Fibromyalgia
Fibromyalgia syndrome (FMS) is a chronic noninflammatory, nonautoimmune central afferent processing disorder leading to a diffuse pain syndrome as well as other symptoms.
Similar to patients with other chronic pain disorders, functional magnetic resonance images (MRIs) show expanded receptive fields for central pain perception and emotional modulation in patients with fibromyalgia.
The most effective drugs for FMS are tricyclic agents (TCAs), dual reuptake inhibitors, and anticonvulsants, which downregulate sensory processing.
Opioids and corticosteroids are not effective in the treatment of fibromyalgia and should be avoided.
Patient education, aerobic exercise, and cognitive behavioral therapy are important adjuncts to medical therapy of FMS.
Therapy recommendations
Soft tissue rheumatic complaints https://www.irheuma.com/de/rhe...
Fibromyalgia https://www.irheuma.com/de/rhe...
Current EULAR recommendations for the management of fibromyalgia
English: https://air.unimi.it/retrieve/...
German: https://www.rosenfluh.ch/media...
Non-pharmacological interventions should be the first line of treatment for fibromyalgia, especially aerobic exercise and strength training
If this does not lead to success, further therapies should be tailored to the individual's needs (e.g. psychological procedures, pharmacotherapy, multimodal rehabilitation program).
Overriding principles
Optimal treatment requires early diagnosis. A comprehensive understanding of fibromyalgia (FM) requires a comprehensive assessment of pain, function and psychosocial context. FM should be understood as a complex and heterogeneous condition with altered pain processing and other secondary features. In general, the management of FM should be staged.
The treatment of FM should aim to improve health-related quality of life, whereby the benefits and risks of therapy must be weighed against each other. This often requires a multidisciplinary approach with a combination of non-drug and drug treatment modalities. These should be decided jointly with the patient based on their individual pain intensity, function and associated characteristics (such as depression), fatigue, sleep disorders, preferences and concomitant illnesses. Initial therapy should focus on non-medicinal interventions.
Non-medication treatment
Aerobic exercises and strength training
cognitive behavioral therapy
multimodal therapy
defined physical therapies: acupuncture or hydrotherapy
meditative movement therapies (qigong, yoga, tai chi) and MBSR (mindfulness-based stress reduction)
Drug treatment, cf:
English: https://air.unimi.it/retrieve/...
German: https://www.rosenfluh.ch/media...
https://suisse-fibromyalgie.ch...
Flyer Asfm Deutsch 202404 Einseitig Final
Flyer Fibroday 20240512 Final 5
Flyer Asfm Deutsch 202404 2 Final
Web:
The National Institute of Arthritis and Musculoskeletal and Skin Disease