Recognizing and Treating Fibromyalgia

Chronic fatigue syndrome and fibromyalgia: Clinical assessment and treatment

“…With respect to antidepressants, tricyclics may diminish the sleep disturbance and pain associated with FM, whereas selective serotonin reuptake inhibitors (SSRI) may be more useful for coexistent depression (Leventhal, 1999). Tricyclic antidepressants for FM, often prescribed in doses too small to have an antidepressant effect, may increase non-REM stage four sleep by increasing serotonin levels (Maurizo & Rogers, 1997). In a combination therapy trial of tricyclic and SSRI drugs (Goldenberg, Mayskiy, Mossey, Ruthazer, & Schmidt, 1996), amitryptaline and fluoxetine significantly reduced pain, improved sleep, and increased patient function and well-being in a randomized double-blind crossover study.…”

“…Despite these encouraging clinical outcomes, no pharmacologic treatment in FM has been associated with significantly improved daily functioning, e.g., self-report of daily activities (Rossy et al, 1999). Treating physicians must be willing to adjust dosages and try different medications in different combinations to identify the most effective regime for each patient (Maurizo & Rogers, 1997).…”

“…Interdisciplinary approaches to FM also show favorable outcomes. For example, an interdisciplinary treatment protocol for FM, that included education, support groups, stress reduction and cognitive therapy, antidepressants, trigger point injections, and aerobic conditioning reported significant improvements in functional impairment, quality of life, pain analog scores, number of tender points, total myalgic score, attitude index and behavior, and depression and anxiety scores (Maurizo & Rogers, 1997). As in CFS, a case has been made for individualizing treatment in FM in accordance with (functional and psychosocial) subgroup membership (Turk, Okifuji, Sinclair, & Starz, 1998).…”

Juvenile fibromyalgia syndrome: The role for occupational therapists

“…Fibromyalgia syndrome often occurs simultaneously with other conditions. In addition, the presence of muscle spasms, nodules, reticular skin discolouration (mottling) and a non‐restorative sleep pattern are characteristic of the syndrome (Maurizio & Rogers, 1997). There are a number of systems that can be potentially involved with FS including musculoskeletal, nervous, cardiovascular, pulmonary, gastrointestinal, urinary, systemic, and thermal (Russell, 1997).…”

A Review of Multidisciplinary Interventions for Fibromyalgia Patients: Where Do We Go from Here?

“…Because pharmacological and behavioral interventions have produced variable rates of success in treating FMS, researchers have examined the possibility that combining singular treatment modalities into multidimensional programs would yield better results than administering individual treatments one at a time (22)(23)(24). The findings of a recent meta-analysis examining 49 FMS treatment outcome studies support this notion, with the authors recommending interventions combining education, physical activity, and CBT for managing self-reported FMS symptoms and daily functioning, with appropriate pharmacological treatment as needed for individualized sleep and pain symptoms (19).…”