Multi-Modal Pain Therapy of Fibromyalgia Syndrome with Integration of Systemic Whole-Body Hyperthermia – Effects on Pain Intensity and Mental State: A Non-Randomised Controlled Study

Abstract

Objectives: This controlled study evaluates a multi-modal pain therapy for treating severe progressions of fibromyalgia [FMS] syndrome. The aim is to establish whether the use of multi-modal therapy with inclusion of whole-body hyperthermia represents a useful therapeutic addition to inpatient therapy of FMS syndrome at a high level of chronification. Methods: The study involved 130 patients who fulfilled the criteria of the American College of Rheumatology [ACR] for FMS and whose disease showed severe progression. One group of patients [HTG] received whole-body hyperthermia, while the control group [CG] did not. The main parameters of the study were pain intensity and the mental state of the patients. Further study parameters were the diagnoses additional to FMS syndrome and the therapy density of the treatment provided in the two groups. Results: The integration of whole-body hyperthermia into the multi-modal pain therapy showed superior pain reduction [p ¼ 0.023] and an improvement in the mental state of the patients [p ¼ 0.055]. In addition to the primary disease, the patients presented with an average of 6.7 accompanying diseases, primarily from major diagnostic categories 8 [diseases and disturbances of the musculoskeletal system and connective tissues], 19 [mental diseases and disturbances] and 10 [endocrine, nutritional and metabolic diseases]. Analysis of the therapy density of the inpatient multi-modal pain therapy revealed a close-meshed and high-frequency therapy. Conclusions: Multi-modal pain therapy was also found to be a highly effective therapy option in the case of severely progressive FMS syndrome. Extension of the multi-modal therapy setting to include whole-body hyperthermia can be considered as a useful and effective complement for pain relief and stabilisation of the mental state.

The impact of whole-body hyperthermia interventions on mood and depression – are we ready for recommendations for clinical application?

“…Six out of seven studies found statistically significant reductions in depressive symptomology somewhere between 1 and 6 weeks post-intervention. Romeyke [21] did not report significant findings when measuring depressive symptomology using the PHQ-D assessment. Overall 21 study end-points were provided from the studies with significant anti-depressant effects reported for 19; only 2 end-points (H€ uppe) did not reach statistical significance.…”

“…PRISMA study flowchart. Overall, our literature search identified 13 studies [11][12][13][14][15][16][17][18][19][20][21][22][23] for further review. After evaluating all studies with the aforementioned criteria, the seven studies [14,15,18,19,[21][22][23] outlined below were selected for further analysis and data extraction.…”

“…Romeyke [21] studied the effects of whole-body heating in 103 patients (m/w ¼ 2/102, average age 55.2 (10.0)) with fibromyalgia and also diagnosed with severe depression based on criteria from the American Psychiatric Association (DSM-V) and the International Statistical Classification of Disease and Related Health Problems. As part of this quasiexperimental observational study, patients were asked to complete a Patient Health Questionnaire (PHQ-D) with a focus on mental well-being and depression.…”

Severe forms of fibromyalgia with acute exacerbation of pain: costs, comorbidities, and length of stay in inpatient care

“…With reasons uncertain, there are many varied approaches to treatment. Multimodal treatment under inpatient conditions has proven to be effective for the complex and multilayered pattern of symptoms associated with fibromyalgia 5–8…”

Levels of Patient Satisfaction on Integrative Medicine Before and After Implementation of Diagnosis-related Groups

“…When conventional medical in-hospital procedures are broadened to a holistically orientated patient care, studies show positive effects on the quality outcomes. 16 – 20 Yet these studies refer to condition without DRGs.…”