Talking treatment may help with arthritis pain

People with a joint condition called osteoarthritis often have trouble sleeping because of pain. And lack of sleep can make pain worse. So it can become a vicious cycle.
Although painkilling medicines can help a lot, some people with arthritis find they still get pain. Also, painkillers can cause troublesome side effects when you have to take them long-term. So a way of improving sleep and helping with pain, that doesn’t involve taking more medicine, sounds like a step forward.

Researchers have been interested for some time in the effects on both sleep and pain of a talking treatment called cognitive behaviour therapy (CBT). This therapy helps people to change the way they think and feel about themselves and the world, and also how they behave. It is already used for several other health problems, including depression and anxiety.

A recent small study looked to see whether CBT could help people with arthritis, pain, and sleep problems.

What does the new study say?

People who took part in the CBT sessions said they slept better and reported feeling less pain immediately after finishing the course. They were still getting some benefit a year later, although the effects had worn off a bit.
The people who had CBT did better than a comparison group of people who learned about things including breathing techniques, stress, anxiety, exercise techniques, and nutrition.

How reliable are the findings?

The study is a randomised controlled trial, which is the best type of study for finding out whether a treatment works. However, it was quite small (only 51 people altogether). This means the results are a bit less reliable. It would be helpful to see bigger studies of CBT for people with arthritis and sleep problems.
The study showed more reliable findings for improved sleep than for improved pain. The researchers measured pain using two different questionnaires. Only one of the two showed a difference for the people who’d had CBT.

Where does the study come from?

The researchers came from a number of US universities. The study was published in the Journal of Clinical Sleep Medicine. It was paid for by grants from research institutions.

What does this mean for me?

If you have arthritis and you find it hard to sleep, this study suggests that a course of CBT aimed at helping you to sleep better might be helpful. Unfortunately, you may find it hard to find a therapist trained in this type of CBT. If you’re interested in finding out more about CBT, talk to your GP to help you find a therapist locally.

Tips

If you have problems sleeping, these are some things that doctors recommend. They were also taught to the people in the study.
* Exercise during the day, but not just before you go to sleep.
* Avoid eating a large meal just before you go to bed.
* Avoid tobacco and drinks that contain caffeine or alcohol for a few hours before bedtime.
* Use the bedroom just for sleeping and having sex. Don’t use it to read, watch television, eat, or work. Try to keep your room cool and quiet. If you can’t sleep after about 15 or 20 minutes, go to another room.
* Try reading with a fairly dim light.
* Get up at the same time every morning, even if you don’t feel rested.

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