ContentList volumes - List articles in this issue
Do fibromyalgia patients use active pain management strategies? A cohort study
OBJECTIVE: The aim of this study was to examine the types of pain management strategies used by patients with fibromyalgia.
METHODS: A total of 158 patients with primary fibromyalgia attended a clinical visit to confirm the diagnosis. They completed 3 questionnaires: (i) a self-made questionnaire, (ii) Beck Depression Inventory IA (BDI IA), and (iii) Finnish version of Fibromyalgia Impact Questionnaire. The self-made questionnaire included questions about: intensity of current pain; general well-being; pain management strategies, including pain medications; efficacy of the pain management methods; current health problems other than fibromyalgia. The pain management strategies were subcategorized (e.g. physical exercise, massage and heat treatment). The strategies were also divided into active and passive types.
RESULTS: The most frequently reported pain management strategies were physical exercise (54%), physical therapy (32%) and cold treatment (27%). The use of active pain management strategies, BDI IA < 10 points and age were independent predictors of the reported pain management efficacy. Patients who used active pain management strategies reported better efficacy with the BDI IA score ≥ 10 points.
CONCLUSION: Active pain management strategies are most efficacious for fibromyalgia patients, regardless of the severity of fibromyalgia or optional comorbid depression.
Jarno Gauffin, Tiina Hankama, Pekka Hannonen, Hannu Kautiainen, Timo Pohjolainen, Maija Haanpää
Rehabilitation, ORTON Rehabilitation Centre, ORTON Foundation, 00280 Helsinki, Finland. E-mail: firstname.lastname@example.org
2. Arnold LM, Clauw DJ, Wohlreich MM, Wang F, Ahl J, Gaynor PJ, et al. Efficacy of duloxetine in patients with fibromyalgia: pooled analysis of 4 placebo-controlled clinical trials. Prim Care Companion J Clin Psychiatry 2009; 11: 237–244.
3. Bigatti SM, Hernandez AM, Cronan TA, Rand KL. Sleep disturbances in fibromyalgia syndrome: relationship to pain and depression. Arthritis Rheum Arthritis Care Res 2008; 59: 961–967.
4. Abeles AM, Pilliger MH, Solitar BM, Abeles M. Narrative review: the pathophysiology of fibromyalgia. Ann Intern Med 2007; 146: 726–734.
5. Arnold LM. Strategies for managing fibromyalgia. Am J Med 2009; 122: 31–43.
6. Recla JM. New and emerging therapeutic agents for the treatment of fibromyalgia: an update. J Pain Res 2010; 3: 89–103.
7. Geisser ME, Strader DC, Petzke F, Gracely RH, Clauw DJ, Williams DA. Comorbid somatic symptoms and functional status in patients with fibromyalgia and chronic fatigue syndrome: sensory amplification as a common mechanism. Psychosomatics 2008; 49: 235–242.
8. Carville SF, Arendt-Nielsen S, Bliddal H, Blotman F, Branco JC, Buskila D, et al. EULAR evidence based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis 2008; 67: 536–541.
9. Burckhardt CS. Multidisciplinary approaches for management of fibromyalgia. Curr Pharm Des 2006; 12: 59–66.
10. Suoyrjö H, Oksanen T, Hinkka K, Pentti J, Kivimäki M, Klaukka T, et al. A comparison of two multidisciplinary inpatient rehabilitation programmes for fibromyalgia: a register linkage study on work disability. J Rehabil Med 2009; 41: 66–72.
11. Clauw DJ. Fibromyalgia: An overview. Am J Med 2009; 122: 3–13.
12. Annemans L, Le Lay K, Taïeb C. Societal and patient burden of fibromyalgia syndrome. Pharacoeconomics 2009; 27: 547–559.
13. Häuser W, Bernardy K, Uçeyler N, Sommer C. Treatment of fibromyalgia syndrome with gabapentin and pregabalin – a meta-analysis of randomized controlled trials. Pain 2009; 145: 69–81.
14. van Koulil S, Effting M, Kraaimaat FW, van Lankveld W, van Helmond T, Cats H, et al. Cognitive–behavioral therapies and exercise programs for patients with fibromyalgia: state of the art and future directions. Ann Rheum Dis 2007; 66: 571–581.
15. Beck AT, Steer RA. Manual of the Beck Depression Inventory. San Antonio Texas: Psychology Corporation; 1988.
16. Viinamäki H, Tanskanen A, Honkalampi K, Koivumaa-Honkanen H, Haatainen Kaustio O, Hintikka J. Is the Beck Depression Inventory suitable for screening major depression in different phases of the disease? Nord J Psychiatry 2004; 58: 49–53.
17. Burckhardt C, Clark S, Bennet R. The Fibromyalgia Impact Questionnaire: Development and validation. J Rheumatol 1991; 18: 728–733.
18. Gauffin J, Hankama T, Kautiainen H, Arkela-Kautiainen M, Hannonen P Haanpää M. Validation of a Finnish version of the Fibromyalgia Impact Questionnaire (Finn-FIQ). Scand J Pain 2012; 3: 15–20.
19. Wolfe F, Smythe HA, Yunus MB, Bennett RB, Bombardier C, Goldenberg DL, et al. The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 1990; 33: 160–172.
20. Busch AJ, Webber SC, Brachaniec M, Bidonde J, Bello-Haas VD, Danyliw AD, et al. Exercise therapy for fibromyalgia. Cur Pain Headache Rep 2011; 15: 358–367.
21. Jensen MP, Turner JA, Romano JM, Strom SE. The Chronic Pain Coping Inventory: development and preliminary validation. Pain 1995; 60: 203–216.
22. McCarberg BH. Clinical overview of fibromyalgia. Am J Ther 2012; 19: 357–368.
View at PubMed