Cedars Sinai Chronic Pain And Fibromyalgia Program
A small, prospective, observational study with 2-year follow up of patients diagnosed with fibromyalgia has found that the burden of disease remains high – but stable – for most patients over time, despite pain treatment and other interventions. 1,2 “The good news is that we can reassure patients that their symptoms are unlikely to get worse,” said co-author on both studies Stuart Silverman, MD, clinical professor of medicine, Cedars-Sinai Medical Center and UCLA School of Medicine, and medical director, OMC Clinical Research Center, in Los Angeles. Take Note. Most patients with established FM remain stable over time, and the burden on patients remains high.
- Chronic Pain Syndrome
- Cedars Sinai Chronic Pain And Fibromyalgia Program Reviews
- Chronic Pain Fibromyalgia Symptoms
Improvements in pain scores of greater than or equal to 2 points are associated with significant improvements in several quality of life measures. Pharmacologic management of FM depends inappropriately on opioids for pain management.In the current study, patients were recruited from an online panel and had to opt in to be included in the study. Included patients completed an online survey to screen for chronic widespread pain (CWP), were examined in person by a physician experienced with FM patients to confirm a diagnosis, and then completed demographic information and several patient-reported outcome (PRO) instruments online. 2 Each patient completed the 11-item Brief Pain Inventory – Short Form (BPI-SF), Pain Severity Index, Pain Interference Index, the 3-item modified ACR 2010 criteria self-report, 12-item Medical Outcomes Study – Sleep Scale, and the 12-item Short Form Health Survey version 2 (SF-12 v2) that included physical and mental component summaries. Two years later patients were again examined in person and completed the same pain, function, and quality of life PROs.
2 During the 2 years, most patients were managed by their regular physicians without intervention from the study team.Among the original screening group, 1939 screened positive for CWP, 475 attended a site visit for physician examination, and 174 confirmed cases of FM with CWP were identified, of which a total of 76 patients completed physician diagnosis and had data for both time points. 1,2 Most included patients were female; at baseline mean age was 51 years and mean duration of FM was 4 years. For most patients, overall status did not change significantly over time in terms of employment and health insurance, number of comorbid conditions, body mass index, or health care resource use. 1 The most commonly used prescription pain medications at both baseline and follow up were opioids (40%); other commonly used medications were selective-serotonin reuptake inhibitors, tramadol, anti-epileptics, and NSAIDs. Although not statistically significant, use of muscle relaxants and NSAIDs decreased by 5% over the 2-year period. 1Similarly, most PROs remained stable over time. However, significant improvements in several pain measures, sleep, and mood on the BPI-SF, symptom severity on the modified ACR criteria, and the physical role question of the SF-12 Mental Component Summary were reported.
1 Only 14.5% of the patients (11/76) saw a 2-point improvement in their average pain between baseline and follow up; in these patients, the mean number of tender points also decreased, from 14.0 to 12.1. 1 Achievement of 2-point improvement in pain at follow up was associated with significant improvements from baseline in BPI-SF pain severity and pain interference. These patients had greater, but not significant, improvements in other PROs versus patients with.
The signs of FMS include aches and pains in muscles, tendons and joints all over the body, but especially along the spine. Some people feel more pain when they try to relax and less when they are active, busy or exercising.Other symptoms include:. Disturbed sleep. Daytime tiredness. Alternating diarrhea and constipation.
Numbness and tingling in the hands and feet. Feelings of weakness. Memory difficulties. DizzinessOne characteristic of FMS is the presence of multiple tender points. This refers to specific points in the neck, spine, shoulders and hips that feel tender.Causes and Risk FactorsThe exact cause of fibromyalgia is not known. It is not associated with injuries to muscles, nerves or joints nor to any serious body damage or disease.
FMS affects more women than men and occurs in people of all ages. In some people, FMS is associated with measurable changes in body chemistry and functioning, but it is not known whether these changes are causes or effects of FMS.Stress and difficulty sleeping may contribute to FMS because lack of restful sleep can decrease the body's production of the chemicals needed to regulate pain. Other factors (such as illness, infection or anxiety) may also cause changes in body chemistry that lead to these symptoms.
FMS is usually treated with:. Drugs (such as low doses of anti-depressant drugs) taken before bed to improve sleep. Other kinds of sleeping pills have not proven effective for people with FMS. Non-steroidal anti-inflammatory drugs (such as aspirin and ibuprofen) may help decrease pain. Lifestyle changes, such as stress reduction and using relaxation techniques. In particular, anxiety and depression need to be treated to reduce stress.
Chronic Pain Syndrome
Cedars Sinai Chronic Pain And Fibromyalgia Program Reviews
Exercise, including brisk walking, biking, swimming and water aerobics. Aerobic exercise for half an hour three times a week helps increase heart and lung function while stretching tight, sore musclesOften if stressful situations are resolved, fibromyalgia may improve and medications may not be necessary. Even with treatment, however, many people with FMS will continue to have symptoms, especially if they have stressful lives.
Chronic Pain Fibromyalgia Symptoms
With treatment, there can be a significant reduction in symptoms. Those who are able to continue working and fulfilling their social obligations despite their pain do best.