Progress towards improved non-pharmacological management of fibromyalgia

Trajectories of change in symptom severity in patients with fibromyalgia: exploratory analyses of a randomised controlled trial

“…To date, few studies have examined which and how components of nonpharmacological treatment for patients with FM should be combined and whether their interaction has additive or synergistic effects (212). In our study, the VTP followed by physical activity for patients with recently diagnosed FM was not more effective than treatment as usual, with no differences between the groups in any disease-related secondary outcomes.…”

The challenge of differentiating fibromyalgia from small-fiber neuropathy in clinical practice

“…More specifically, dysregulation of conditioned pain modulation (also called diffuse noxious inhibitory control-like effect) which is a powerful inhibitory system from brain stem to spinal cord can lead to hypersensitivity to pain. The presence of depressive symptoms could further accentuate the failure to activate this brain network [13].…”

“…Fibromyalgia is associated with a reduced reactivity of the hypothalamic-pituitary-adrenal axis and the sympathetic system to stress (physical and/or psychological), which could modify modulation of pain [4,13].…”

“…The diagnostic criteria of fibromyalgia have significantly evolved: the 1990 criteria required a physical examination [13]. The 2010 and 2016 American College of Rheumatology criteria only need interview data to quantify the Widespread Pain Index (WPI : 19 body area) and Symptom Severity (SS) scores during the past week: fatigue, waking unrefreshed, and cognitive symptoms [19].…”

The role of cannabis in treatment‐resistant fibromyalgia women

“…Fibromyalgia treatment includes non pharmacological, 5 , 6 , 7 , 8 , 9 pharmacological, or combined strategies. Non pharmacological treatment includes education, 10 cognitive therapies, 11 , 12 , 13 , 14 , 15 and passive versus active physical therapies.…”