Efficacy of an out-patient pain management programme for people with joint hypermobility syndrome

Abstract

Joint hypermobility syndrome (JHS) is common in patients presenting to rheumatologists and can cause a range of symptoms leading to physical and psychological distress. Chronic musculoskeletal pain in patients with JHS often responds poorly to analgesics, and a pain management approach may be helpful. Since patients with JHS often have beliefs and experiences different to those of other chronic pain patients, they could fare better in JHS-specific programmes. Here, we report on the outcomes of patients in a JHS cognitive behavioural pain management programme. Patients fulfilling the Brighton criteria for JHS, who had suffered pain for at least 3months, were assessed by a psychologist and physiotherapist for suitability for this programme. Those accepted took part in a programme of 8days spread over 6weeks, delivered by a multidisciplinary team and incorporating a cognitive behavioural approach. Outcomes were assessed at baseline, 1- and 5-month post-programme using validated outcome measures. Outcome measures at baseline and 1-month were available for 87 patients (96% female, mean age 35years). There were significant improvements in self-efficacy, pain catastrophising, depression, anxiety, frustration, impact of pain and average pain intensity (all P < 0.001). Although by 5months all these outcomes had regressed towards pre-programme levels there remained significant improvements compared to baseline in all except average pain intensity. This open study shows that patients with JHS experienced significant benefits after attending a JHS-specific pain management programme, which were still evident 5months later. Longer-term controlled studies are required.