EULAR revised recommendations for the management of fibromyalgia

Macfarlane, Gary J.; Kronisch, Caroline; Dean, Linda E; Atzeni, Fabiola; Haüser, Winfried; Flüß, Elisa; Choy, Ernest; Kosek, Eva; Amris, Kirstine; Branco, Jaime; Dinçer, Fitnat; Leino-Arjas, Päivi; Longley, Kathy; McCarthy, Géraldine; Makri, Souzi; Perrot, Serge; Sarzi-Puttini, Piercarlo; Taylor, Ann M.; Jones, Gareth T

doi:10.1136/annrheumdis-2016-209724

Cited by 1,089 publications

(1,147 citation statements)

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“…Pain diagrams for patients with chronic widespread pain: painful areas are marked by the patient with grey (A) and blue colors (B) A B was to synthesize and summarize the recom mendations of the Canadian, 15 German, 16,17 and Israeli 14 guidelines for the diagnosis and of the Eu ropean League Against Rheumatism (EULAR) 18 recommendations for the management of FM.…”

Section: Figurementioning

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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Section: Figurementioning

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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“…The greatest benefit was seen in an overall functional improvement, and these results were confirmed over time. 28,30,31 However, availability, compliance, and maintenance over the long term are the main limitations for these forms of therapy. 28 EULAR, 32 the latest review of FM treatment, emphasises the need to properly inform and educate patients about their disease and the usefulness of moderate aerobic exercise, such as yoga or meditation, amongst others.…”

Section: Therapeutic Suggestionsmentioning

confidence: 99%

Use of oxygen-ozone therapy in the treatment of fibromyalgia

2017

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Fibromyalgia (FM) is a pathology that is manifested by a spectrum of heterogeneous symptoms that are difficult to frame, from both a diagnostic and therapeutic point of view. On one hand, the clinical features are highly variable, and on the other, the pathophysiology has yet to be fully clarified. This paper aims to highlight how oxygen ozone -administered using a precise protocol from the Scientific Society of Oxygen Ozone Therapy -is able to act on several levels of the pathophysiology of FM by virtue of its intrinsic biochemical mechanisms, making it a viable option for treating the disease. The following case studya 45 year old woman who came to our attention due to diffuse pain and a feeling of general tiredness -responded positively to a standard treatment with oxygen-ozone therapy delivered via bi-weekly sessions, for a total of 12 sessions from September to October 2016. The treatment was followed by a maintenance therapy of about one session a month. One month after the end of the 12 sessions, the patient reported a significant improvement in pain, mood, and a significant reduction in fatigue, a new feeling of well-being and an improved quality of sleep. In the light of these results, oxygen-ozone therapy emerges as a viable therapeutic option for the treatment of FM patients.

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“…10 There is no definite cure for FM, though current treatment options offer symptomatic management through both pharmacological and non-pharmacological therapies. 11 The nonpharmacological treatments proposed are acupuncture, biofeedback, capsaicin, chiropractic, cognitive behavioural therapies, exercise, hydrotherapy, spa therapy, hypnotherapy, massage, meditative movement (Quigong, yoga, tai chi), mindfulness/mind-body therapy, multicomponent therapy, S-adenosyl methionine and other complementary and alternative therapies. 11 Modern medicine like physical therapy aides with modalities like stretching, strengthening, aerobic training and endurance training to provide symptomatic relief for these subjects.…”

Section: Introductionmentioning

confidence: 99%

“…11 The nonpharmacological treatments proposed are acupuncture, biofeedback, capsaicin, chiropractic, cognitive behavioural therapies, exercise, hydrotherapy, spa therapy, hypnotherapy, massage, meditative movement (Quigong, yoga, tai chi), mindfulness/mind-body therapy, multicomponent therapy, S-adenosyl methionine and other complementary and alternative therapies. 11 Modern medicine like physical therapy aides with modalities like stretching, strengthening, aerobic training and endurance training to provide symptomatic relief for these subjects. 12,13 Of these, strengthening provides greater results in reducing symptoms like pain in subjects with fibromyalgia.…”

Section: Introductionmentioning

confidence: 99%