Reduction in anxiety during treatment with exercise and duloxetine is related to improvement of low back pain-related disability in patients with non-specific chronic low back pain

Onda, Akira; Kimura, Masashi

doi:10.5387/fms.2020-22

Cited by 5 publications

(5 citation statements)

References 27 publications

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“…Combination treatment has been effective and is recommended to treat conditions including depression and fibromyalgia [81,82] and other non-pharmacological approaches such as exercise combined with medication successfully treat chronic pain [83]. Combining medication and psychological approaches is recommended for treatment of depression, and it has been shown to reduce pain in patients with coexisting depression and musculoskeletal pain [84].…”

Section: Discussionmentioning

confidence: 99%

Duloxetine and cognitive behavioral therapy with phone-based support for the treatment of chronic musculoskeletal pain: study protocol of the PRECICE randomized control trial

Ang,

Davuluri,

Kaplan

et al. 2024

Trials

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Background Chronic musculoskeletal pain (CMP) is the most common, disabling, and costly of all pain conditions. While evidence exists for the efficacy of both duloxetine and web-based cognitive behavioral therapy (CBT) as monotherapy, there is a clear need to consider study of treatment components that may complement each other. In addition, given the reported association between patient’s adherence and treatment outcomes, strategies are needed to enhance participant’s motivation to adopt and maintain continued use of newly learned pain coping skills from CBT. Methods Two hundred eighty participants will be recruited from the primary care clinics of a large academic health care system in North Carolina. Participants with CMP will be randomized to one of three treatment arms: (1) combination treatment (duloxetine + web-based self-guided CBT) with phone-based motivational interviewing (MI), (2) combination treatment without phone-based MI, and (3) duloxetine monotherapy. Participants will be in the study for 24 weeks and will be assessed at baseline, week 13, and week 25. The primary outcome is the Brief Pain Inventory (BPI)-Global Pain Severity score, which combines BPI pain severity and BPI pain interference. Secondary measures include between-group comparisons in mean BPI pain severity and BPI pain interference scores. Data collection and outcome assessment will be blinded to treatment group assignment. Discussion This randomized controlled trial (RCT) will determine if combination treatment with duloxetine and web-based CBT is superior to duloxetine monotherapy for the management of CMP. Furthermore, this RCT will determine the effectiveness of phone-based motivational interviewing in promoting the continued practice of pain coping skills, thereby enhancing treatment outcomes. Trial registration NCT04395001 ClinicalTrials.gov. Registered on May 15, 2020.

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Section: Discussionmentioning

confidence: 99%

Duloxetine and cognitive behavioral therapy with phone-based support for the treatment of chronic musculoskeletal pain: study protocol of the PRECICE randomized control trial

Ang,

Davuluri,

Kaplan

et al. 2024

Trials

View full text Add to dashboard Cite

show abstract

“…Combination treatment has been effective and is recommended to treat conditions including depression and fibromyalgia, 81 , 82 and other nonpharmacological approaches such as exercise combined with medication successfully treat chronic pain. 83 Combining medication and psychological approaches is recommended for treatment of depression, and it has been shown to reduce pain in patients with coexisting depression and musculoskeletal pain. 84 Overall, the study of the combined treatment and its effects on CMP are limited in number.…”

Section: Discussionmentioning

confidence: 99%

Duloxetine and Cognitive Behavioral Therapy with Phone-based Support for the Treatment of Chronic Musculoskeletal Pain: Study Protocol of the PRECICE Randomized Control Trial

Ang,

Davuluri,

Kaplan

et al. 2024

Preprint

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Background: Chronic musculoskeletal pain (CMP) is the most common, disabling, and costly of all pain conditions. While evidence exists for the efficacy of both duloxetine and web-based cognitive behavioral therapy (CBT) as monotherapy, there is a clear need to consider study of treatment components that may complement each other. In addition, given the reported association between patient’s adherence and treatment outcomes, strategies are needed to enhance participant’s motivation to adopt and maintain continued use of newly learned pain coping skills from CBT. Methods: Two hundred eighty participants will be recruited from the primary care clinics of a large academic health care system in North Carolina. Participants with CMP will be randomized to one of 3 treatment arms: (1) combination treatment (duloxetine + web-based self-guided CBT) with phone-based motivational interviewing (MI), (2) combination treatment without phone-based MI and (3) duloxetine monotherapy. Participants will be in the study for 24 weeks and will be assessed at baseline, week 13, and week 25. The primary outcome is the Brief Pain Inventory (BPI)-Global Pain Severity score, which combines BPI pain severity and BPI pain interference. Secondary measures include between-group comparisons in mean BPI pain severity and BPI pain interference scores. Data collection and outcome assessment will be blinded to treatment group assignment. Discussion: This randomized controlled trial (RCT) will determine if combination treatment with duloxetine and web-based CBT is superior to duloxetine monotherapy for the management of CMP. Furthermore, this RCT will determine the effectiveness of phone-based motivational interviewing in promoting the continued practice of pain coping skills; thereby, enhancing treatment outcomes. Trial Registration: NCT04395001. Registered in ClinicalTrials.gov on May 15, 2020.

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“…Мультидисциплинарный подход к лечению пациента с хронической неспецифической БНЧС и тре-вожным расстройством включает следующие методы: кинезиотерапию, КПТ, оптимальную фармакотерапию [28][29][30][31][32]. Выбор лекарственных препаратов при хронической неспецифической БНЧС зависит от сопутствующих заболеваний, наличия и выраженности симптомов тревоги и депрессии, предшествующего опыта и предпочтений самого пациента [33][34][35][36][37][38][39][40]. Мультидисциплинарный подход позволяет эффективно и относительно быстро облегчить боль, повысить повседневную активность и улучшить эмоциональное состояние пациентов.…”

Section: Neurologyunclassified

Management of patients with musculoskeletal back pain and comorbid anxiety

Головачева¹,

Tabeeva²,

Fateeva³

2023

Medicinskij sovet

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Musculoskeletal back pain (MSBP) is one of the most common reasons for seeking medical care. A socioeconomic burden of MSBP is significant, as it leads to reduced working capacity of the adult population. It is important to consider that the MSBP chronicity develops under the impact of “yellow flags”, i. e. factors that contribute to the central pain sensitization (pathophysiologically) and pain chronicification (clinically). The most common factor of pain chronicity is anxiety that underlies the development of pain catastrophization, maladaptive escape (“pain”) behaviour, and anxiety disorders. Anxiety symptoms can be expressed not only in the emotional, but also in the somatic, cognitive and behavioural sphere. Timely detection and management of anxiety in patients with chronic MSBP improves the effectiveness of pain syndrome treatment. The chronic MSBP treatment requires a multidisciplinary approach, which comprises kinesiotherapy, cognitive behavioural therapy, and optimal pharmacotherapy. Evidence-based drugs include non-steroidal anti-inflammatory drugs, such as dexketoprofen, which can be prescribed for the treatment of chronic MSBP with a short course and at an average therapeutic dose. The efficacy and safety of dexketoprofen in the treatment of pain syndromes, data from clinical studies and a systematic review are discussed. The authors present their own experience in managing a patient with chronic nonspecific MSBP and anxiety. The “yellow flags” that led to the MSBP chronicity in the patient are provided. The effective multidisciplinary approach to the treatment of a patient with chronic MSBP and anxiety disorder is demonstrated.

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Reduction in anxiety during treatment with exercise and duloxetine is related to improvement of low back pain-related disability in patients with non-specific chronic low back pain

Cited by 5 publications

References 27 publications

Duloxetine and cognitive behavioral therapy with phone-based support for the treatment of chronic musculoskeletal pain: study protocol of the PRECICE randomized control trial

Duloxetine and cognitive behavioral therapy with phone-based support for the treatment of chronic musculoskeletal pain: study protocol of the PRECICE randomized control trial

Duloxetine and Cognitive Behavioral Therapy with Phone-based Support for the Treatment of Chronic Musculoskeletal Pain: Study Protocol of the PRECICE Randomized Control Trial

Management of patients with musculoskeletal back pain and comorbid anxiety

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