Classification and Clinical Diagnosis of Fibromyalgia Syndrome: Recommendations of Recent Evidence-Based Interdisciplinary Guidelines

Fitzcharles, Mary‐Ann; Shir, Yoram; Ablin, Jacob N.; Buskila, Dan; Amital, Howard; Henningsen, Peter; Haüser, Winfried

doi:10.1155/2013/528952

Cited by 55 publications

(50 citation statements)

References 25 publications

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“…Recent evidence-based guidelines for the management of FM published for Canada, Germany, Israel, and the European League Against Rheumatism attest to the relative lack of sound evidence on which to base some recommendations. 19,22 It is therefore hoped that the uncertainties raised by this current JLA endeavor will add further clarification for treatment options for FM and that the current knowledge gap will be addressed.…”

Section: Discussionmentioning

confidence: 99%

A paradigm change to inform fibromyalgia research priorities by engaging patients and health care professionals

Fitzcharles

Brachaniec

Cooper

et al. 2017

Canadian Journal of Pain

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Background: Research objectives should be focused toward advancing knowledge that has meaningful impact on health. However, research agendas are mostly driven by the health care community, with limited input from patients. Aims: In this study, prioirities of uncertainties for the management of fibromyalgia (FM) that could propel future research were identified by a defined process using the James Lind Alliance Priority Setting Partnership (JLA-PSP) methodology. Methods: As a first step, a survey was distributed across Canada that engaged patients, caregivers, and health care professionals to provide narrative input to eight open-ended questions regarding FM care. Responses were thematically condensed and synthesized into an initial list of 43 uncertainties used to guide a comprehensive literature search. Questions already effectively addressed in the literature were excluded, leaving 25 uncertainties that were ranked during a one-day consensus workshop. Results: Three broad themes emerged: the value of personalized targeted treatment and subgrouping of patients; the efficacy of various self-management strategies and educational initiatives; and identification of the ideal health care setting to provide FM care. Opioids and cannabinoids were the only specific pharmacologic interventions ranked as needing further research. Conclusions: The prioritized questions highlight the importance of recognizing the heterogeneity of FM symptoms, the need for a personalized treatment approach, and a better understanding of the value of self-management strategies. This is the first study that uses an established and transparent methodology to engage all FM stakeholders to help inform researchers and funding bodies of clinically relevant research priorities.

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Section: Discussionmentioning

confidence: 99%

A paradigm change to inform fibromyalgia research priorities by engaging patients and health care professionals

Fitzcharles

Brachaniec

Cooper

et al. 2017

Canadian Journal of Pain

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“…[3,9] The necessity of informing about the natural course of the disease at the moment the diagnosis is made and the follow up is reported. [9] Education sessions were performed at the beginning of the treatment and after the treatment at certain intervals to the patients in our study. The patients benefited significantly in all parameters in 6 month follow-up period.…”

Section: Discussionmentioning

confidence: 99%

Comparison of education and balneotherapy efficacy in patients with fibromyalgia syndrome: A randomized, controlled clinical study

Koçyiğit¹

2016

Agri

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SummaryObjectives: Fibromyalgia is a disease characterized by chronic, widespread pain. Pharmacological and non-pharmacological treatment methods are used. The aim of the present study was to determine the effect of balneotherapy on treatment of fibromyalgia syndrome, compared with education alone. Methods: A total of 66 patients diagnosed with fibromyalgia syndrome were randomly separated into balneotherapy and control groups. Patients in both groups were informed about fibromyalgia syndrome. In addition, the balneotherapy group received 21 sessions of spa treatment with 34.8 °C thermomineral water, attending the spa 5 days a week. Patients were evaluated by visual analogue scale, tender point count, fibromyalgia impact questioning, and modified fatigue impact scale at initiation of treatment on the 15th day, 1st month, 3rd month, and 6th month. Evaluations were performed by the same doctor. Results: Statistically significant improvement was detected in all parameters, compared to starting evaluation, in both groups. Most improved results among all parameters were observed in the balneotherapy group on the first 3-month follow-up. In addition, all parameters beyond tender point count and modified fatigue impact were improved on 6-month follow-up. Conclusion: It was concluded that addition of balneotherapy to patient education has both short-and long-term beneficial effects on female patients with fibromyalgia.Keywords: Balneotherapy; fibromyalgia; patient education; pain. ÖzetAmaç: Fibromiyalji, kronik yaygın kas iskelet ağrısı ile karakterize bir hastalıktır. Tedavide farmakolojik ve non-farmakolojik yöntemler kullanılmaktadır. Bu çalışmayı planlarken amacımız, balneoterapinin FMS'de tedaviye katkısını eğitim ile karşılaştı-rarak belirlemekti. Gereç ve Yöntem: Çalışmamızda, fibromiyalji sendromu tanısı almış olan 66 hasta randomize olarak ikiye ayrıldı, balneoterapi ve kontrol grubu olarak isimlendirildi. Her iki gruptaki hastaya fibromiyalji sendromu hakkında eğitim verildi. Balneoterapi grubundaki hastalara haftada 5 gün toplam 21 seans 34,8 derece termomineral su ile kaplıca tedavisi uygulandı. Hastalar aynı hekim tarafından tedavi başlangıcında, 15. gün, 1. ay, 3. ay ve 6. ayda görsel analog skala, hassas nokta sayısı, fibromiyalji etki sorgulaması, modifiye yorgunluk etki skalası ile değerlendirildi. Bulgular: Her iki gruptaki hastalarda başlangıç değerlendirmelerine göre tüm parametrelerde istatistiksel olarak anlamlı derecede düzelme saptandı. Balneoterapi grubu, kontrol grubuna göre ilk 3 aylık takipte tüm parametrelerde üstündü. 6. aydaki takipte hassas nokta sayısı ve modifiye yorgunluk etki skalası dışındaki parametrelerde üstünlük devam etmekteydi. Sonuç: Sonuç olarak hasta eğitimi ile balneoterapi tedavisinin birlikte kullanımının, 6 aylık takipte tek başına eğitime göre daha fazla klinik fayda sağladığı görüldü.

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“…All 3 guidelines were in agreement that the diagnosis remains clinical and the pur pose of the physical examination and laboratory investigations is to rule out alternative diagno ses. 23 The recommendations for the clinical diag nosis of FM of the Canadian, German, and Israe li guideline are summarized in TABLE 2.…”

Section: Diagnostic Workup Of a Patient With Chronic Widespread (Genementioning

confidence: 99%

Management of fibromyalgia: practical guides from recent evidence-based guidelines

Haüser¹,

Ablin²,

Perrot³

et al. 2017

Polish Archives of Internal Medicine

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REVIEW ARTICLE Management of fibromyalgia 47pharmacologic therapies. The costs related to FM can be substantial, with over 75% attributed to indirect costs from lost productivity and with in creased costs related to increased severity of FM. 5The concept of FM continues to stimulate de bate amongst researchers and clinicians alike. Advances in the field of functional neuroimaging over the last 2 decades, as well as other lines of physiological experimentation, have highlighted the role of central sensitization (or pain central ization), that is, increased processing of pain, as the main pathogenetic process in FM (and related conditions).6,7 Some authors have reported a more peripheral abnormality with changes consistent Background Fibromyalgia (FM) is a frequent, ex pensive, and controversial condition.1 Studies re port varied prevalence depending on diagnostic criteria used, a country, and a setting. One review reported a global mean prevalence of 2.7% (range, 0.4%-9.3%), with a mean in the Americas of 3.1%, in Europe of 2.5%, and in Asia of 1.7%.2 The prev alence rates of FM in Poland are unknown. FM is more common in women, with a female to male ratio of 3:1 in epidemiology studies 2 and of 8:1 to 10:1 in clinical settings. ABSTRACTFibromyalgia (FM) is a prevalent and costly condition worldwide, affecting approximately 2% of the general population. Recent evidence-and consensus -based guidelines from Canada, Germany, Israel, and the European League Against Rheumatism aim to support physicians in achieving a comprehensive diagnostic workup of patients with chronic widespread (generalized) pain (CWP) and to assist patients and physicians in shared decision making on treatment options. Every patient with CWP requires, at the first medical evaluation, a complete history, medical examination, and some laboratory tests (complete blood count, measurement of C -reactive protein, serum calcium, creatine phosphokinase, thyroid--stimulating hormone, and 25 -hydroxyvitamin D levels) to screen for metabolic or inflammatory causes of CWP. Any additional laboratory or radiographic testing should depend on red flags suggesting some other medical condition. The diagnosis is based on the history of a typical cluster of symptoms (CWP, nonrestorative sleep, physical and/or mental fatigue) that cannot be sufficiently explained by another medical condition. Optimal management should begin with education of patients regarding the current knowledge of FM (including written materials). Management should be a graduated approach with the aim of improving health -related quality of life. The initial focus should ensure active participation of patients in applying healthy lifestyle practices. Aerobic and strengthening exercises should be the foundation of nonpharmacologic management. Cognitive behavioral therapies should be considered for those with mood disorder or inadequate coping strategies. Pharmacologic therapies may be considered for those with severe pain (duloxetine, pregabalin, tramadol) or sleep disturbance (amitriptyline, c...

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Classification and Clinical Diagnosis of Fibromyalgia Syndrome: Recommendations of Recent Evidence-Based Interdisciplinary Guidelines

Cited by 55 publications

References 25 publications

A paradigm change to inform fibromyalgia research priorities by engaging patients and health care professionals

A paradigm change to inform fibromyalgia research priorities by engaging patients and health care professionals

Comparison of education and balneotherapy efficacy in patients with fibromyalgia syndrome: A randomized, controlled clinical study

Management of fibromyalgia: practical guides from recent evidence-based guidelines

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