Rheumatology Medical News about Fibromyalgia, Nonpharmacologic, ExPRESS

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Nonpharmacologic treatment for fibromyalgia: Patient education, cognitive-behavioral therapy, relaxation techniques, and complementary and alternative medicine
Rheumatic Disease Clinics of North America, 08/10/09

Hassett AL et al. – The importance of including exercise in the treatment of fibromyalgia (FM) has been substantiated in several studies. In addition to exercise, patient education, cognitive-behavioral therapy (CBT), relaxation, biofeedback, and other complementary and alternative medicine (CAM) approaches are gaining empiric support and should be considered. This article is a brief overview of these techniques and the evidence for their inclusion as fundamental elements of FM treatment.

For daily clinical practice, using the principles of comprehensive nonpharmacologic pain management represented by the acronym ExPRESS is suggested:

Ex is for exercise
P is for psychiatric comorbidity, because depression and anxiety disorders are common in chronic pain conditions
R is for regaining functions in FM; often involves helping pts with activity pacing
E is for education, in which simply informing a patient through internet or books
S is for sleep hygiene, which is necessary for many who have developed counterproductive habits
Finally, S is for stress management, which includes any number of elements, such as CBT, relaxation techniques, hydrotherapy, and gentle exercise to name just a few