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Fibromyalgia Treatment: A Review of Current Management Strategies

I don't want to bore my fibro friends with some long boring article in this I am going to get to the nitty gritty as quickly as possible.  So, here we go:

A study posted in the December 2013 edition of Pain and Therapy (Okifuji & Hare) presents the results of a study that reviewed effectiveness of various strategies for managing fibromyalgia. The authors considered medications, exercise, behavioral modifications, and multimodal approaches to the condition.  In the end, they say that a lack of methodology really prevents them from statistically comparing these various strategies to each other. 

That being the case, the authors did come to a very interesting conclusion--and here it is, word for word:

"...Although there are some other variations, a typical trial testing a multidisciplinary approach includes education, exercise and psychological (typically cognitive behavioral) therapy. Programs aimed at acquisition of coping and pain management skills seem to provide better results than those that mostly aim to provide information/education [109]. A systematic review [116] points to the methodological weakness, yet provides some evidence of the effectiveness of the approach for various chronic pain conditions including FMS. The effectiveness seems to last beyond the therapy; reduction in pain and other symptoms was observed 12 months later [117]. A recent recommendation [118] by FMS experts strongly emphasizes the importance of educating patients, establishing working goals, and applying multimodal therapy approaches consisting of education, medications, exercise and CBT. There has only been one published study thus far that specifically tested the combination of CBT with medication [119]. In this trial, patients were randomized to a combination of CBT and milnacipran, drug monotherapy or CBT alone. The results suggest that the combination approach and CBT monotherapy were equally beneficial in reducing symptoms, i.e., milnacipran added very little to the clinical benefit of CBT."

Once again, I can only come to one conclusion ...that medicine plays a very small role in the treatment of fibromyalgia.  The drug milnacipran (Savella) is one of the newest medications and is marketed specifically for the treatment of fibromyalgia. These authors are suggesting, like many others before them, that medications we have for this condition really are not all that effective. This is not a cause for fear...if you read the paragraph above you know that there are still many things available for the condition that can produce long lasting treatment success!

Note: CBT=Cognitive Behavioral Therapy

Source: NIH,Wikimedia


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