, patients can and do learn to live better with their pain," she added.

Given the different approaches and treatment options available to patients with arthritis, Keefe said, "If patients begin to develop problems coping with persistent pain, they could ask their health care provider to refer them to a psychologist who specializes in pain coping skills and cognitive behavior interventions."

Over 43 million adults in the United States have an arthritis diagnosis and another 23 million adults report symptoms of arthritis, making the disease the leading cause of pain and disability in the country. Arthritis is also a major contributor to workplace disability.

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Contact: Lisa Esposito
hbns-editor@cfah.org
Center for the Advancement of Health
10-May-2007