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Linz WorldLiving with fibromyalgia syndrome
November 04 Exercise for treating fibromyalgia syndromeThe Cochrane Database of Systematic Reviews published an article on October 17th reviewing the evidence for using exercise to treat fibromyalgia syndrome.
The Cochrane Collaboration is an international not-for-profit organization, providing up-to-date information about the effects of health care. an international not-for-profit organization, providing up-to-date information about the effects of health care. The Cochrane Library is a collection of databases that contain high-quality, independent evidence to inform healthcare decision-making. Cochrane Reviews explore the evidence for and against the effectiveness and appropriateness of treatments (medications, surgery, education, etc) in specific circumstances.
The primary objective of this review was to:
Various databases of medical and sports literature were searched for conrolled trials, up to and including July 2005, and reference lists from reviews and meta-analyses of treatment studies were also searched. Randomized trials focused on cardiorespiratory endurance, muscle strength and/or flexibility as treatment for FMS were selected.
The review found that there is moderate quality evidence that aerobic-only exercise training at recommended intensity levels has positive effects global well-being and physical function. and possibly also on pain and tender points. Strength and flexibility remain under-evaluated as factors in the treatment of FM patients.
The review's authors concluded that:
Antidepressants as treatment for FibromyalgiaAn article on Duloxetine for women with FM was published in the October edition of the Journal of Womens Health. The study aimed to assess the efficacy, safety and tolerability of duloxetine in female patients with fibromyalgia. In particular, it's efficiacy was measured in terms of pain, functional impairment, and quality of life. The Ohio researchers pooled data from two randomised, double-blind, placebo-controlled clinical trials of 12-week duration, comparing duloxetine 60 mg a day or 60 mg twice daily with placebo, in women who met the American College of Rheumatology criteria for primary fibromyalgia.
They found that duloxetine-treated female patients demonstrated a significantly greater improvement in the Brief Pain Inventory (BPI) average pain severity score and in the Fibromyalgia Impact Questionnaire (FIQ) total score, beginning at week 1 and continuing through week 12. Duloxetine was superior to placebo on all efficacy measures, including mean tender point threshold, Clinical Global Impression of Severity, Patient Global Impression of Improvement, and average interference from pain scores. The duloxetine-treated group was superior to placebo on all quality of life and functional measures. A direct treatment effect of duloxetine on pain reduction was demonstrated and shown to be independent of secondary improvement in mood.
One aspect I noted with cynical dismay was the Women's Health Research Program that did the study is based in the Department of Psychiatry at the University of Cincinnati, College of Medicine.
The same research program also published an article in a supplement to the September issue of the Journal of Pain Medicine, titled 'Duloxetine and other antidepressants in the treatment of patients with fibromyalgia'. This also concluded that Duloxetine, along with other selective serotonin and norepinephrine reuptake inhibitors (SNRIs) are promising treatments for many of the symptoms associated with fibromyalgia, particularly for women. It noted that there are few randomized, controlled studies of selective serotonin reuptake inhibitors in fibromyalgia, and the results have been mixed. And the author also noted that:
It's nice to see a mention, in a medical journal, that the use of TCAs in treating FM is limited by their side effects. They are still the drug of choice for many doctors faced with a patient with FM and with the advent of modern SNRIs like Duloxetine, there is no need for them to be. I am still dealing with the after effect of being given amitrityline, a TCA, for years despite it's limited and reducing effectiveness.
The article concluded that:
Ericksonian hypnosis for FMAsix-month Mexican study compared the use of Ericksonian hypnosis with sham hypnosis in patients with Fibromyalgia. The researchers found that, although the values for the patient and physician global disease assessment and the FIQ (Fibromyalgia Impact Questionnaire) scores did not differ significnatly between the two groups of patients, the number of tender points in the patients getting the Ericksonian hypnosis did decrease. Children with FM more likely to choose CAMA group of researchers from UCLA published an article titled 'Treatment Preferences for CAM in Children with Chronic Pain' in the September issue of "Evidence-based complementary and alternative medicine".
The study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM (Complementary & Alternative Medicine) therapies for their pain. The study participants were 129 children, with a mean age of 14.5 years old, who went to a multidisciplinary, tertiary clinic specializing in pediatric chronic pain.
Over 60% of patients elected to try at least one CAM approach for pain, the most popular therapies being biofeedback, yoga and hypnosis and the least popular being art therapy and energy healing. Other therapies offered included craniosacral, acupuncture and massage. The study found that patients with a diagnosis of fibromyalgia were more likely to try CAM versus those with other pain diagnoses. The study also found that pain duration emerged as a significant predictor of CAM preferences. For mind-based approaches (i.e. hypnosis, biofeedback and art therapy), pain duration and limitations in family activities were both significant predictors. Longer duration of pain and greater impairment in functioning, particularly during family activities increased the likelihood that such patients agreed to engage in CAM treatments, especially those that were categorized as mind-based modalities. When given a choice of CAM therapies, this sample of children with chronic pain, irrespective of pain diagnosis, preferred non-invasive approaches that enhanced relaxation and increased somatic control. Cannabinoid trialled for FibromyalgiaResearchers from the section of Physical Medicine and Rehabilitation at the University of Manitoba Rehabilitation Hospital (Canada) recently published an article on a trial conducted to determine the benefit of nabilone, a synthetic cannabinoid, in pain management and quality of life improvement in fibromyalgia patients. The article was e-published ahead of print in the Journal of Pain, on October 30th. The randomized, double-blind, placebo-controlled trial was conducted to determine the benefit of nabilone in pain management and quality of life improvement in 40 patients with fibromyalgia. A visual analog scale (VAS) for pain was used as the primary measure, with secondary outcome measures being number of tender points, the average tender point pain threshold, and the Fibromyalgia Impact Questionnaire (FIQ). The 4 week trial found that there were significant decreases in the VAS and anxiety in the nabilone treated group, with no significant improvements in the placebo group. The researchers said:
November 02 Berkshire Me & FM groups working togetherThe Reading Area ME Support Group, the West Berks ME & FM Group and the Reading/Wokingham Fibromyalgia Support Group are now all working together in the campaign to get specialist services for people with CFS/ME and FM across Berkshire.
The West Berks ME & FM Group recently hosted its first Awareness Event, on Friday 19th October 2007, in Newbury, which was supported by the Reading Area ME Support Group and the West Berkshire Neurological Alliance. Sixty people, including Richard Benyon MP, the Mayor of Newbury and the Mayor & Mayoress of Hungerford attended this event. Launched at the event were petitions to all the MPs of Berkshire, asking that they ensure that appropriate provision is made for the diagnosis, management and treatment of ME-CFS and Fibromyalgia (FM), within our area and without private payment.
The groups, which together cover all of Berkshire, would like to keep all people with CFS/ME and/or FM updated on the campaign for services, especially those who were not well enough to travel to this event.
For some years, the Reading Area ME Support group, which covers all of Berkshire, has been pressing for improvements in the care available to CFS/ME patients. Following some meetings between the Reading Area ME Support group and the Berks West/East PCT in the Autumn of 2006, it was proposed that a pilot service would be implemented this year. However, following staff changes within the PCT with the reorganisation, no further progress, or consistent communications, has been possible. Following a formal letter of complaint the Reading Area ME Support Group and the West Berks ME & FM Group have now had an initial meeting with the Berks West PCT to restart negotiations for services for people with both CFS/ME and Fibromyalgia. Ideas proposed at the initial meeting included a plan for a GP Guide and a ME/FM adapted Living well course, run by a volunteer with ME and one with FM. If anyone with ME or FM is interested in becoming a course leader, please contact Lindsey, the group leader for the West Berks ME & FM Group. The Reading/Wokingham Fibromyalgia Support Group has now joined the campaign.
The groups should soon be meeting with the appropriate commissioners from the Berkshire West PCT to discuss possible service further. A Needs Assessment is also taking place in Berkshire East – the person involved is liaising with Berkshire West to hopefully supply a service Berkshire wide.
To continue the campaign we will now be writing to local MPs, and request that local people affected by ME or FM do so too, as well as signing the petitions. We are hoping that this will help move forward our campaign to achieve some real improvement in the local services for CFS/ME and FM patients. If anyone interested in services for people with CFS/ME or FM would like to sign the petition or get a letter to send to their MP, please contact Lindsey, the group leader for the West Berks ME & FM Group at info@wbme.org or 01635 529676. October 20 We Did It!!Yesterday was the West Berks ME & FM Group's first Awareness Event! Overall it was a fantastic success, although there were quite a few lessons learnt for next time.
Approximately 60 people turned up and it was great to see so many new faces. One couple had even travelled all the way from Essex to see what our group ws up to! Richard Benyon, MP very kindly attended and it was great to have a chance to talk to him. He was suprised to hear that ME & FM together affect between 10, 000 and 24,500 people in the Berkshire West PCT area alone. This is a big issue! The Mayor of Newbury, the Mayor & Mayoress of Hungerford and the Chairman of the Council also attended and it was good to see them there supporting the event. October 03 16 days to go!There are 16 days to go (2 weeks, 2 days - eek!) until the West Berks ME & FM Group's Awareness Event. It's being held on Friday 19th October from 4pm till around 6pm, at the Baptist Church Hall on Cheap Street in Newbury. Highlights now confirmed include:
Quite a few local VIPs have said they are going to attend and Richard Benyon MP is hoping to make it.
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