A stepwise approach to fibromyalgia therapy
Dr. Don Goldenberg from Tufts University School of Medicine in Boston, Massachusetts has a video and print slide program on Medscape that reviews evidence-based treatments for fibromyalgia.
The emphasis is on drugs, but more interesting is his support for a combined drug/CAM approach to treatment.
Treatment options are divided into primary and tertiary care.
Primary care
- Medications: simple analgesics, antidepressants, anticonvulsants
- Education
- Exercise (low impact, such as walking, water exercises)
- Treatment of mood disturbances
Tertiary care
- Medication: combined antidepressants, anticonvulsants, potent pain drugs
- Cognitive-behavioral therapy, stress management therapy
- Multidisciplinary pain management
The bottom line?
Dr. Goldenberg says all patients should…
- Receive some education in regard to fibromyalgia.
- Be encouraged to exercise, including low-impact cardiovascular exercises such as walking or water exercises.
- Be screened for both mood disturbances and sleep disturbances, and treated appropriately.
“Most of the time,” he says, “multidisciplinary approaches are encouraged, including formal cognitive-behavioral therapy programs, stress management therapies, and multidisciplinary pain management approaches.”
10/3/08 18:45 JR
