Fibromyalgia treatment update.
OBJECTIVE
Fibromyalgia is a common chronic pain disorder characterized by complex symptomatology and few consistently effective treatments. The purpose of this review is to highlight the recent literature from April 2005 through September 2006 involving treatment options.


RESULTS
Prior evidence suggests that medication and self-management approaches to care can improve symptoms, function and well-being in this patient population. Recent studies examining the efficacy of two serotonin and norepinephrine-reuptake inhibitors--duloxetine and milnacipran--and the anticonvulsant pregabalin are encouraging. Studies evaluating different forms of exercise continue to support the belief that increased physical activity is an essential component of any treatment plan for the patient with fibromyalgia. Three studies added to the understanding of treatment adherence. Finally, three studies evaluating the efficacy of acupuncture in the treatment of fibromyalgia showed conflicting results, but added to the knowledge needed for clinicians to have substantive conversations with patients.


CONCLUSIONS
Recent studies support the recommendation of a multimodal approach to treatment involving individualized, evidence-based pharmacotherapy and self-management. Treatment goals should include the improvement of symptoms, primarily pain and sleep, and the promotion of positive health behaviors with the aim of improving physical function and emotional well-being.
Rooks
Daniel S
DS
Division of Rheumatology and the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA. drooks@bidmc.harvard.edu
D003131:Combined Modality Therapy; D000529:Complementary Therapies / Q000379:methods; D005356:Fibromyalgia / Q000523:psychology / Q000628:therapy*; D006801:Humans; D010147:Pain Measurement; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic; D012648:Self Care / Q000523:psychology