Patients with fibromyalgia (FM) who exercise and practice relaxation and other non-drug techniques report fewer symptoms such as pain, fatigue, and morning stiffness than do patients who receive medication alone, according to scientists at the University of Missouri-Columbia.
"Optimal treatment of FM should include non-pharmacological interventions, specifically exercise and cognitive behavioral therapy, in addition to appropriate medication management as needed for sleep and pain symptoms," says Lynn A. Rossy, MA, head of the study.
FM is a poorly understood rheumatologic disorder that leaves those afflicted with fatigue, painful 'tender points,' and difficulties with sleep and functioning throughout the day. Rossy and colleagues examined data on more than 2,000 patients in 33 studies of drug treatments – including antidepressants, muscle relaxants, and non-steroidal anti-inflammatory drugs – and 16 studies of non-drug treatments, such as aerobic exercise, relaxation, and cognitive behavioral techniques.
The researchers used a statistical technique called 'meta-analysis' to pool the data from the disparate studies and compare the overall effectiveness of drug and non-drug treatments for FM. They report their findings in the Annals of Behavioral Medicine.
Overall, both drug and non-drug treatments produce significant improvements in FM patients' physical condition, their report of FM symptoms, and their mental condition. Non-drug treatments were superior to drug treatments in reducing the number of FM symptoms patients reported and in improving their ability to function on a daily basis. In fact, no drug treatment had any significant effect on daily functioning.
There was no difference between drug and non-drug treatments in their effects on patients' physical or mental condition.
"Our analysis suggests that a combination of drug and non-drug treatments is superior to drug treatment alone," says Rossy.
The research was supported by grants from the National Center for Medical Rehabilitation Research of the National Institute of Child Health and Human Development and from the National Institute on Disability and Rehabilitation Research of the Office of Special Education and Rehabilitative Services.