Recommendations by the Spanish Society of Rheumatology on Fibromyalgia. Part 1: Diagnosis and treatment

Redondo, Javier Rivera; Fontecha, Petra Díaz del Campo; Miquel, Cayetano Alegre de; Bernabé, Miriam Almirall; Fernández, Benigno Casanueva; Ojeda, Cristina Castillo; Cruz, Antonio Collado; Montesó‐Curto, Pilar; Tarrero, Ángela Palao; Calvo, Eva Trillo; Pareja, Miguel Ángel Vallejo; García, Noé Brito; Argumánez, Carol Merino; Farras, M. Nieves Plana

doi:10.1016/j.reumae.2021.02.002

Cited by 5 publications

(9 citation statements)

References 94 publications

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“…With respect to pharmacological management, it was found that almost all patients were receiving acetaminophen, in contrast with other reports in which its use was much lower (3.4%–40.5%) (de Assis et al., 2020; Robinson et al., 2012; Valentini et al., 2020). According to clinical practice guidelines, the first‐line drugs that have shown efficacy are gabapentinoids and some antidepressants (Fitzcharles et al., 2013; Macfarlane et al., 2017; Rivera Redondo et al., 2022). In this sense, gabapentinoids were used in two‐thirds of patients, which was also higher than that described in other studies (19.0%–31.0%) (Kaouk et al., 2018; Rico‐Villademoros et al., 2020; Robinson et al., 2012; Valentini et al., 2020).…”

Section: Discussionmentioning

confidence: 99%

“…Hydrocodone was the most commonly prescribed opioid in this study, while in other local and international studies, tramadol was the most common opioid (de Assis et al., 2020; Fernández‐Avila et al., 2020; Rico‐Villademoros et al., 2020; Robinson et al., 2012; Valentini et al., 2020). Clinical practice guidelines do not recommend the use of opioids in patients with fibromyalgia because there is insufficient evidence of their effectiveness, and they increase the risk of adverse drug reactions, including dependence (Fitzcharles et al., 2013; Macfarlane et al., 2017; Rivera Redondo et al., 2022). However, tramadol could be prescribed in patients with moderate to severe pain who have not responded to the initial management with pain modulators (Fitzcharles et al., 2013; Macfarlane et al., 2017; Rivera Redondo et al., 2022; Sarzi‐Puttini et al., 2020).…”

Section: Discussionmentioning

confidence: 99%

“…Clinical practice guidelines do not recommend the use of opioids in patients with fibromyalgia because there is insufficient evidence of their effectiveness, and they increase the risk of adverse drug reactions, including dependence (Fitzcharles et al., 2013; Macfarlane et al., 2017; Rivera Redondo et al., 2022). However, tramadol could be prescribed in patients with moderate to severe pain who have not responded to the initial management with pain modulators (Fitzcharles et al., 2013; Macfarlane et al., 2017; Rivera Redondo et al., 2022; Sarzi‐Puttini et al., 2020). In patients with fibromyalgia, there is a deficit in the downward modulation of pain mediated by opioids, an increase in the levels of endogenous opioids and a downregulation of opioid receptors, which explains the low efficacy of these drugs.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Treatment is aimed at reducing the main symptoms and includes a variety of nonpharmacological therapies and medications, such as antidepressants, gabapentinoids, muscle relaxants, and, for some patients, tramadol (Fitzcharles et al., 2013; Macfarlane et al., 2017; Rivera Redondo et al., 2022). However, the use of other opioids has not been shown to be effective and has been shown to be associated with an increased risk of adverse drug reactions (Fitzcharles et al., 2013; Macfarlane et al., 2017; Rivera Redondo et al., 2022). Despite this the literature reveals that opioids are frequently prescribed to treat fibromyalgia in clinical practice (Kaouk et al., 2018; Rico‐Villademoros et al., 2020; Robinson et al., 2012; Turner et al., 2016; Valentini et al., 2020; Vincent et al., 2015).…”

Section: Introductionmentioning

confidence: 99%

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Treatment patterns in fibromyalgia including the use of opioids

Valladales‐Restrepo

Oyuela-Gutiérrez

Alzate-García

et al. 2022

Musculoskeletal Care

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Objective: Opioids (except for tramadol) have not been shown to be effective in patients with fibromyalgia, but they can increase the risk of adverse drug reactions.The aim was to determine the treatment patterns of a group of patients with fibromyalgia and to identify the factors associated with the use of opioids in Colombia.Methods: This was a cross-sectional study of a group of patients with fibromyalgia from a pain clinic in Colombia. Sociodemographic, clinical and pharmacological variables were identified. Descriptive, bivariate, and multivariate analyses were performed.Results: A total of 559 patients were analysed, 88.6% of whom were women, and the mean age was 53.4 � 12.6 years. A total of 40.6% received nonpharmacological management, and the majority were treated with acetaminophen (96.1%) and pregabalin (62.8%). A total of 69.6% received opioids, the most common of which was hydrocodone (36.3%). The average morphine equivalent milligrammes was 36.9 � 91.2 (range: 2.3-750 mg), and 43.8% had intermediate/high doses. Being

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Treatment patterns in fibromyalgia including the use of opioids

Valladales‐Restrepo

Oyuela-Gutiérrez

Alzate-García

et al. 2022

Musculoskeletal Care

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Perceived benefits and limitations of a psychoeducation program for patients with fibromyalgia: an interpretative phenomenological analysis

Di-Bonaventura,

Ferrer-Peña,

Pardo-Montero

et al. 2024

Front. Psychol.

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ObjectiveTo analyze the perceived benefits and limitations of a pain psychoeducation program as a non-pharmacological treatment for patients with fibromyalgia.MethodsAn interpretative phenomenological analysis was applied to analyze the subjective experiences of 11 patients with fibromyalgia who participated in a pain psychoeducation program. This program includes educational sessions that address pain understanding, coping strategies, and relaxation techniques. Semi-structured interviews were conducted, transcribed, and analyzed using ATLAS.ti software.ResultsPatients reported significant improvements in cognitive-functional capacity and socio-emotional ability, including better disease understanding and management, emotional stability, and interpersonal relationships. Despite these benefits, they identified limitations in program individualization and insufficient coverage of certain topics, such as sexual health and legal aspects of disability. Enhanced self-management skills were evident, with observed shifts in disease perception and coping strategies.ConclusionThe psychoeducation program was viewed positively, influencing functional, cognitive, and emotional enhancements. Nonetheless, the need for increased program personalization and expanded socio-economic support was noted. Future research should focus on the long-term impacts of psychoeducation and the feasibility of tailored interventions.

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Physical Activity and Exercise Experience in Spanish and US Men with Fibromyalgia: A Qualitative Cross-Cultural Study

Montesó-Curto,

Toussaint,

Kueny

et al. 2023

IJERPH

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Physical exercise is an indispensable element in the multidisciplinary treatment of fibromyalgia syndrome (FMS). The present study examined if men diagnosed with FMS engaged in any type of physical activity or exercise, the perceived effects from exercise, and who specifically recommended exercise. A qualitative cross-cultural study was performed in fibromyalgia clinical units in Spain and the United States. A total of 17 participants, 10 men from Spain and 7 men from the US, were included. In Spain, a focus group was completed in two parts, one month apart in 2018. In the US, five individual interviews and one joint interview with two men were completed in 2018. Three central themes appeared in the qualitative data: (1) Understanding what constitutes physical activity or exercise, (2) Facilitating or discouraging the performance of physical exercise, and (3) Effects of physical activity or exercise on psychological and social symptoms. The actual practice of exercise by patients with FMS is often perceived as leading to pain and fatigue, rather than a treatment facilitator. Physical activity and exercise can provide benefits, including relaxation, socialization, and increased muscle tone. However, minor opioids limit physical activity as they cause addiction, drowsiness, and decrease physical activity in Spanish men. Recommendations in a clinical setting should incorporate exercise as well as physical activity via daily life activities.

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Recommendations by the Spanish Society of Rheumatology on Fibromyalgia. Part 1: Diagnosis and treatment

Cited by 5 publications

References 94 publications

Treatment patterns in fibromyalgia including the use of opioids

Treatment patterns in fibromyalgia including the use of opioids

Perceived benefits and limitations of a psychoeducation program for patients with fibromyalgia: an interpretative phenomenological analysis

Physical Activity and Exercise Experience in Spanish and US Men with Fibromyalgia: A Qualitative Cross-Cultural Study

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