Nonpharmacologic Treatment for Fibromyalgia: Patient Education, Cognitive- Behavioral Therapy, Relaxation Techniques, and Complementary and Alternative Medicine
Rheum Dis Clin N Am 35 (2009) 393–407 doi:10.1016/j.rdc.2009.05.003
California School of Professional Psychology, Alliant International University, 104 Daley Hall, 10455 Pomerado Road, San Diego, CA 92131, USA E-mail address: email@example.com (A.L. Hassett).
Treating patients who have chronic pain conditions has long held challenges and been rife with pitfalls for health care professionals. Pain is a complex and dynamic phenomenon influenced by genetic, physiologic, cognitive, affective, behavioral, and social factors. Melzack and Wall’s gate-control theory revolutionized the understanding of and treatment for chronic pain.1 Central to this theory is the existence of a gating system at the dorsal horn of the spinal cord that can control pain transmission from the periphery to the somatosensory cortices in the brain. The gating of pain signals is thought to be controlled by peripheral input and the neural centers that govern thoughts, emotions, and behaviors.1 The gate-control theory explains why certain factors, such as depression and anxiety, worsen the experience of pain, whereas other factors, such as active coping, positive affect, and social support, moderate the experience of pain.