October 2005, Volume 35 Number 10 , p 17 - 18
D'ARCY, YVONNE CRNP, CNS, MS
QUESTION: I'm caring for a patient with fibromyalgia who's being treated with an opioid. But I understand that new guidelines recommend other medications. What can you tell me about this disorder, and how should it be managed?
ANSWER: Fibromyalgia, a chronic pain syndrome affecting 2% of Americans, consists of a cluster of symptoms that includes fatigue, pain, and sleep and mood disturbances. Diagnosis and treatment are challenging. Varying clinical symptoms and comorbid conditions can confuse the clinical picture. Because fibromyalgia isn't curable, treatment aims to relieve symptoms.
New fibromyalgia guidelines from the American Pain Society recommend a multimodal treatment approach that combines patient education, drug therapy, exercise, and cognitive behavioral therapy. With one exception that I'll discuss shortly, opioids aren't recommended for fibromyalgia pain. First, let's review what we know (and don't ...