Does psychiatric treatment help patients with intractable chronic pain?
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Tricyclic antidepressants and intensive multidisciplinary programs are moderately effective for reducing chronic back pain; tricyclics are also effective for diabetic neuropathy and irritable bowel syndrome (strength of recommendation [SOR]: A, meta-analyses and multiple small randomized controlled trials). Cognitive therapies are modestly effective for reducing pain in the following: chronic back pain, other chronic musculoskeletal disorders including rheumatoid arthritis (SOR: B, multiple meta-analyses with significant heterogeneity), and for chronic cancer pain (SOR: B, 1 meta-analysis of various quality studies).
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