Skip to main content

Advertisement

SpringerLink
Log in

Pain and Its Management in Systemic Sclerosis

  • Pain in Rheumatology (W Nielson, Section Editor)
  • Published:
Current Treatment Options in Rheumatology Aims and scope Submit manuscript

Abstract

Purpose of review

Pain is one of the most common quality of life concerns in systemic sclerosis (SSc). This review summarizes the literature on risk factors and potential clinical assessment and treatment strategies.

Recent findings

SSc pain is associated with, but not defined by, disease parameters and severity. The extant literature suggests that psychosocial factors such as mental health are relevant to pain. Brief pain screenings can be followed by a more comprehensive assessment to help inform intervention strategies for affected patients. The literature on pain management is relatively small, but numerous studies and clinical practice recommendations suggest that there are multiple avenues for intervention. These include medical treatments, physical activity and rehabilitation programs, and psychotherapeutic techniques.

Summary

There are many promising approaches to SSc pain treatment. Future research should include systematic evaluation of treatments that have been proposed in SSc and/or have demonstrated efficacy in other chronic pain or rheumatic samples. Particular attention should be paid to treatments that include a non-pharmacological component and are more easily accessible for patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Medsger TA. Natural history of systemic sclerosis and the assessment of disease activity, severity, functional status, and psychologic well-being. Rheum Dis Clin N Am. 2003;29(2):255–73.

    Article  Google Scholar 

  2. Barnes J, Mayes MD. Epidemiology of systemic sclerosis: incidence, prevalence, survival, risk factors, malignancy, and environmental triggers. Curr Opin Rheumatol. 2012;24(2):165–70.

    Article  PubMed  Google Scholar 

  3. Borenstein D, Altman R, Bello A, et al. Report of the American College of Rheumatology Pain Management Task Force. Arthritis Care Res. 2010;62(5):590–9.

    Article  Google Scholar 

  4. Benrud-Larson LM, Haythornthwaite JA, Heinberg LJ, Boling C, Reed J, White B, et al. The impact of pain and symptoms of depression in scleroderma. Pain. 2002;95(3):267–75.

    Article  PubMed  Google Scholar 

  5. •• Schieir O, Thombs BD, Hudson M, Boivin JF, Steele R, Bernatsky S, et al. Prevalence, severity, and clinical correlates of pain in patients with systemic sclerosis. Arthritis Care Res. 2010;62(3):409–17. Presents prevalance and correlates of SSc pain in a large sample.

  6. Merz EL, Malcarne VL, Roesch SC, Nair DK, Salazar G, Assassi S, et al. Longitudinal patterns of pain in patients with diffuse and limited systemic sclerosis: integrating medical, psychological, and social characteristics. Qual Life Res. 2017;26(1):85–94.

    Article  PubMed  Google Scholar 

  7. Georges C, Chassany O, Toledano C, Mouthon L, Tiev K, Meyer O, et al. Impact of pain in health related quality of life of patients with systemic sclerosis. Rheumatology. 2006;45(10):1298–302.

    Article  PubMed  CAS  Google Scholar 

  8. Hudson M, Thombs BD, Steele R, Watterson R, Taillefer S, Baron M, et al. Clinical correlates of quality of life in systemic sclerosis measured with the World Health Organization Disability Assessment Schedule II. Arthritis Rheum. 2008;59(2):279–84.

    Article  PubMed  Google Scholar 

  9. Mura G, Bhat KM, Pisano A, Licci G, Carta M. Psychiatric symptoms and quality of life in systemic sclerosis. Clin Pract Epidemiol Ment Heal. 2012;8:30–5.

    Article  CAS  Google Scholar 

  10. Milette K, Razykov I, Pope J, Hudson M, Motivala SJ, Baron M, et al. Clinical correlates of sleep problems in systemic sclerosis: the prominent role of pain. Rheumatology. 2011;50(5):921–5.

    Article  PubMed  Google Scholar 

  11. •• Peytrignet S, Denton CP, Lunt M, Hesselstrand R, Mouthon L, Silman A, et al. Disability, fatigue, pain and their associates in early diffuse cutaneous systemic sclerosis: the European Scleroderma Observational Study. Rheumatology. 2018;57(2):370–81. Recent, large study describing correlates of SSc pain in a large sample.

  12. Bassel M, Hudson M, Taillefer SS, Schieir O, Baron M, Thombs BD. Frequency and impact of symptoms experienced by patients with systemic sclerosis: results from a Canadian National Survey. Rheumatology. 2011;50(4):762–7.

    Article  PubMed  Google Scholar 

  13. Yacoub YI, Amine B, Bensabbah R, Hajjaj-Hassouni N. Assessment of fatigue and its relationships with disease-related parameters in patients with systemic sclerosis. Clin Rheumatol. 2012;31(4):655–60.

    Article  PubMed  Google Scholar 

  14. Poole JL, Anwar S, Mendelson C, Allaire S. Workplace barriers encountered by employed persons with systemic sclerosis. Work. 2016;55(4):923–9.

    Article  PubMed  Google Scholar 

  15. Sandqvist G, Scheja A, Hesselstrand R. Pain, fatigue and hand function closely correlated to work ability and employment status in systemic sclerosis. Rheumatology. 2010;49(9):1739–46.

    Article  PubMed  Google Scholar 

  16. Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150:971–9.

    Article  PubMed  CAS  Google Scholar 

  17. Fava GA, Sonino N. The biopsychosocial model thirty years later. Psychother Psychosom. 2008;77(1):1–2.

    Article  PubMed  Google Scholar 

  18. Carreira PE. “Quality of pain” in systemic sclerosis. Rheumatology. 2006;45(10):1185–6.

    Article  PubMed  CAS  Google Scholar 

  19. Sousa-Neves J, Cerqueira M, Santos-Faria D, Afonso C, Teixeira F. Neuropathic pain in systemic sclerosis patients: a cross-sectional study. Reumatol Clínica. 2018; https://doi.org/10.1016/J.REUMA.2017.12.010.

  20. Malcarne VL, Hansdottir I, McKinney A, Upchurch R, Greenbergs HL, Henstorf GH, et al. Medical signs and symptoms associated with disability, pain, and psychosocial adjustment in systemic sclerosis. J Rheumatol. 2007;34:359–67.

    PubMed  Google Scholar 

  21. Richards HL, Herrick AL, Griffin K, Gwilliam PDH, Loukes J, Fortune DG. Systemic sclerosis: patients’ perceptions of their condition. Arthritis Rheum. 2003;49(5):689–96.

    Article  PubMed  Google Scholar 

  22. Del Rosso A, Boldrini M, D’Agostino D, et al. Health-related quality of life in systemic sclerosis as measured by the Short Form 36: relationship with clinical and biologic markers. Arthritis Rheum. 2004;51(3):475–81.

    Article  PubMed  Google Scholar 

  23. Merkel PA, Herlyn K, Martin RW, Anderson JJ, Mayes MD, Bell P, et al. Measuring disease activity and functional status in patients with scleroderma and Raynaud’s phenomenon. Arthritis Rheum. 2002;46(9):2410–20.

    Article  PubMed  Google Scholar 

  24. Franck-Larsson K, Graf W, Rönnblom A. Lower gastrointestinal symptoms and quality of life in patients with systemic sclerosis: a population-based study. Eur J Gastroenterol Hepatol. 2009;21(2):176–82.

    Article  PubMed  Google Scholar 

  25. Amaral TN, Peres FA, Lapa AT, Marques-Neto JF, Appenzeller S. Neurologic involvement in scleroderma: a systematic review. Semin Arthritis Rheum. 2013;43(3):335–47.

    Article  PubMed  Google Scholar 

  26. Edwards RR, Cahalan C, Calahan C, Mensing G, Smith M, Haythornthwaite JA. Pain, catastrophizing, and depression in the rheumatic diseases. Nat Rev Rheumatol. 2011;7(4):216–24.

    Article  PubMed  CAS  Google Scholar 

  27. Kwakkenbos L, van Lankveld WGJM, Vonk MC, Becker ES, van den Hoogen FHJ, van den Ende CHM. Disease-related and psychosocial factors associated with depressive symptoms in patients with systemic sclerosis, including fear of progression and appearance self-esteem. J Psychosom Res. 2012;72:199–204.

    Article  PubMed  Google Scholar 

  28. Hyphantis TN, Tsifetaki N, Siafaka V, Voulgari PV, Pappa C, Bai M, et al. The impact of psychological functioning upon systemic sclerosis patients’ quality of life. Semin Arthritis Rheum. 2007;37(2):81–92.

    Article  PubMed  Google Scholar 

  29. • Merz EL, Malcarne VL, Assassi S, Nair DK, Graham TA, Yellman BP, et al. Biopsychosocial typologies of pain in a cohort of patients with systemic sclerosis. Arthritis Care Res. 2014;66(4):567–74. This study presents a comprehensive, biopsychosocial framework of SSc pain.

  30. Hansdottir I, Malcarne VL, Furst DE, Weisman MH, Clements PJ. Relationships of positive and negative affect to coping and functional outcomes in systemic sclerosis. Cognit Ther Res. 2004;28(5):593–610.

    Article  Google Scholar 

  31. van Lankveld W, Teunissen H, Näring G, Vonk M, van den Hoogen F. Social support, disease-related cognitions and coping as predictors of depressed mood in systemic sclerosis. Cogn Ther Res. 2008;32(3):434–47.

    Article  Google Scholar 

  32. Edwards RR, Goble L, Kwan A, Kudel I, McGuire L, Heinberg L, et al. Catastrophizing, pain, and social adjustment in scleroderma: relationships with educational level. Clin J Pain. 2006;22(7):639–46.

    Article  PubMed  Google Scholar 

  33. Gatchel RJ, Peng YB, Peters ML, Fuchs PN, Turk DC. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychol Bull. 2007;133(4):581–624.

    Article  PubMed  Google Scholar 

  34. •• Joint Commission. New and revised standards related to pain assessment and management. Off Newsl Jt Comm. 2017;37(7):3–4. Provides updated standards for pain assessment and treatment of pain for healthcare providers.

    Google Scholar 

  35. El-Baalbaki G, Lober J, Hudson M, Baron M, Thongs BD, Canadian Scleroderma Research Group. Measuring pain in systemic sclerosis: comparison of the short-form McGill Pain Questionnaire versus a single-item measure of pain. J Rheumatol. 2011;38(12):2581–7.

    Article  PubMed  Google Scholar 

  36. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: visual analog scale for pain (VAS pain), numeric rating scale for pain (NRS pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale. Arthritis Care Res. 2011;63(S11):S240–52.

    Article  Google Scholar 

  37. • Pope J. Measures of systemic sclerosis (scleroderma). Arthritis Care Res. 2011;63(S11):S98–S111. Reviews the literature on evidence-based assessment tools for pain.

  38. Melzack R. The McGill Pain Questionnaire: major properties and scoring methods. Pain. 1975;3:277–99.

    Article  Google Scholar 

  39. Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singap. 1994;23(2):129–38.

    PubMed  CAS  Google Scholar 

  40. Nicholas MK. The pain self-efficacy questionnaire: taking pain into account. Eur J Pain. 2006;11:153–63.

    Article  PubMed  Google Scholar 

  41. Turk DC. The potential of treatment matching for subgroups of patients with chronic pain: lumping versus splitting. Clin J Pain. 2005;21(1):44–55.

    Article  PubMed  Google Scholar 

  42. Khanna D, Khanna PP. A 54-year old woman with pain and stiffness of hands and tendon friction rubs. In: Silver RM, Denton CP, editors. Case studies in systemic sclerosis. New York: Springer; 2011. p. 267–72.

    Chapter  Google Scholar 

  43. Shah AA, Wigley FM. My approach to the treatment of scleroderma. Mayo Clin Proc. 2013;88(4):377–93.

    Article  PubMed  Google Scholar 

  44. Motegi S, Yamada K, Toki S, Uchiyama A, Kubota Y, Nakamura T, et al. Beneficial effect of botulinum toxin A on Raynaud’s phenomenon in Japanese patients with systemic sclerosis: a prospective, case series study. J Dermatol. 2016;43(1):56–62.

    Article  PubMed  CAS  Google Scholar 

  45. Motegi S, Uehara A, Yamada K, Sekiguchi A, Fujiwara C, Toki S, et al. Efficacy of botulinum toxin B injection for Raynaud’s phenomenon and digital ulcers in patients with systemic sclerosis. Acta Derm Venereol. 2017;97(7):843–50.

    Article  PubMed  CAS  Google Scholar 

  46. Bello RJ, Cooney CM, Melamed E, Follmar K, Yenokyan G, Leatherman G, et al. The therapeutic efficacy of botulinum toxin in treating scleroderma-associated Raynaud’s phenomenon: a randomized, double-blind, placebo-controlled clinical trial. Arthritis Rheumatol. 2017;69(8):1661–9.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  47. Uppal L, Dhaliwal K, Butler PE. A prospective study of the use of botulinum toxin injections in the treatment of Raynaud’s syndrome associated with scleroderma. J Hand Surg Am. 2014;39(8):876–80.

    Article  CAS  Google Scholar 

  48. DeLea SL, Chavez-Chiang NR, Poole JL, et al. Sonographically guided hydrodissection and corticosteroid injection for scleroderma hand. Clin Rheumatol. 2011;30(6):805–13.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Sencan S, Güler E, Cüce I, Erol K. Fluoroscopy-guided intra-articular steroid injection for sternoclavicular joint arthritis secondary to limited cutaneous systemic sclerosis: a case report. Korean J Pain. 2017;30(1):59–61.

    Article  PubMed  Google Scholar 

  50. Lundborg CN, Nitescu P V, Appelgren LK, Curelaru ID. Progressive systemic sclerosis: intrathecal pain management. Reg Anesth Pain Med. 24(1):89–93.

  51. Ingegnoli F, Ughi N, Crotti C. Effectiveness and safety of oxycodone/naloxone in the management of chronic pain in patients with systemic sclerosis with recurrent digital ulcers: two case reports. Clin Interv Aging. 2016;11:307.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Giuggioli D, Manfredi A, Colaci M, Ferri C. Oxycodone in the long-term treatment of chronic pain related to scleroderma skin ulcers. Pain Med. 2010;11(10):1500–3.

    Article  PubMed  Google Scholar 

  53. Dowell D, Haegerich TM, Chou RCDC. Guideline for prescribing opioids for chronic pain—United States, 2016. Morb Mortal Wkly Rep. 2016;65(1):1–49.

    Article  Google Scholar 

  54. Chiou G, Crowe C, Suarez P, Chung L, Curtin C, Chang J. Digital sympathectomy in patients with scleroderma. Ann Plast Surg. 2015;75(6):637–43.

    Article  PubMed  CAS  Google Scholar 

  55. Bogoch ER, Gross DK. Surgery of the hand in patients with systemic sclerosis: outcomes and considerations. J Rheumatol. 2005;32(4):642–8.

    PubMed  Google Scholar 

  56. Momeni A, Sorice SC, Valenzuela A, Fiorentino DF, Chung L, Chang J. Surgical treatment of systemic sclerosis-is it justified to offer peripheral sympathectomy earlier in the disease process? Microsurgery. 2015;35(6):441–6.

    Article  PubMed  Google Scholar 

  57. Tomaino MM, Goitz RJ, Medsger TA. Surgery for ischemic pain and Raynaud’s phenomenon in scleroderma: a description of treatment protocol and evaluation of results. Microsurgery. 2001;21(3):75–9.

    Article  PubMed  CAS  Google Scholar 

  58. Francaviglia N, Silvestro C, Maiello M, Bragazzi R, Bernucci C. Spinal cord stimulation for the treatment of progressive systemic sclerosis and Raynaud’s syndrome. Br J Neurosurg. 1994;8(5):567–71.

    Article  PubMed  CAS  Google Scholar 

  59. Provenzano DA, Nicholson L, Jarzabek G, Lutton E, Catalane DB, Mackin E. Spinal cord stimulation utilization to treat the microcirculatory vascular insufficiency and ulcers associated with scleroderma: a case report and review of the literature. Pain Med. 2011;12(9):1331–5.

    Article  PubMed  Google Scholar 

  60. Fitzcharles M-A, Almahrezi A, Shir Y. Pain: understanding and challenges for the rheumatologist. Arthritis Rheum. 2005;52(12):3685–92.

    Article  PubMed  Google Scholar 

  61. Iversen MD, Brawerman M, Iversen CN. Recommendations and the state of the evidence for physical activity interventions for adults with rheumatoid arthritis: 2007 to present. Int J Clin Rheumtol. 2012;7(5):489–503.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  62. Veldhuijzen van Zanten JJCS, Rouse PC, Hale ED, et al. Perceived barriers, facilitators and benefits for regular physical activity and exercise in patients with rheumatoid arthritis: a review of the literature. Sport Med. 2015;45(10):1401–12.

    Article  Google Scholar 

  63. Sharif K, Watad A, Bragazzi NL, Lichtbroun M, Amital H, Shoenfeld Y. Physical activity and autoimmune diseases: get moving and manage the disease. Autoimmun Rev. 2018;17(1):53–72.

    Article  PubMed  CAS  Google Scholar 

  64. Azar M, Rice DB, Kwakkenbos L, et al. Exercise habits and factors associated with exercise in systemic sclerosis: a Scleroderma Patient-centered Intervention Network (SPIN) cohort study. Disabil Rehabil 2017:1–7.

  65. Liem SIE, Meessen JMTA, Wolterbeek R, Ajmone Marsan N, Ninaber MK, Vliet Vlieland TPM, et al. Physical activity in patients with systemic sclerosis. Rheumatol Int. 2018;38(3):443–53.

    Article  PubMed  CAS  Google Scholar 

  66. Cuomo G, Santoriello C, Polverino F, Ruocco L, Valentini G, Polverino M. Impaired exercise performance in systemic sclerosis and its clinical correlations. Scand J Rheumatol. 2010;39(4):330–5.

    Article  PubMed  CAS  Google Scholar 

  67. Oliveira NC, dos Santos Sabbag LM, de Sá Pinto AL, Borges CL, Lima FR. Aerobic exercise is safe and effective in systemic sclerosis. Int J Sports Med. 2009;30(10):728–32.

    Article  PubMed  CAS  Google Scholar 

  68. Pinto ALS, Lia N, Oliveira C, et al. Efficacy and safety of concurrent training in systemic sclerosis. J Strength Cond Res. 2011;25(5):1423–8.

    Article  PubMed  Google Scholar 

  69. Maddali-Bongi S, Del Rosso A. Systemic sclerosis: rehabilitation as a tool to cope with disability. Clin Exp Rheumatol. 2016;34(5):162–9.

    PubMed  Google Scholar 

  70. Maddali Bongi S, Del Rosso A, Galluccio F, et al. Efficacy of a tailored rehabilitation program for systemic sclerosis. Clin Exp Rheumatol. 2009;27(3):44–50.

    PubMed  CAS  Google Scholar 

  71. Mugii N, Hamaguchi Y, Maddali-Bongi S. Clinical significance and usefulness of rehabilitation for systemic sclerosis. J Scleroderma Relat Disord. 2018;3(1):71–80.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Poole JL. Musculoskeletal rehabilitation in the person with scleroderma. Curr Opin Rheumatol. 2010;22(2):205–12.

    Article  PubMed  Google Scholar 

  73. Murphy SL, Barber M, Homer K, Dodge C, Cutter G, Khanna D. Occupational therapy treatment to improve upper extremity function in individuals with early systemic sclerosis: a pilot study. Arthritis Care Res. 2018; https://doi.org/10.1002/acr.23522.

  74. • Rannou F, Boutron I, Mouthon L, Sanchez K, Tiffreau V, Hachulla E, et al. Personalized physical therapy versus usual care for patients with systemic sclerosis: a randomized controlled trial. Arthritis Care Res. 2017;69(7):1050–9. Presents data from a recent randomized trial of physical therapy for SSc pain treatment that may serve as a model for randomized trials evaluating other treatments.

  75. Daste C, Rannou F, Mouthon L, Sanchez K, Roren A, Tiffreau V, et al. Patient acceptable symptom state and minimal clinically important difference for patient-reported outcomes in systemic sclerosis: a secondary analysis of a randomized controlled trial comparing personalized physical therapy to usual care. Semin Arthritis Rheum. 2018; https://doi.org/10.1016/J.SEMARTHRIT.2018.03.013.

  76. Parisi S, Celletti C, Scarati M, Priora M, Laganà A, Peroni CL, et al. Neuromuscular taping enhances hand function in patients with systemic sclerosis: a pilot study. Clin Ter. 2017;168(6):e371–5.

    PubMed  CAS  Google Scholar 

  77. Pfizenmaier DH, Kavros SJ, Liedl DA, Cooper LT. Use of intermittent pneumatic compression for treatment of upper extremity vascular ulcers. Angiology. 2005;56(4):417–22.

    Article  PubMed  Google Scholar 

  78. • Poole JL, Skipper B, Mendelson C. Evaluation of a mail-delivered, print-format, self-management program for persons with systemic sclerosis. Clin Rheumatol. 2013;32(9):1393–8. Presents data from a pre- and post-test designed study of a self-management program for SSc pain treatment that may serve as a model for randomized trials evaluating other treatments.

  79. Mancuso T, Janet Poole L. The effect of paraffin and exercise on hand function in persons with scleroderma: a series of single case studies. J Hand Ther. 2009;22(1):71–8.

    Article  PubMed  Google Scholar 

  80. Sandqvist G, Åkesson A, Eklund M. Evaluation of paraffin bath treatment in patients with systemic sclerosis. Disabil Rehabil. 2009;26(16):981–7.

    Article  Google Scholar 

  81. Maddali Bongi S, Del Rosso A, Passalacqua M, Miccio S, Cerinic MM. Manual lymph drainage improving upper extremity edema and hand function in patients with systemic sclerosis in edematous phase. Arthritis Care Res. 2011;63(8):1134–41.

    Article  Google Scholar 

  82. Young A, Khanna D. Systemic sclerosis: a systematic review on therapeutic management from 2011 to 2014. Curr Opin Rheumatol. 2015;27(3):241–8.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  83. Poole JL, Mendelson C, Skipper B, Khanna D. Taking charge of systemic sclerosis: a pilot study to assess the effectiveness of an Internet self-management program. Arthritis Care Res. 2014;66(5):778–82.

    Article  Google Scholar 

  84. Landim SF, Bertolo MB, Marcatto de Abreu MF, del Rio AP, Mazon CC, Marques-Neto JF, et al. The evaluation of a home-based program for hands in patients with systemic sclerosis. J Hand Ther. 2017; https://doi.org/10.1016/J.JHT.2017.10.013.

  85. •• Ehde DM, Dillworth TM, Turner JA. Cognitive-behavioral therapy for individuals with chronic pain: efficacy, innovations, and directions for research. Am Psychol. 2014;69(3):22–9. Reviews the literature on psychotherapeutic interventions for pain.

  86. Veehof MM, Oskam M-J, Schreurs KMG, Bohlmeijer ET. Acceptance-based interventions for the treatment of chronic pain: a systematic review and meta-analysis. Pain. 2011;152(3):533–42.

    Article  PubMed  Google Scholar 

  87. McCracken LM, Vowles KE. Acceptance and commitment therapy and mindfulness for chronic pain: model, process, and progress. Am Psychol. 2014;69(2):178–87.

    Article  PubMed  Google Scholar 

  88. Keefe FJ, Somers TJ. Psychological approaches to understanding and treating arthritis pain. Nat Rev Rheumatol. 2010;6(4):210–6.

    Article  PubMed  Google Scholar 

  89. Haythornthwaite JA, Heinberg LJ, McGuire L. Psychologic factors in scleroderma. Rheum Dis Clin N Am. 2003;29(2):427–39.

    Article  Google Scholar 

  90. •• Thombs BD, van Lankveld W, Bassel M, Baron M, Buzza R, Haslam S, et al. Psychological health and well-being in systemic sclerosis: state of the science and consensus research agenda. Arthritis Care Res. 2010;62(8):1181–9. Reviews the literature on SSc pain and describes research agenda for assessment and treatment.

  91. Center for Connected Health Policy. What is telehealth? http://www.cchpca.org/what-is-telehealth%0A.

  92. Buenaver LF, McGuire L, Haythornthwaite JA. Cognitive-behavioral self-help for chronic pain. J Clin Psychol. 2006;62(11):1389–96.

    Article  PubMed  Google Scholar 

  93. Greco CM, Rudy TE, Manzi S. Effects of a stress-reduction program on psychological function, pain, and physical function of systemic lupus erythematosus patients: a randomized controlled trial. Arthritis Rheum. 2004;51(4):625–34.

    Article  PubMed  Google Scholar 

  94. Navarrete-Navarrete N, Peralta-Ramírez MI, Sabio-Sánchez JM, Coín MA, Robles-Ortega H, Hidalgo-Tenorio C, et al. Efficacy of cognitive behavioural therapy for the treatment of chronic stress in patients with lupus erythematosus: a randomized controlled trial. Psychother Psychosom. 2010;79(2):107–15.

    Article  PubMed  CAS  Google Scholar 

  95. Zautra AJ, Davis MC, Reich JW, Nicassario P, Tennen H, Finan P, et al. Comparison of cognitive behavioral and mindfulness meditation interventions on adaptation to rheumatoid arthritis for patients with and without history of recurrent depression. J Consult Clin Psychol. 2008;76(3):408–21.

    Article  PubMed  Google Scholar 

  96. Sharpe L. Psychosocial management of chronic pain in patients with rheumatoid arthritis: challenges and solutions. J Pain Res. 2016;9:137–46.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: the process and practice of mindful change. 2nd ed. New York: Guilford; 2012.

    Google Scholar 

  98. Davis MC, Zautra AJ, Wolf LD, Tennen H, Yeung EW. Mindfulness and cognitive-behavioral interventions for chronic pain: differential effects on daily pain reactivity and stress reactivity. J Consult Clin Psychol. 2015;83(1):24–35.

    Article  PubMed  Google Scholar 

  99. Sporbeck B, Mathiske-Schmidt K, Jahr S, Huscher D, Becker M, Riemekasten G, et al. Effect of biofeedback and deep oscillation on Raynaud’s phenomenon secondary to systemic sclerosis: results of a controlled prospective randomized clinical trial. Rheumatol Int. 2012;32(5):1469–73.

    Article  PubMed  Google Scholar 

  100. Freedman RR, Ianni P, Wenig P. Behavioral treatment of Raynaud’s phenomenon in scleroderma. J Behav Med. 1984;7(4):343–53.

    Article  PubMed  CAS  Google Scholar 

  101. Macfarlane GJ, Paudyal P, Doherty M, Ernst E, Lewith G, MacPherson H, et al. A systematic review of evidence for the effectiveness of practitioner-based complementary and alternative therapies in the management of rheumatic diseases: osteoarthritis. Rheumatology. 2012;51(12):2224–33.

    Article  PubMed  Google Scholar 

  102. Hall A, Richmond H, Copsey B, Hansen Z, Williamson E, Jones G, et al. Physiotherapist-delivered cognitive-behavioural interventions are effective for low back pain, but can they be replicated in clinical practice? A systematic review. Disabil Rehabil. 2018;40(1):1–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, California State University, Dominguez Hills, Carson, CA, 90747, USA

    Erin L. Merz PhD, MPH

  2. Division of Rheumatology, University of Texas McGovern Medical School, Houston, TX, 77030, USA

    Shervin Assassi MD, MS

  3. Department of Psychology, San Diego State University, San Diego, CA, 92182, USA

    Vanessa L. Malcarne PhD

  4. San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, 92120-4913, USA

    Vanessa L. Malcarne PhD

Authors
  1. Erin L. Merz PhD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shervin Assassi MD, MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vanessa L. Malcarne PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vanessa L. Malcarne PhD.

Ethics declarations

Conflict of Interest

Dr. Assassi reports grants from Bayer, grants and personal fees from Boehringer Ingelheim, grants from Biogen Idec, grants from Momenta, and personal fees from Reata, outside the submitted work.

Erin L. Merz and Vanessa L. Malcarne declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Pain in Rheumatology

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Merz, E.L., Assassi, S. & Malcarne, V.L. Pain and Its Management in Systemic Sclerosis. Curr Treat Options in Rheum 4, 255–267 (2018). https://doi.org/10.1007/s40674-018-0104-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40674-018-0104-4

Keywords

Search

Navigation