The Effect of Depression and Anxiety on the Success of Multidisciplinary Treatment of Chronic Resistant Myofascial Pain

Abstract

Objective: To determine the effect of anxiety and depression on the outcomes of the treatment of chronic resistant myofascial pain by a multidisciplinary program.

Methods: We treated 52 consecutive patients with chronic myofascial pain which failed to respond to physical, chiropractic, medical, surgical, and pharmacologic treatment with myofascial technique physical therapy, clinical psychophysiology [biofeedback, counseling], medications, and trigger point injections. We assessed outcomes with a Global Self Assessment Scale of Improvement. We compared groups with clinically defined anxiety and depression or both with the group having neither. All patients with anxiety took anxiolytic medication during the study and all but one with depression took antidepressants.

Results: Anxiety alone had no effect on outcomes. Compared with nondepressed patients, those with depression were 3.7 percent as likely to improve > 75 percent and 32 percent as likely to improve > 50 percent using the Global Self Assessment Scale of Improvement. No patients with both anxiety and depression improved > 50 percent.

Conclusions: Depression significantly reduced the likelihood of success of treatment of chronic resistant myofascial pain with a multidisciplinary treatment program.

KEYWORDS:

• Myofascial pain
• depression
• anxiety