Pain Medicine News - Fibromyalgia Now Widely Recognized as Requiring Multimodal Approach

Israeli fibromyalgia guidelines published online in November 2013 and Canadian guidelines published in May 2013 follow in the solid footsteps of the 2010 American College of Rheumatology preliminary diagnostic criteria for fibromyalgia. The Canadian and Israeli documents eschew an extensive physical examination and a tender-point count, focus on the importance of nonpharmacologic treatments and recognize fibromyalgia as neither a distinct rheumatic nor mental disorder. German guidelines cut from similar cloth were published in 2008."All three guidelines focus on a multimodal approach; and we emphasize the primacy of physical activity and self-management strategies that may be augmented by interventions such as cognitive-behavioral therapy. Mary-Ann Fitzcharles, MD, lead author of the Canadian guidelines (Pain Res Manag 2013;18:119-126), said after discussing the three guidelines at the American College of Rheumatology's 2013 annual meeting, "Medications do play a role in patient care, but with the acknowledgment that responses are generally modest at best."Jacob Ablin, MD, lead author of the Israeli guidelines (2013; 152:L742-L747; www.ima.org.il/​Ima/​FormStorage/​Type7/​clinical_68_fibrom.pdf) and director of the Fibromyalgia Clinic at the Tel-Aviv Sourasky Medical Center, told meeting attendees the Israeli and German guidelines also recommend against the use of nonsteroidal anti-inflammatory drugs, systemic steroids, benzodiazepines and thyroid hormone. A...
Source: Psychology of Pain - Category: Psychiatrists and Psychologists Source Type: blogs