Fibromyalgia treatment and management considerations for nurse practitioners

Abstract

The purpose of this case study is to examine the role of the nurse practitioner in the management and treatment of a 35-year-old female patient diagnosed with several conditions, including fibromyalgia posttraumatic stress disorder, anxiety, and depression. Fibromyalgia is a chronic, nonprogressive rheumatic condition with cardinal symptoms of widespread pain and fatigue; it affects more than 5 million people in the United States. This case study examines the nurse practitioner's role in managing fibromyalgia. Benzodiazepines and opioids may be prescribed for treatment of symptoms but prove ineffective, thus contributing to dependency issues. Controversy exists over classification of fibromyalgia as a rheumatologic condition versus a mental health disorder. Fibromyalgia frequently is accompanied by anxiety and depression, making this illness difficult to diagnose and treat.

Is Perfectionism Always Dysfunctional? Looking into Its Interaction with Activity Patterns in Women with Fibromyalgia

“…A recent study that explores the experiences and views of nurses who provide nonpharmacological therapies for chronic pain management emphasizes the need for them to get to know their patient and their psychological variables, as this provides the necessary knowledge for optimal care and pain management. Nurses should be encouraged and given the opportunity to attend specialized training in pain management, especially in FM (Munkombwe et al, 2020; Stournaras & Petrovic, 2019). Examining perfectionism may assist in identifying individuals in the acute or subacute stage who are at risk of potentially developing chronicity or long-term disability and help target early intervention (Mehta et al, 2016).…”

Fibromialgia: Manifestaciones neuropsiquiátricas y abordaje terapéutico en la atención primaria

“…Es importante explicar al paciente el concepto de dolor centralizado, como un dolor producido desde el SNC, con el fin de despojar al paciente de la idea de la proveniencia de una causa estructural. 33,34,35 El enfoque del tratamiento se basa en una coordinación de lo farmacológico y no farmacológico.…”

“…El uso de opioides se encuentra contraindicado, pero según el Colegio Americano de Reumatología recomienda al tramadol como el único opioide que debe ser prescrito en caso de ser necesario. 33,37,41 Artículo de Revisión Gruezo-Realpe P., Cusme-Diaz N., León-Llanos H., Benavidez-López A., Yanzaguano-Morquecho V.…”

“…21 No obstante, la tolerabilidad a sus efectos adversos principalmente mareos y nauseas no le son favorables, y por tal razón deben ser evitados. 33,47,48 Por otro lado el uso de pregabalina para el manejo de los desórdenes del sueño señala buenos resultados con mejores efectos dosis dependiente, pues en un meta análisis realizado en 2022 Migliorini et 49 al, observaron resultados muy positivos medidos mediante el FIQ (Fibromyalgia Impact Questionnaire) con el uso de 450 mg de Pregabalina, al mismo tiempo que se halló una mejoría muy significativa en la calidad del sueño con dosis de 600mg/día de pregabalina y mejores efectos adversos al medicamento a dosis de 300mg/día . Así también, se ha demostrado buenos resultados en cuanto a la reducción del dolor y la mejoría del sueño con el uso de amitriptilina.…”

Hydroxytyrosol as a Promising Ally in the Treatment of Fibromyalgia

“…Although there is a plethora of drugs currently used for FM treatment, none of them seem to be completely effective by itself. As a result, a combination of pharmacological and nonpharmacological treatments seems to be the more usual approach [16]. Even more, treatments that do not use drugs at all are strongly recommended by several organisms and researchers [17,18].…”