• Masayuki Inoue, Shinsuke Inoue, Tatsunori Ikemoto, Young-Chang P Arai, Masatoshi Nakata, Atsuko Miyazaki, Makoto Nishihara, Takashi Kawai, Noboru Hatakeyama, Setsuko Yamaguchi, Kazuhiro Shimo, Hirofumi Miyagawa, Tomomi Hasegawa, Hiroki Sakurai, Yoshinobu Hasegawa, Yusuke Ohmichi, and Takahiro Ushida.
• Pain Res Manag. 2014 Nov 1; 19 (6): 302-8.

BackgroundChronic pain is a major problem because it can result in not only a reduction in activities of daily living and quality of life but also requires initiation of social assistance. Seeking only to eliminate pain itself would appear to be too narrow an objective, in addition to often being unachievable; therefore, a multifaceted, comprehensive approach with multiple objectives is needed.ObjectiveTo describe the effects of a program (the 'Chronic Pain Class') offering cognitive behavioural therapy to small groups of individuals with refractory chronic pain in Japan. Exercise was an important feature of the program.MethodsA total of 46 patients who were experiencing treatment difficulties and decreased activity participated in the program. The programs were conducted in groups of five to seven patients who met weekly for nine weeks. Weekly sessions, which were approximately 2 h in duration, combined lectures with exercise. Several measures related to pain and physical function were administered at the beginning and the conclusion of the program.ResultsNine patients dropped out during the program. A number of measures (eg, pain intensity, disability, catastrophizing thoughts) showed significant improvements after intervention (P<0.002 after Bonferroni correction). Furthermore, most measures of physical function showed substantial improvement, especially seated forward bends, zig-zag walking, self-care and 6 min walk test (P<0.001).ConclusionThe results of the present study provide evidence that a combination of cognitive behavioural therapy and exercise should be recommended to patients with refractory chronic pain.

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