The Effect of Guided Imagery and Amitriptyline on Daily Fibromyalgia Pain

They monitored them daily for pain in a randomized, controlled clinical trial. One group (n=17) received relaxation training and "pleasant" guided imagery designed to distract them from their pain. Another group (n=21) received relaxation training and attention imagery that focused on the "active workings of the internal pain control systems". The control group received treatment as usual (n=17). Patients were also randomly assigned to 50-mg amitriptyline/day or placebo. The slopes of diary pain ratings over a 4-week period were used as the outcome measures. The team found significant differences of the pain-slopes between the three psychological conditions (P=0.0001). The pleasant imagery declined significantly (P<0.005) when compared with the control group (P>0.05). The attention imagery group's slope did not. Neither was there a difference between the amitriptyline and placebo slopes (main effects, P=0.98). The study concludes that pleasant imagery is an effective intervention in reducing fibromyalgic pain during the 28-day study period. Amitriptyline had no significant advantage over placebo during the study period.

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