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Rehabilitation of chronic myofascial pain disorders [myofascial pain and/or Fibromyalgia]

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By SH Wigers and A Finset • www.ProHealth.com • March 14, 2007


Journal: Tidsskrift for den Norske Laegeforening. 2007. Mar 1;127(5):604-8. [Article in Norwegian]

Authors and affiliation: Wigers SH, Finset A. Opptreningssenteret Jeloy Kurbad Bratengaten 94 1515 Moss. [E-Mail: sigrid.wigers@c2i.net ]sigrid.wigers@c2i.net

PMID: 17332816

Background. Chronic musculoskeletal pain of diffuse origin affects many, and at a significant cost. Evidence-based guidelines for therapeutic interventions are presented and exemplified.

Material and methods. 200 patients with chronic myofascial pain and/or Fibromyalgia who participated in a 4-week multidimensional rehabilitation program were included in the study. [Note: Myofascial pain has been characterized as pain of the muscle/connective tissue, often with hypersensitive muscle ‘trigger’ points that may refer pain and other symptoms to another part of the body.]

The program included education and pain management in a cognitive setting, various forms of aerobic exercises, myofascial pain treatment, relaxation and medication as needed.

The patients filled in questionnaires on arrival, at follow-up after six and 12-months and at discharge. They completed visual analogue scales (pain, fatigue, sleep problems, depression), the Nottingham Health Profile, the Fibromyalgia Impact Questionnaire, global subjective improvement, and during the follow-up period also the physical activity level, changes in quality of life and occupational workload.

Work capacity, a tender point count and whether patients met the diagnostic criteria for Fibromyalgia were assessed at baseline and at discharge.

Results:

  • Significant improvements were seen in all variables throughout the follow-up period.
  • Thirty percent of the Fibromyalgia patients no longer met the diagnostic criteria at discharge.
  • There was a significant increase in quality of life over time.
  • After one year, more patients had returned to work and fewer were off sick, but there was also an increased number on disability pensions.
  • The majority did exercise training on a regular basis.

Interpretation: Our findings confirm the existing evidence-based guidelines by showing that multidimensional rehabilitation is an effective intervention for patients with widespread chronic pain. It is a challenge for health politicians to change today's common practice towards that described in evidence-based guidelines.





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