A rehabilitation approach to chronic pain in rheumatologic practice

There have been several recent studies of the epidemiology and costs attributable to the chronic pain and chronic fatigue syndromes. Although investigations of the putative mechanisms of these disorders continue, there remains a poor understanding of their underlying pathophysiology. Four studies are reviewed that further support the commonality of both physical symptoms and psychological distress in chronic pain and chronic fatigue syndromes. By considering these commonalities, a comprehensive behavioral-rehabilitative approach can be undertaken to assist patients in addressing their adaptive difficulties. An overview of admission criteria for pain rehabilitation services is provided. Finally, recent empirical studies of both treatment process and outcome provide further support for the effectiveness and long-term benefits of this approach.