Does psychiatric treatment help patients with intractable chronic pain?
Tricyclic antidepressants and intensive multidisciplinary programs are moderately effective for reducing chronic back pain; tricyclics are also effective for diabetic neuropathy and irritable bowel syndrome (strength of recommendation [SOR]: A, meta-analyses and multiple small randomized controlled trials). Cognitive therapies are modestly effective for reducing pain in the following: chronic back pain, other chronic musculoskeletal disorders including rheumatoid arthritis (SOR: B, multiple meta-analyses with significant heterogeneity), and for chronic cancer pain (SOR: B, 1 meta-analysis of various quality studies).
Kerns
J Williams
JW
Department of Family Medicine, Virginia Commonwealth University, Winchester, VA, USA.
White
Andy
A
Nashelsky
Joan
J
Sherman
Stan
S
D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy; D006801:Humans; D010148:Intractable Pain / Q000628:therapy*
D000929:Antidepressive Agents, Tricyclic