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FOTO Rehab Outcomes Blog

Relaxation Response Resiliency Program (3RP) in Patients with Headache and Musculoskeletal Pain

When someone is in pain, all they want it to be relieved of their pain experience. I found this nice, recent study in a nursing journal. I think it offers some additional food for thought when dealing with people who are experiencing pain.


I know from the upcoming report, Data Trends in U.S. Healthcare and Patient Rehabilitation - Focus Patient Characteristics, Patient Outcomes and Clinical Performance, that many patients present for services for musculoskeletal problems. Most of these individuals have had pain for a substantial length of time and continue to be employed.

So much work has been done in the rehabilitation world to identify biopsychosocial factors. We know that those factors affect functional outcomes of our patients. The first options that pop into my head to address psychosocial factors include cognitive functional therapy and pain science education or therapeutic neuroscience education. I can see from the Relaxation Response Resiliency Program that other options may be included to help these patients down regulate their autonomic nervous system.

You'll find the abstract to the recent study below.

The Relaxation Response Resiliency Program (3RP) in Patients with Headache and Musculoskeletal Pain: A Retrospective Analysis of Clinical Data.



Headache and musculoskeletal pain are associated with both physical and mental health symptoms, which together are mutually reinforcing. Addressing mental and physical health symptoms (including pain) concomitantly may provide an effective and efficient way to improve outcomes in this population. We tested an evidence-based, eight-session multimodal group program, the Relaxation Response Resiliency Program (3RP), in patients with headache and musculoskeletal pain. A total of 109 adults (30 with headaches, 79 with musculoskeletal pain). Participant were 109 adults (30 with headaches, 79 with musculoskeletal pain) referred by their medical doctor, who completed a battery of questionnaires before and after completion of the 3RP. On average, patients with headache and musculoskeletal pain had higher pretreatment scores for anxiety, depression, and somatization symptoms than the nonpatient normative sample for the Symptom Checklist 90-Revised. Significant improvements were identified from pre- to post-treatment in all mental health symptoms (moderate to large effects) and frequency of pain and co-occurring physical health symptoms (small to moderate effects). Patients also reported significant decreases in degree of discomfort and life interference, which were relatively more modest in the musculoskeletal pain group compared with the headache group. Overall, results of this study suggest that the 3RP may be an effective treatment for reducing pain and psychological symptoms in patients with headaches and musculoskeletal pain. Future work is needed to evaluate the 3RP via a randomized clinical trial in these patient populations.

 2018 May 14. pii: S1524-9042(17)30608-2. doi: 10.1016/j.pmn.2018.04.003. [Epub ahead of print]

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