Patient Management Strategies in Fibromyalgia

Patient Management Strategies in Fibromyalgia
Presentation by: Anna Mae Smith,MPAS, PA-C
Lock Haven University of PA

Education

* Not a ‘psychiatric’ illness
* Usually chronic but controllable
* Not deforming or Life-threatening
* Medications that improve sleep appear to be the best treatment!

Amitriptyline & Cyclobenzaprine

* They tend to increase NREM Stage IV sleep
* the availability of brain serotonin
* decrease muscle spasm
* Decreases patients' reports of pain intensity
* Sleep quality
* Improvements in pain threshold or tender point counts
* Loses effect after 6 months

Alprazolam and ibuprofen
Other Treatments

* Aerobic Exercise
* Cognitive Behavior Therapy
* Biofeedback
* Hypnotherapy
* Acupuncture
* Inject trigger points with steroids
* Treat underlying depression if needed

Diet
* avoid the following:
* refined sugar
* alcohol
* caffeine
* foods high in saturated fats
* high-calorie, high-fat, low-food-value junk food
* A moderate diet containing the following ratio (based on percentages of calories, not grams):
40% carbohydrate/ 30% protein/ 30% fat for each meal and snack
* Water…8/8oz

Herbs

* Ginseng and gotu kola, have both been found to improve energy and mental alertness.
* Ginseng is known to contain a steroid
* Valerian Root
* St John’s Wort
* Gingko Biloba
* Grape See Extract
* Devils Claw Root

Patient Management Strategies in Fibromyalgia.ppt