Search for pain relief in people with chronic fatigue syndrome: A descriptive study

[Dolphin]

The search for pain relief in people with chronic fatigue syndrome: A descriptive study.

Physiother* Theory Pract. 2011 Jul;27(5):373-83. Epub 2010 Nov 1.

Marshall R, Paul L, Wood L.

Source

Physiotherapist, Research Assistant, Nursing & Health Care, Faculty of Medicine, University of Glasgow, Glasgow, Scotland, United Kingdom.

Abstract**

The purpose of this study was to investigate the use and perceived benefit of complimentary and alternative medicine (CAM) and physiotherapy treatments tried by people with chronic fatigue syndrome (CFS) to ease painful symptoms.

This study used a descriptive, cross-sectional design. People with CFS who experienced pain were recruited to this study.

Participants were asked during a semistructured interview about the treatments they had tried to relieve their pain.

Each interview was conducted in the home of the participant.

Fifty participants were recruited, of which, 10 participants were severely disabled by CFS.

Eighteen participants were trying different forms of CAM treatment for pain relief at the time of assessment.

Three participants were currently receiving physiotherapy.

Throughout the duration of their illness 45 participants reported trying 19 different CAM treatments in the search for pain relief.

Acupuncture was reported to provide the most pain relief (n=16).

Twenty-seven participants reported a total of 16 different interventions prescribed by their physiotherapist.

The results of this study suggest some physiotherapy and CAM treatments may help people manage painful CFS symptoms.

Future research should be directed to evaluating the effectiveness of interventions such as acupuncture or gentle soft tissue therapies to reduce pain in people with CFS.

PMID: 21039301 [PubMed - in process]

* Physiotherapy is called Physical Therapy in the US (and probably in some other countries also)

** I've given each sentence its own paragraph

 

[Dolphin]

I just read the full text of this. The numbers for any one therapy were generally very, very small.

Anyway, I thought the following was interesting:

"In total, 12 participants with CFS had tried graded exercise therapy, although 11 participants reported that they had stopped because it had increased their pain."

-----
(This is a subset of the above data)

"Graded exercise was the intervention that was most commonly prescribed by physiotherapists (n=6) and generally caused the most pain." (5 out of 6 reported increased pain while 1 out of 6 said it helped reduce pain)

=========
Results for Massage:

Massage was the next most popular treatment (n=18), which helped reduce pain for 5 participants. However, 13 participants who received massage treatments reported that their pain increased during treatment and became worse the following day. Only 1 participant who received massage did so from a physiotherapist.

Discussion for massage:

Massage was also a popular treatment for relief of painful CFS symptoms. In this study 13 of 18 people reported that massage was painful at the time of treatment or the following day. In comparison, Field et al (1997) reported pain relief in patients with CFS following massage treatment, although only one dimension of pain was measured. The difference between the self-reported increase in pain with massage in this study and the reduction in pain with massage in the study by Field et al (1997) may be due to the type and depth of massage given. In the present study people with CFS reported massage was given using deep and firm pressure, whereas Field et al (1997) delivered massage with gentle pressure. An adverse reaction to massage treatment may be due to central sensitization, which can cause hyperalgesia in patients with CFS (Meeus and Nijs, 2007). There are more than 80 styles of massage, and different techniques are used to achieve specific results (e.g., relaxation and relieving pain) (Sherman, Dixon, Thompson, and Cherkin, 2006). Further research into the effectiveness of gentle soft tissue treatments to help relieve pain in people with CFS may be warranted (e.g., gentle massage and myofascial release).

 

[Dolphin]

Helpful self-management strategies

Helpful self-management strategies

TABLE 1
The activities, situations, and applications that help
to ease pain in people with CFS (n=50)

Easing factors Number of subjects

Warm baths 29
Heat applications 25
Lying down/rest 22
Drinking water 17
Pain medication 11
Electric massager 8
Stretching exercises 7
Pacing 6
Raising legs 6
Breathing exercises 5
Ice bags/cold compress 5
Meditation 4
Routine 4
Warm shower 4
Warm weather 4
Other techniques 15