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An in-depth report on the causes, diagnosis, treatment, and prevention of fibromyalgia.
Fibromyositis; Fibrositis; Myofascial pain syndrome
Fibromyalgia is a mysterious condition whose causes are still largely unknown, as is how it inflicts damage. There is no strong evidence that any single treatment (or combination of treatments) has any significant effect for most patients. Treatment must involve not only relieving symptoms but also changing the patients' attitudes about their disease. Treatment should also teach patients behaviors that help them cope.
Treatments usually use a trial and error, many-sided approach:
According to a 2005 study published in the Clinical Journal of Pain , a combination of non-drug therapies works just as well as drug therapy in improving pain, depression, and disability. This combination includes exercise, stress management, massage, and diet. In 2004, the Journal of the American Medical Association published an evaluation of various fibromyalgia treatments. Based on clinical trial data reported in medical journals, the researchers assessed and ranked the evidence supporting the usefulness of these treatments.
Non-Drug Treatments:
Treatments with the strongest evidence for usefulness: Cardiovascular exercise, cognitive-behavioral therapy, patient education groups, and combinations of these treatments
Drug Treatments:
No evidence: Opioids, corticosteroids, NSAIDs, benzodiazepine and non-benzodiazepine hypnotics, melatonin, calcitonin, thyroid hormone, guaifenesin, DHEA, magnesium
These evidence-based rankings were determined from published clinical trials. However, some treatments have not been as extensively studied as others and have less available published evidence. Doctors' recommendations and individual patients' experiences may differ from clinical trial results.
Patients must have realistic expectations about the long-term outlook of their condition, and their own individual abilities. It is important to understand that fibromyalgia can be managed, and patients can live a full life. The following tips may be helpful when starting a treatment program for fibromyalgia:
The definition of improvement is personal. For example, some patients are pleased with only a 10% reduction in pain and other symptoms.
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