Describe the approach.
Optimize patient education and supportive therapy for all patients.
Consider adding pharmacotherapy for severe pain and/or sleep disturbance refractory to nonpharmacological measures.
Engage a multidisciplinary team (e.g., rheumatology, psychiatry) for patients who do not achieve adequate relief.
Describe the patient education.
Exercise: There is strong evidence to support the benefits of aerobic and strengthening exercises. [11][12]
Reassurance: Fibromyalgia is not a progressive illness and does not result from muscle or nerve damage.
Coping strategies, e.g., relaxation techniques
Sleep hygiene
Describe the supportive therapy.
Physiotherapy (e.g., stretching, hydrotherapy, and heat application)
Cognitive behavioral therapy
Describe the pharmacological therapy.
Severe pain: pregabalin and/or duloxetine and/or tramadol (off-label)
Sleep disturbance: low dose amitriptyline
NSAIDs and opioids (with the exception of tramadol) are generally ineffective and not recommended for the treatment of fibromyalgia.
Zuletzt geändertvor 2 Jahren