Update on the Treatment of Fibromyalgia

Discussion in 'Fibromyalgia Main Forum' started by jaltair, Feb 9, 2007.

  1. jaltair

    jaltair New Member

    From: "Bulletin on the Rheumatic Diseases" (Arthritis Foundation)
    "For Evidence-Based Management of Rheumatic Diseases"

    <b>Update on the Treatment of Fibromyalgia</b>

    Don L. Goldenberg, MD
    Division of Rheumatology
    Newton-Wellesley Hospital
    Tufts University School of Medicine
    Boston, MA

    You can find this interesting info at the arthritis dot org webiste.

    http://www.arthritis.org/research/Bulletin/Vol53No1/Introduction.asp


  2. Diva55

    Diva55 New Member

    Hi
    Thanks for posting this - it was well written.

    It appears that it's main thrust of treatment is Anti-depressants, exercise & CBT.

    This is exactly what our Health System in the U.K is pushing as the only treatment for FMS.

    I personally think this "you're depressed, you're lazy & get a life" (as I like to translate them) are a step back in time.

    I've tried all AD's which don't do anything, I can't exercise at all & CBT sounds condescending. - just my opinion as I don't want to upset anyone that it has worked for.

    I sincerely hope this approach works for some but it is not the fix-all that it claims to be and unfortunately for us British it will be the ONLY "treatment" that will be offered for patients!




  3. thanks for the website
  4. IntuneJune

    IntuneJune New Member

    Jaltair, thank you for posting this information.

    However it does make me sad. UPDATE?

    I was diagnosed over 20 years ago. I wish these studies would study someone in my situation. Years ago, I tried these regimens. Had one of the best rheumys in the state who was up on everything at that time.

    Quote from the article: on antidepressants: "The dose may be increased after 2 weeks, with increases of 5 mg at 2-week intervals. The final dose should be set by the patient, based on efficacy and side effects, always keeping the dose as low as possible. The long-term use of these agents has not been well established and improvement with these drugs seems to fade over time." THAT LAST SENTENCE SCARES ME...... AND IT ENDS WITH IMPROVEMENT FADES OVERTIME!

    Quote from the article on: "Anticonvulsants, including gabepentin and pregabalin, have also been effective in preliminary reports (27). Currently, gabepentin is still under study for FMS and pregabalin has not been FDA-approved. Tramadol, with or without acetaminophen, has been effective in a number of randomized clinical trials in FMS (28). The usual dose has been 200 to 300 mg per day. Tramadol has opioid receptor agonist activity and inhibits serotonin and norepinephrine reuptake" I believe Tramadol has been equally uneffective for some FMSers.... in my situation, I cared less about the pain while on Tramadol but the drug did not target the pain.

    On exercising, so many on this board have been avid exercisers BEFORE FMS hit.

    Maybe what upset me about this article was its title and visually the title is right under the word "BULLETIN" guess I was hoping for something new.

    As I said I was diagnosed over twenty years ago, yes initially I did improve a little on some regimens but the results really were short lived when compared to how long I have lived with FMS.

    And I dumped some powerful stuff into my body which my body probably did not appreciate.

    So far what has helped me the most or my turnaround point was falling into the hands of the RIGHT physical therapists with myofascial release and yes, exericse, but NOT the way I was used to exercising. I had to redefine the approach to exercising.

    I used to be a runner and lap swimmer (alternating days) now I am still in the pool, but cannot long-distance swim (too repetitive) I was so helped by water, I became certified as an instructor and now am helping others in the water.

    It is not enough to tell a FMS patient to "exercise."

    I don't understand where the "update" is, they put forth a regimen I received over twenty years ago and some of the modalities they are putting forth benefitted me only short-term, after a period of time I was right back where I started.

    Jaltair, I do thank you, you gave me an opportunity to vent. I did not know I was STILL this upset with the medical community..... certainly I could have posted this before...... (lol maybe I needed another cup of coffee before coming to the board this morning)

    Love, June
  5. Suzan

    Suzan New Member

    I have only been dx'd for 4 years..but you wrote what I think...At this point..there IS no long term good solution out there..and throwing all these misc drugs into our bodies..probably isn't helping us in the long run..although we may feel better in the short term.

    Right now I am very happy to have found a doctor that HEARS what I say..and respects the fact that I need some help with some symptom relief..but I do not want to take all the "fibro" drugs that are fraught with loads of side effects and do not offer any long term relief at all!

  6. jaltair

    jaltair New Member

    I was very disappointed in the "Newsletter." And, there is nothing "new." To me when I read the article, it seemed as though rheumatologist were pushing treatment back on to the primary doctors. Most doctors have absolutely No idea what to do with people who have FMS.

    To me this was a very frustrating and not very hopeful article. Thanks to all for the view points, good to know I'm not alone in taking the article the way I did!
  7. IntuneJune

    IntuneJune New Member

    There is so much more info out there... that can help us...what worries me about the article is.. if a FMS patient walks into a doc's office next week, and the doc read the article above, is that going to be the limit of care, of information given.

    I would rather the doctor's office send the patient Devin Starlanyl's books than book an appointment with the doctor.

    Jaltair, we are fortunate we can come here and share, and learn. We know not everything we hear here "works" and no far really no "cures" but it is a good clearing house.

    Tufts University School of Medicine.... so prestigious... could have gone so much further to help FMS sufferers.

    Thanks again, Jaltair.

    Love,June