title: Efficacy of an out-patient pain management programme for people with joint hypermobility syndrome.
abstract: Joint hypermobility syndrome (JHS) is common in patients presenting to rheumatologists and can cause a range of symptoms leading to physical and psychological distress. Chronic musculoskeletal pain in patients with JHS often responds poorly to analgesics, and a pain management approach may be helpful. Since patients with JHS often have beliefs and experiences different to those of other chronic pain patients, they could fare better in JHS-specific programmes. Here, we report on the outcomes of patients in a JHS cognitive behavioural pain management programme. Patients fulfilling the Brighton criteria for JHS, who had suffered pain for at least 3 months, were assessed by a psychologist and physiotherapist for suitability for this programme. Those accepted took part in a programme of 8 days spread over 6 weeks, delivered by a multidisciplinary team and incorporating a cognitive behavioural approach. Outcomes were assessed at baseline, 1- and 5-month post-programme using validated outcome measures. Outcome measures at baseline and 1-month were available for 87 patients (96 % female, mean age 35 years). There were significant improvements in self-efficacy, pain catastrophising, depression, anxiety, frustration, impact of pain and average pain intensity (all P < 0.001). Although by 5 months all these outcomes had regressed towards pre-programme levels there remained significant improvements compared to baseline in all except average pain intensity. This open study shows that patients with JHS experienced significant benefits after attending a JHS-specific pain management programme, which were still evident 5 months later. Longer-term controlled studies are required.
authors.affiliation: Centre for Rheumatology, Research, Division of Medicine, University College London, Room 412, Rayne Institute, 5 University Street, London, WC1E 6JF, UK, anisur.rahman@ucl.ac.uk.
authors.forename: Anisur
authors.initials: A
authors.lastname: Rahman
authors.forename: Clare
authors.initials: C
authors.lastname: Daniel
authors.forename: Rodney
authors.initials: R
authors.lastname: Grahame
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology / Q000523:psychology / Q000628:therapy; D058443:Catastrophization / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003863:Depression / Q000209:etiology / Q000523:psychology / Q000628:therapy; D005260:Female; D005639:Frustration; D006801:Humans; D007593:Joint Instability / Q000150:complications* / Q000523:psychology; D008297:Male; D059352:Musculoskeletal Pain / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D010045:Outpatients; D059408:Pain Management / Q000379:methods*; D020377:Self Efficacy; D016896:Treatment Outcome