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Treating Fibromyalgia

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For patients with fibromyalgia, treatment should be individualized and include nonpharmacologic approaches, which are often more effective than drugs, according to an expert in the field.

There is no magic drug against fibromyalgia and, in my opinion, there will never be. Psychotherapists don’t work miracles, but psychotherapy can help and, in a few cases, turn people with fibromyalgia into nonpatients. Drugs may help, but patients don’t like them,” said investigator Winfried Hauser, MD, from Technische Universität München in Germany, who has published widely on fibromyalgia.

Aerobic exercise is the most effective weapon we have; healthy people profit from continuous physical exercise, and so do patients with fibromyalgia,” he explained.

Dr. Hauser presented an overview of research on fibromyalgia treatment here at the European League Against Rheumatism Congress 2014.

A Meta-Analysis

Pharmacologic therapies for fibromyalgia include GABA analogues, serotonin–norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, and serotonin-specific reuptake inhibitor (SSRIs). Nonpharmacologic therapies include aerobic exercise, acupuncture, and psychotherapy.

Few head-to-head comparisons of pharmacologic and nonpharmacologic approaches have been published, making the question of which treatments are more effective difficult to answer, said Dr. Hauser.

He and his colleagues recently published a network meta-analysis that was an indirect comparison of all available therapies (Ann Rheum Dis. 2013;72:955-962). They found no significant differences in effectiveness between drug and nondrug therapies.

Studies may show an effect of drugs, but the effects of drugs are lost once the patient is not taking them,” he explained.

In contrast, we see sustained but declining effects of aerobic exercise and multicomponent therapy [e.g. psychotherapy and exercise] in fibromyalgia at 1 or 2 years. Cognitive behavioral therapies do have some effect on pain and disability, but these may be small,” he reported.

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This web site is run by an Arthritis Specialist based in Dubai, United Arab Emirates. On this site you will find news about the latest in arthritis, information about research results in the field, tips and information and diet and exercise, and much more.

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