Treatment preferences in fibromyalgia patients: A cross‐sectional web‐based survey

Abstract

Background: Therapeutic approaches to fibromyalgia (FM) are shifting towards a combined multi-treatment approach to tackle the variety of symptoms experienced in FM. Importantly, little is known about FM patients' attitude towards the available treatments. Methods: A cross-sectional web survey obtained responses from 464 individuals who satisfied diagnostic criteria for FM. Respondents were asked to report which treatments they adopted in their past, present and intend to adopt in the future. They also rated their level of well-being, depression, anxiety and pain catastrophizing. Results: Data revealed a predominantly combined multi-treatment approach in a sample characterized by middle-aged, Caucasian women. Respondents reported pervasive use of pharmacological therapy but had also adopted non-pharmacological treatment in the past. Future intentions clustered on alternative treatment or no treatment. Regression analyses revealed that pharmacological treatment in the past was predictive of both pharmacological and non-pharmacological treatments in the present. However, use of non-pharmacological treatment in the past was uniquely predictive of its reuse in the present and future. This pattern was also accounted for by individual differences in pain magnification and well-being in the past. Conclusions: Treatment preferences of FM individuals reveal an ambivalent combination of heavy reliance on pharmacological treatment with lower but consistent reliance on non-pharmacological treatment for those individuals who used it in the past and present. This finding may inform longitudinal research into the relationship between pharmacological and non-pharmacological treatment preference in FM patients, which could in turn inform guidelines for individualized therapeutic plans for clinicians. Significance: Individuals with fibromyalgia reported the use of non-pharmacological and pharmacological treatments in the past but a predominant use of a pharmacological approach overall. Patterns of treatment experienced in the past were differentially related to future preferences. Pharmacological treatment in the past was likely to lead to both pharmacological and non-pharmacological choices in the present. However, non-pharmacological treatment in the past was more likely to be chosen again in the present and future, but unlikely to lead to a pharmacological choice.

Effects of Manual Therapy on Fatigue, Pain, and Psychological Aspects in Women with Fibromyalgia

“…The aim of this study was to analyse the effectiveness of a manual therapy performed with moderate pressure on the variables of muscle fatigue, pain, sleep, and mood state in women with fibromyalgia. The effectiveness of a manual therapy in healthy people seems evident [35], however the literature shows little evidence of the effects of manual therapy in relation to the most characteristic symptoms suffered by FM patients [26]. Now, conclusions can be drawn on what the characteristics of manual therapy should be for FM patients-painless, progressive, and the intensity should gradually increase [26] from session to session depending on the patient's symptoms.…”

“…The effectiveness of a manual therapy in healthy people seems evident [35], however the literature shows little evidence of the effects of manual therapy in relation to the most characteristic symptoms suffered by FM patients [26]. Now, conclusions can be drawn on what the characteristics of manual therapy should be for FM patients-painless, progressive, and the intensity should gradually increase [26] from session to session depending on the patient's symptoms. It has been observed [29] that the therapeutic benefit is greater than a direct deep application without any kind of light pre-pressure as a warm-up.…”

“…In terms of the benefits of manual therapy for patients, it promotes restful sleep, decreases anxiety and depression, and reduces the immediate and delayed perception of pain [25,26]. Regarding number of sessions, it is suggested to do at least 1-2 times per week [26], although the reason why this should be 2 and not a greater or lesser number of sessions is not clear.…”

“…The intervention was performed in one month. Each group had two weekly sessions following the recommendations [26] for four weeks, with a total of 8 treatment sessions. The interventions of both groups were performed during the same time (15 min) and in the same anatomical area (posterior cervical musculature).…”

“…The main causes for patients to seek medical care are musculoskeletal pain and sleep disorders [25]. Patients often seek relief from their symptoms [26]. Physical exercise treatment has been shown to show promising results for this population [27].…”