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According to Daniel Clauw, M.D., "One of the biggest problems I see in practice is that doctors and patients try too many things at once, and then they have limited ability to tell if something is working, or whether a new symptom is a side effect of a treatment. After I find the correct one or two medications to reasonably control many of the symptoms, then I will add aerobic exercise, and sometimes cognitive behavioral therapy (CBT). Both exercise and CBT can either be done simply (with simple instructions for exercise or a workbook or Arthritis Foundation course for CBT) or with more professional guidance (e.g., with a physical therapist, personal trainer, social worker, or psychologist). These treatments take many months to work (in contrast to medications which usually work within a month or so if they are going to work at all), but the benefits are more durable than the benefits obtained from medications. If this combination of treatments doesn’t work, I will sometimes add complementary and alternative therapies at this point." (Source: Pro Health's Healthwatch Treatment Guide 2002. Read the complete article online at http://www.immunesupport.com/Library/showarticle.cfm/ID/3854/HealthWatch/HealthWatch-Treatment-Guide-2002 .)

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