EDU: Fibromyalgia - The Latest Treatments and Evaluation (Nov 2005)

[Guest guest]

Listen now to installment #2 (transcript) on Fibromyalgia -

From Dr. Shiel who is at the Arthritis Conference in San Diego, CA (MP3

4:53min 2.24MB)

Arthritis Conference - Installment #2 (transcript) on Fibromyalgia

Fibromyalgia – The Latest Treatments and Evaluation

Tuesday, November 15 – This is Dr. Shiel from MedicineNet.com

reporting from San Diego at the 2005 annual scientific meeting of the American

College of Rheumatology and National Arthritis meeting.

Today I’d like to report on the latest in the treatment and evaluation of

fibromyalgia. At the national meeting, researchers from University of Cincinnati

have shown that duloxetine, which is the generic name for the brand-name product

Cymbalta , is effective and safe in the treatment of fibromyalgia whether or not

depression is present. This is a very important finding that is, we have used

antidepressants in the treatment of fibromyalgia for decades but it's clear that

their effects are not dependent on whether or not depression is present. They

seem to work in other ways and it may have to do with their secondary pain

relieving qualities.

Researchers at Rush University in Chicago showed that low doses of muscle

relaxants can be effective in treating fibromyalgia by decreasing pain,

decreasing stiffness and fatigue, and also decreasing depression. Now this also

is an interesting paper because we've used muscle relaxants, usually at night,

in the treatment of fibromyalgia for some time now. But what these researchers

showed that was unique was that very low doses of muscle relaxants, much lower

than the standard prescribed doses, can be extremely effective in reducing the

symptoms of chronic fibromyalgia.

Patients with fibromyalgia often have disorders of sleep. Researchers from

West Reading Pennsylvania described that sleep disordered breathing is extremely

common in patients with fibromyalgia. Now this includes sleep apnea and this is

important as we know as health care givers in the treatment of fibromyalgia,

that sleep is essential part of the treatment in improving symptoms of

fibromyalgia.

Other researchers at the University of Pennsylvania presented a paper related

to acupuncture and fibromyalgia. These researchers in fact found that

acupuncture improves sleep disordered breathing in fibromyalgia patients. So

look for doctors to be considering acupuncture more as an adjunctive of

treatment for fibromyalgia.

Researchers from the University of Michigan have noted a very interesting

diagnostic test abnormality in patients with fibromyalgia. Using a sophisticated

magnetic resonance imaging technique involving spectroscopy, these are big words

for a specialized type of an MRI scan, these researchers noted that a particular

part of the brain that is generally involved in pain processing showed regional

concentration of certain brain metabolites. This is very important, it turns

out, because we've known heretofore or suspected that patients with fibromyalgia

have an abnormally increased pain perception. And this actually gives us

anatomic potential reasons as to why that might be.

Researchers from Mexico reported at the national meeting that using the

standard blood-pressure cuff that we all know and recognize in taking a standard

physical examination, if the cuff is blown up to 180 mm of mercury or 180, that

patients with fibromyalgia reported pain 70% of the time, whereas patients with

other forms of arthritis reported it in 5-10% of the time and controls, healthy

controls, in 1.5% of the time. This seems to document, which has been known in

the past, that patients with fibromyalgia seem to have this increased pain

perception. Very interesting data from this year's meeting of the American

College of Rheumatology.

Shiel, M.D., FACP, FACR, Editor of MedicineNet's Arthritis Overview,

Offers Perspectives Of Interest On Topics From 2005 Annual Scientific Meeting of

The American College of Rheumatology (held November 12-17, 2005) For more

information, go to www.medicinenet.com

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