This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Disorders such as Fibromyalgia currently have no cure and pharmacological agents are only partially successful for symptom management. It is a disorder that relies heavily upon non-pharmacological management methods for symptom relief. Studies such as the ones proposed, that explore mechanisms by which non-pharmacological interventions work and the means by which these interventions can be made more effective, represent a critically needed step in the clinical management of chronic conditions like FM. More importantly, though, this application combines a behavioral intervention with techniques that can help us understand how these therapies may be working. Certainty in ones ability to control pain may actually change how the brain processes pain. Two ways to boost one s certainty is to actually succeed in decreasing pain either through relaxation techniques or through exercise. Thus this study will evaluate the effectiveness of these two non-pharmacological methods of improving patients certainty that they can control pain and see if certainty is indeed related to reported pain outcomes as well as changes in pain processing as confirmed by fMRI scanning. Commitment to this study spans 4 months. The study will require participation in an initial and final baseline assessment battery that includes collection of salivary cortisol and completion of questionnaires about demographics, treatment history, symptoms, functional status, affective status, and beliefs about pain. An initial and final fMRI scan combined with pressure pain testing will be administered. All participants with a diagnosis of FM will be randomly assigned to one of three interventions (a) relaxation training (b) prescribed exercise or (c) standard control group. Interventions will last for 8 weeks (30 min/3x week). A total of 100 participants will be recruited via advertisements distributed among U of M physician offices, newspapers, or subject inquiries. Subjects may be of any gender, ethnicity, or race, but must be 18 years or older.
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