Biology and therapy of fibromyalgia. New therapies in fibromyalgia

Women's Health Research Program, University of Cincinnati College of Medicine, Piedmont Avenue, Cincinnati, Ohio 45219, USA.
Arthritis research & therapy (Impact Factor: 4.12). 02/2006; 8(4):212. DOI: 10.1186/ar1971
Source: PubMed

ABSTRACT Fibromyalgia is a chronic, musculoskeletal pain condition that predominately affects women. Although fibromyalgia is common and associated with substantial morbidity and disability, there are no US Food and Drug Administration-approved treatments. However, progress has been made in identifying pharmacological and non-pharmacological treatments for fibromyalgia. Recent pharmacological treatment studies have focused on selective serotonin and norepinephrine reuptake inhibitors, which enhance serotonin and norepinephrine neurotransmission in the descending pain pathways and lack many of the adverse side effects associated with tricyclic medications. Promising results have also been reported for medications that bind to the alpha2delta subunit of voltage-gated calcium channels, resulting in decreased calcium influx at nerve terminals and subsequent reduction in the release of several neurotransmitters thought to play a role in pain processing. There is also evidence to support exercise, cognitive behavioral therapy, education, and social support in the management of fibromyalgia. It is likely that many patients would benefit from combinations of pharmacological and non-pharmacological treatments, but more study is needed.

  • Disease-a-Month 03/2015; 61(3). DOI:10.1016/j.disamonth.2015.01.002 · 0.54 Impact Factor
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    ABSTRACT: Sleep disorders are highly prevalent in patients with fibromyalgia (FM). Many of the daytime symptoms, such as chronic pain and fatigue, may be related to the non-restorative sleep patterns associated with the disease. Pain influences the sleep process and sleep disturbances decrease the pain threshold in a reciprocal framework. Thus, understanding the link between sleep and FM has become an important research topic in basic science. Therefore, in the current review we connect these topics and provide some insights into the cyclic relationship between sleep and pain, which has been addressed mainly in animal models. Additionally, we highlight the urgent need for sleep studies in FM animal models, which might improve the knowledge base and accelerate advances in this field.
    Current Pain and Headache Reports 08/2014; 18(8):434. DOI:10.1007/s11916-014-0434-3 · 2.26 Impact Factor
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    ABSTRACT: Electromyogram-Biofeedback in Patients with Fibromyalgia: A Randomized Controlled Trial Objective: To evaluate the effectiveness of EMG-biofeedback in patients with Fibromyalgia. Design: The study design was a randomized controlled pilot trial with blinded assessors and three points of assessment: before intervention (baseline, T0), at the end of treatment (T1) and a 3-months follow-up (T2). Setting: Outpatient clinic. Patients: Patients from the waiting list of the Fibromyalgia day hospital program fulfilling the inclusion criteria. Intervention: During eight weeks, 14 sessions of EMG-biofeedback training versus usual care only. Outcome Measures and Analysis: For primary outcome, the disease specific health status was followed using the Fibromyalgia Impact Questionnaire (FIQ). Secondary outcome measures comprise assessment of pain (Tender Point Score), tenderness (Tender Point Count = number of Tender Points, Pain Pressure Threshold), generic health status (SF-36), Patients’ Global Clinical Impression of Change and psychic impact (Beck depression Inventory, Symptom Checklist 90-Revised). Effects were analyzed with sensitivity statistics (effect size, ES), parametric and nonparametric tests. Results: The data of 36 patients with complete follow-up data could be analyzed. EMG-EMG-biofeedback did not improve health status of patients with Fibromyalgia (FIQ, T1: ES = 0.02, p = 0.95, T2: ES = 0.26, p = 0.43). Also, the secondary outcome measures, with the exception of the pressure pain threshold (T1: ES = 0.26, p = 0.014), showed no superiority of EMG-biofeedback in addition to usual care compared to usual care alone. Conclusion: In the treatment of patients with Fibromyalgia, EMG-biofeedback training in addition to usual medical care is not superior to usual medical care alone.

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