Ask the Experts: Fibromyalgia

Neurology Now
February–March 2013
Volume 9(1)
p 34
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QCan fibromyalgia symptoms be managed effectively without drugs?

CHARLES E. ARGOFF RESPONDS:

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A Fibromyalgia syndrome (FMS) is a common condition that involves long-term, body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues. FMS has also been linked to fatigue, sleep problems, headaches, depression, and anxiety. While no one can say with absolute certainty what causes FMS, we are learning more about the role of central nervous system excitability in connection with FMS.

Because it is a condition that affects people very differently, FMS should be treated by addressing the specific symptoms that are most bothersome to the individual who has it. The most effective approach almost always requires a combination of drug and non-drug therapies.

Evidence shows that people with FMS are often helped simply by learning that they have a condition that can be treated.

A non-drug approach with strong evidence for people with FMS is aerobic exercise. Moderate-intensity aerobic exercise, strength training, and swimming pool-based programs are associated with more consistent benefits than flexibility training and stretching. It is important for the person with FMS to adhere to a consistent exercise regimen in order to see improvement.

Cognitive behavioral therapy (CBT) is also a potentially helpful non-drug treatment for FMS. The basis of CBT is that changing maladaptive thinking leads to changes in mood and in behavior, allowing a person to function more effectively. CBT generally requires working with a specially trained professional, such as a psychotherapist. At least one study has found that patients treated with CBT in addition to drug therapy obtain more benefit than those treated with standard drug therapy alone.

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