MANAGEMENT & TREATMENT (1)
There are things you can do to help yourself and others with FMS. Start with
a positive attitude: “I am not going to die or become deformed from this, and I
can live a full and meaningful life”. There are psychological tools for coping,
such as: dealing with emotional challenges, reducing stress, becoming involved
with a quality support group or a voluntary FMS organization, setting realistic
expectations, believing that it can be managed and that you can live a
reasonably normal life. There are treatments that can help you manage this
illness. Most treatment does not result in progressive improvement, but does
provide symptomatic relief and better functioning in daily life.
Components of Therapy for Fibromyalgia Syndrome (1-2)
- A positive and empathetic physician
- Firm diagnosis
- Patient education
- Individualized therapy, considering severity and relative contribution of
aggravating factors – address these factors
- Addressing psychological factors (anxiety, stress and depression),
referral to a mental health professional in difficult cases
- Behavior modification through cognitive behavior therapy, focusing on a
positive attitude and self-responsibility
- Improvement of sleep quality
- Gradual increase of physical activities to achieve physical fitness
- Physical/occupational therapy, including flexibility and
muscle-strengthening exercises
- Other non-pharmacologic approaches (biofeedback, meditation, hypnotherapy,
electro-acupuncture)
- Simple analgesics (acetaminophen and low-dose NSAIDS)
- Serotonergic/noradrenergic (mostly antidepressant) medications; anxiolytic
drugs (in patients with significant anxiety)
- Myofascial therapy, including injection of symptomatic tender points with
a local anesthetic
- Multidisciplinary approach under “one umbrella”, incorporating cognitive
behavior therapy, physical fitness exercises, relaxation techniques, and other
forms of therapy
Avoid Perpetuating Factors That May Cause A “Flare” (2,5)
Weather changes, cold drafts, dampness, noise, poor sleep, excessive physical
activities and stress are all reported to be aggravating factors and can really
set off or aggravate FMS pain. Other factors include working in one place with
arms suspended above the work surface, repetitive activities, and remaining in
one position for prolonged periods of time. Sustained contraction of shoulder
muscles to support arms in front tends to produce pain in the neck, upper back
and shoulders that gradually builds and spreads up and down the back. Infections
and stress also aggravate FMS symptoms. FMS is not simply a stress reaction; it
is a condition that is aggravated by any combination of stress factors.
Developing a Positive Strategy (1,2)
The first step in learning to live with FMS is to develop a positive attitude
about dealing with the condition. Those of us with FMS need to go ahead with our
lives. The condition is not lethal and we have to go on! Medication will help,
but we need to do our parts. We must try to modify our stresses and make
exercise (to achieve physical fitness) a regular part of our lives. We need to
avoid those activities that aggravate our muscles especially on “bad days” and
learn to control our tendencies to “overdo it” at home, work or school. Finally
we need to educate our families and friends about FMS so that they will
understand our problems and us. Find good information sources to keep current on
what’s happening with fibromyalgia. And try to help research the best way you
can. Only research can cure FMS.
Written by Shari Ferbert (I want to thank Dr. Yunus for
taking the time to medically review and edit this document. I have learned a lot
from Dr. Yunus, and I hope this informational document will help you learn more
about FMS as well.)
© Copyright AFFTER 1999
(Duplication of this document is allowed only if copied in its entirety for
nonprofit use, and kept in original form.)
REFERENCES
- Muhammad B. Yunus, MD – Based on his April, 1999
lecture in a seminar on FMS held in Rockford, IL. Dr. Yunus is a professor of
medicine in the section of rheumatology at the University of Illinois College
of Medicine at Peoria. He is well known for his research, patient care, and
teaching of fibromyalgia syndrome.
- Consultant, June 1996 issue (Volume 36) – Based on
articles written by Dr. Yunus “Fibromyalgia Syndrome: Blueprint for a Reliable
Diagnosis” (pages 1260-74), and “Fibromyalgia Syndrome: Is There Any Effective
Therapy?”(pages 1279-85).
- Arthritis and Rheumatism 1990 (Volume 33, pages
160-72). The American College of Rheumatology criteria for FMS article
(primary author: Dr. Frederick Wolfe).
- Bailliere’s Clinical Rheumatology 1994 (Volume 8,
pages 811-37). This article is on psychologic aspects of FMS and DSS
(currently called CSS) by Dr. Muhammad Yunus.
- The Fibromyalgia Times Newsletter (FMAA) – From an
article “Fibromyalgia: A Perspective for Patients”, by George Waylonis, MD;
Clinical Professor, Physical Medicine and Rehabilitation, The Ohio State
University.
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