Pain management in rheumatoid arthritis: Cognitive behavior modification and transcutaneous neural stimulation

In order to assess the combined effects of cognitive‐behavior modification (CBM) and transcutaneous neural stimulation (TNS) on patients with rheumatoid arthritis, a pilot research project was conducted. An interrupted time‐series design was utilized with subjects serving as their own controls. Eight male rheumatoid arthritis patients were randomly assigned, two subjects each, to one of the following treatment conditions: (1) Cognitive Behavior Modification (CBM); (2) Transcutaneous Neural Stimulation (TNS); (3) CBM followed by a CBM/TNS combination; or (4) TNS followed by a CBM/TNS combination. The dependent measures included a visual analogue scale, grip strength, McGill Pain Questionnaire, and joint evaluations by a rheumatologist blind to the treatment conditions. Regarding self‐reported pain, this study found a slight superiority for the combined TNS/CBM treatments, particularly when the TNS procedures were introduced first. Further research on strategies for maximizing nonpharmacological pain management is recommended.