ProHealth health Vitamin and Natural Supplement Store and Health
Home  |  Log In  |  My Account  |  View Cart  View Your ProHealth Vitamin and Supplement Shopping Cart
800-366-6056  |  Contact Us  |  Help
Facebook Google Plus
Fibromyalgia  Chronic Fatigue Syndrome & M.E.  Lyme Disease  Natural Wellness  Supplement News  Forums  Our Story
Store     Brands   |   A-Z Index   |   Best Sellers   |   New Products   |   Deals & Specials   |   Under $10   |   SmartSavings Club

Trending News

Ultrasound Therapy for Fibromyalgia and Lyme Disease

Curcumin: The All In One Solution, Part 2

What Are the Benefits of Vitamin K2?

Vitamin D deficiency + high fat diet = metabolic syndrome

Why You Should Take Your Apple Cider Vinegar at Night

Use Burdock Oil to Promote Healthy Hair Growth

Meet Your Weight Loss Goals

People with forms of early-onset Parkinson's disease may benefit from boosting niacin in diet, resea...

AMA journal associates iron deficiency with hearing loss

Why the Mediterranean Diet Is so Successful

 
Print Page
Email Article

European Experts Agree on Nine Evidence-Based Recommendations for the Management of Fibromyalgia Syndrome

  [ 268 votes ]   [ Discuss This Article ]
By Editor • www.ProHealth.com • August 21, 2007


On behalf of the European League Against Rheumatism [EULAR], a multidisciplinarytask force of Fibromyalgia experts at 18 research centers in 11 countries has unanimously agreed on a set of Evidence-Based Recommendations for the Management of Fibromyalgia Syndrome. The article detailing these recommendations was published online July 20, 2007 in Annals of the Rheumatic Diseases.*

 

The recommendations reflect the findings of rigorously screened Fibromyalgia research reports published through 2005. They are based on the highest quality trials with the greatest strength of evidence, selected out of 146 eligible studies - 39 on pharmacologic interventions and 59 on non-pharmacologic therapies. In some areas where evidence was lacking owing to few or poor quality studies - e.g., exercise - the evaluation considered expert consensus opinion.

 

• All the eligible studies involved Fibromyalgia patients diagnosed according to the American College of Rheumatology (ACR) classification criteria established in 1990.

 

• Studies that included patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome were excluded “unless they were divided into separate comparison groups for analysis.”

 

Importantly, only two main outcome measures - pain and function - were considered. The cited studies assessed pain using the visual analogue scale (VAS), and assessed function using the Fibromyalgia Impact Questionnaire (FIQ). Other symptoms/measures were not considered.

 

• Additionally, the investigators reviewed abstracts of articles that had not been fully published “to guard against non-inclusion of any negative studies” owing to possible publication bias.

 

The Nine Recommendations – A Synopsis

(Graded A, B, C, and D according to strength of high-quality trial-based evidence; not ordered by importance.)

 

General Recommendations

 

1. Recognize that Fibromyalgia is a complex and heterogeneous condition; it involves “abnormal pain processing and other secondary features.” Full understanding must be based on a comprehensive assessment of the patient’s pain, function, and “psychosocial context.” (D - Based on expert opinion.)

 

2. A multidisciplinary treatment approach with a combination of non-pharmacological and pharmacological modalities is optimal. It should be tailored - based on discussion with the patient - to reflect pain intensity, function, and such associated features as fatigue, depression, and sleep disturbances. May require patient education for self-management. (D - Reflects expert opinion, general practice.)

 

Non-Pharmacological Management

 

3. Heated pool treatment (or balneotherapy) is effective in improving pain and function, both with and without exercise. (B - Small number of studies; fairly high quality.)

 

4. Exercise programs tailored to the individual - including strength training and aerobic exercise - can be of benefit to some FM patients. (C - Largely expert opinion; variable quality studies likely mask positive outcomes, and general health benefits, safety argue for inclusion.)

 

5. Cognitive behavioral therapy (CBT) may be helpful for some patients. (D - Based on expert opinion. “Another area in which the poor quality of trials has masked what experts believe to be a realistic reflection of possible benefits.”)

 

6. Other therapies that may be used depending on the individual patient’s needs include relaxation, rehabilitation, physiotherapy, and psychological support. (C - Based on expert opinion, some experimental evidence.)

 

Pharmacological Management
 

7. Tramadol is recommended for pain management. This is an “atypical opioid” in that it is not considered a controlled substance in many countries, though possibility of withdrawal symptoms with discontinuation should be noted. (A - Evidence includes a large, high quality study.)

 

Simple analgesics can be considered, such as “paracetamol & other weak opioids” - while strong opioids and corticosteroids are not recommended. (D - Based mostly on expert opinion, owing to insufficient trial data.)

 

8. Antidepressants - amitriptyline, fluoxetine, duloxetine, milnacipran, moclobemide, and pirlindole - often improve Fibromyalgia patient function and reduce pain, and are therefore recommended. (A - Based on large, high quality studies of these drugs.)

 

9. Tropisetron, pramipexole, and pregabalin (LyricaR) reduce pain and are recommended for FM. (A - Recent studies suggest these are promising drugs for FM. Studies of longer term effects suggested.)

 

* Source: “EULAR Evidence Based Recommendations for the Management of Fibromyalgia Syndrome,” Annals of the Rheumatic Diseases. 2007 Jul 20; [E-publication ahead of print] PMID: 17644548, by Carville SF, Arendt-Nielsen S, Bliddal H, Blotman F, Branco JC, Buskilla D, Da Silva JA, Danneskiold-Samsøe B, Dincer F, Henriksson C, Henriksson K, Kosek K, Longley K, McCarthy GM, Perrot S, Puszczewicz MJ, Sarzi-Puttini P, Silman A, Spath M, Choy EH. King's College London, United Kingdom (and 17 other centers). [E-mail: serena.carville@kcl.ac.uk ]<

 

To view an abstract of this article, click here. The full text of the article may be purchased at http://ard.bmj.com/cgi/rapidpdf/ard.2007.071522v1




Post a Comment

Featured Products From the ProHealth Store
Mitochondria Ignite™ with NT Factor® FibroSleep™ Ultra EPA  - Fish Oil

Looking for Vitamins, Herbs and Supplements?
Search the ProHealth Store for Hundreds of Natural Health Products


Article Comments



Be the first to comment on this article!

Post a Comment


 
NAD+ Ignite with Niagen

Featured Products

Ultra EPA  - Fish Oil Ultra EPA - Fish Oil
Ultra concentrated source of essential fish oils
Vitamin D3 Extreme™ Vitamin D3 Extreme™
50,000 IU Vitamin D3 - Prescription Strength
Ultra ATP+, Double Strength Ultra ATP+, Double Strength
Get energized with malic acid & magnesium
Mitochondria Ignite™ with NT Factor® Mitochondria Ignite™ with NT Factor®
Reduce Fatigue up to 45%
Energy NADH™ 12.5mg Energy NADH™ 12.5mg
Improve Energy & Cognitive Function

Natural Remedies

More Weight Loss than Any Other Discovery in Supplement History More Weight Loss than Any Other Discovery in Supplement History
Quercetin: Natural Support for Allergy & Inflammation Relief and More Quercetin: Natural Support for Allergy & Inflammation Relief and More
Can Glycine + Amino Acids Be the Secret to Deep, Rejuvenating Sleep? Can Glycine + Amino Acids Be the Secret to Deep, Rejuvenating Sleep?
Thyroid Health and Fibromyalgia Thyroid Health and Fibromyalgia
Reversing Neurodegeneration with a New Magnesium Compound Reversing Neurodegeneration with a New Magnesium Compound

CONTACT US
ProHealth, Inc.
555 Maple Ave
Carpinteria, CA 93013
(800) 366-6056  |  Email

· Become a Wholesaler
· Vendor Inquiries
· Affiliate Program
SHOP WITH CONFIDENCE
Credit Card Processing
SUBSCRIBE TO OUR NEWSLETTERS
Get the latest news about Fibromyalgia, M.E/Chronic Fatigue Syndrome, Lyme Disease and Natural Wellness

CONNECT WITH US ProHealth on Facebook  ProHealth on Twitter  ProHealth on Pinterest  ProHealth on Google Plus

© 2017 ProHealth, Inc. All rights reserved. Pain Tracker App  |  Store  |  Customer Service  |  Guarantee  |  Privacy  |  Contact Us  |  Library  |  RSS  |  Site Map