New Canadian guidelines for treating fibromyalgia

Physicians from the McGill University Health Centre (MUHC) and the University of Calgary have published a review article in the CMAJ (Canadian Medical Association Journal) to help family doctors diagnose and treat fibromyalgia. The article represents the first time researchers have published Canadian guidelines to help manage the condition.

Fibromyalgia is a chronic condition that affects the central nervous system causing pain throughout the body. It is often accompanied by fatigue, depression and sleep problems. It affects mostly women and their multiple symptoms often go years without a proper diagnosis and treatment.

“One million Canadians have fibromyalgia and the time has come to take their suffering seriously. This is a real condition that greatly impacts patients and their families. Finally there are national guidelines to help diagnose and treat this syndrome,” says Dr. John Pereira, a study co-author from the University of Calgary’s Faculty of Medicine and a physician at the Calgary Chronic Pain Centre.

Fibromyalgia is usually diagnosed by rheumatologists but due to the high prevalence of the disease many patients are not able to seek advice from a specialist. Therefore, primary care physicians are best positioned to take over this role, as recommended by the 2012 Canadian Fibromyalgia Guidelines. In the review, the authors provide evidence-based tools for primary care physicians to make the diagnosis and manage the condition long-term.

“We are the first ones to develop guidelines that look at diagnosis, treatment and follow-up of fibromyalgia,” says Dr. Mary-Ann Fitzcharles, corresponding author from the Research Institute of the MUHC and MUHC’s rheumatologist. “Currently, there is no cure for fibromyalgia but the guidelines set out the most appropriate management strategy.”

Authors recommend non-pharmaceutical interventions such as exercise, relaxation techniques, cognitive behavioral therapy as well as medications tailored to the individual patient. The main treatment goal is to improve quality of life by alleviating the most troublesome symptom(s), with pain recognized as the most common and serious.

The authors also urge more research into the effects of early diagnosis and treatment as well as other treatment options. For more information on fibromyalgia, visit http://fmguidelines.ca/.

Added by Craig Payne

Regular, moderate exercise does not worsen pain in people with fibromyalgia

WINSTON-SALEM, N.C., – May 2, 2013 – For many people who have fibromyalgia, even the thought of exercising is painful.

Yet a new study from Wake Forest Baptist Medical Center shows that exercise does not worsen the pain associated with the disorder and may even lessen it over time. The findings are published in the current online issue of the journal Arthritis Care & Research.

According to Dennis Ang, M.D., associate professor of internal medicine at Wake Forest Baptist and senior author of the study, doing light to moderate exercise over a prolonged period of time improves overall symptoms, such as fatigue and trouble sleeping, while not increasing pain.

“For many people with fibromyalgia, they will exercise for a week or two and then start hurting and think that exercise is aggravating their pain, so they stop exercising,” Ang said. “We hope that our findings will help reduce patients’ fear and reassure them that sustained exercise will improve their overall health and reduce their symptoms without worsening their pain.”

To evaluate the relationship between long-term maintenance of moderate intensity exercise, defined as light jogging or brisk walking for 20 minutes a day, the research team enrolled 170 volunteers to participate in a 36-week study. Participants received individualized exercise prescriptions and completed baseline and follow-up physical activity assessments using the Community Health Activities Model Program for Seniors (CHAMPS) questionnaire at weeks 12, 24 and 36.

The study found that participants who engaged in moderate intensity exercise for at least 12 weeks showed greater improvements in clinical symptoms as compared to participants who were unable to achieve higher levels of physical activity.

More importantly, Ang said, the findings showed that long-term physical activity at levels consistent with current medical recommendations is not associated with worsening pain symptoms in fibromyalgia.

Approximately 10 percent of the adult population in the United States has fibromyalgia or fibromyalgia-like conditions. The disorder is characterized by widespread musculoskeletal pain accompanied by sleep disturbance, fatigue and memory issues. Experts believe that fibromyalgia is a disorder of pain processing due to abnormalities in how pain signals are processed in the central nervous system.

Added by: Craig Payne