Outcomes of a Comprehensive Pain Rehabilitation Program for Patients With Fibromyalgia, 2021, Engleberg-Cook et al

Abstract

Objective
To analyze opioid intake interference with psychological, well-being, and functional outcomes and medication tapering in patients with fibromyalgia admitted to the Mayo Clinic Pain Rehabilitation Program (MCPRP) in Florida.

Patients and Methods
A retrospective study on MCPRP outcomes was conducted. We reviewed the health records of 150 patients with fibromyalgia who participated in the program from May 1, 2014, to May 1, 2015. All patients were asked to fill out a survey at admission to and dismissal from the program. Surveys contained questions from the numeric pain score, Multidimensional Pain Inventory (perceived life control and interference of pain subscales), Center for Epidemiological Studies–Depression Scale, Pain Catastrophizing Scale, 36-Item Short-Form Health Status Survey (general health perceptions subscale), and Pain Self-Efficacy Questionnaire. A medical record review identified categories and number of medications at program admission and dismissal. Patients were divided in 2 groups: those whose concomitant medication did not include opioids at admission (no opioids group) and those whose concomitant medication included opioids at admission (opioids group).

Results
By dismissal from the MCPRP, patients with fibromyalgia in the no opioids group had a significant (P<.05) improvement in all the self-reported scores. Medication, including opioids, were effectively tapered at a substantially higher percentage in the opioids group.

Conclusion
Benefit of the comprehensive pain rehabilitation program in patients with fibromyalgia was indicated by clinical improvements in pain severity, physical and emotional health, and functional capacity while successfully tapering medication. Opioid intake at admission may modify the program outcomes.

Open access, https://www.mcpiqojournal.org/article/S2542-4548(21)00127-2/fulltext

 

not a pain rehab program more of a politically motivated drug reduction program . results based on self report forms more than likely filled in in front of therapist . the amount of form filling in itself would likely cause significant pain to many .

 

Please explain the ‘politically motivated’ part?

i think the scientific consensus for chronic pain has been that the opioid drugs are very problematic for a long term application.

For me the ‘comprehensive pain rehabilitation program’ bit is where my eyebrows raise in disbelief. Teaching CSS, catastrophization, doing a lil meditation and getting physical therapy rehab is not likely to deem patients cured upon checking out of their program.

 

the study was based on a californian patient cohort .there has been a consistent push in the usa to reduce the prescribing of opioids which seems to have been followed worldwide with people who have chronic health problems having their meds stopped or reduced .It would of course be perfect if their was some replacement non opioid meds that could give significant pain relief instead of fobbing people of with bullshit programs.

 

Yeah the bullshit programs are problematic.

 

There is quite a bit of US federal funding of opioid reduction programs (aka pain rehab) since the Sackler debacle was attributed more toward pain patients, for a time.

The main federal agency for pain research is all about taper off opioids and there aren't as yet effective replacements.