Multipronged approach relieves osteoarthritis pain

By Lauretta Ihonor

Using behavioral weight-management (BWM) strategies alongside standard pain-coping skills training (PCST) reduces the level of disability and pain experienced by overweight or obese individuals with osteoarthritis (OA), US study results suggest.

Writing in Pain, the researchers remark: "These findings raise the interesting possibility of a synergistic effect created by combining interventions that teach overweight and obese OA patients to cope with their pain as well as manage their weight."

A total of 232 patients with OA were included in the study. All were aged at least 18 years, reported knee pain on most days of the month during the 6-month period preceding the start of the study, and were overweight or obese (body mass index [BMI] ranging from 25-42 [inclusive]).

The participating patients were randomly allocated to receive 6 months of PCST plus BWM (n=62), PCST only (n=60), BWM only (n=59), or standard care only (n=51).

PCST involved 12 weeks of weekly training and role-playing sessions with clinical psychologists, followed by 12 weeks of the same sessions delivered every other week.

BWM consisted of 60-minute group therapy sessions and three 90-minute supervised exercise sessions every week for the first 12 weeks. The next 12 weeks involved group therapy sessions held every other week and no supervised exercise sessions.

The Arthritis Impact Measurement Scale was used to measure pain, physical disability, and psychologic disability.

Francis Keefe (Duke University Medical Center, Durham, North Carolina) and co-authors report that the individuals who received PCST plus BWM had significantly lower postintervention levels of pain, physical disability, and psychologic disability compared with all other intervention groups.

Individuals in the PCST plus BWM group lost more weight than any other treatment group over the follow-up period. An average of 7.0 lb (3.1 kg) was lost by this group by the end of the 12-month postintervention follow up, whereas only an average of 5.1 and 0.2 lb (2.3 and 0.1 kg) was lost by the PCST- and BWM-only groups, respectively.

Those in the standard care group gained an average of 4.0 lb (1.8 kg) over this period.

The authors conclude that adding PCST to BWM may boost weight-loss efforts by providing the pain-coping skills that patients require to increase compliance with the lifestyle changes that encourage weight loss.

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