Part 1 – Fibromyalgia Symptoms
This was a talk a did a little while ago on Fibromyalgia symptoms and medications for the New Zealand College of Pharmacists. In this talk (which I’ve divided into parts for easier listening) I go over how to recognise this syndrome, and then the many options of treatment.
In this segment:
Statistics and prevalence of this condition
Diagnosis of fibromyalgia
Comparison to widespread muscular pain and chronic regional pain
Definition of pain & how the syndrome affects your body
Part 2 – Fibromyalgia Syndrome Defined
In this segment:
How pain works
Physical damage vs perceived pain
How Fibromyalgia Syndrome causes pain amplification, disruption of the limbic system and other symptoms
More symptoms of fibromyalgia ie. the ‘fibro fog’
Part 3 – Fibromyalgia Diagnosis Criteria
In this segment:
Functional MRI’s of the brain
Sleep disruption
Interrelation of fibromyalgia, depression and chronic fatigue
Fibromyalgia diagnosis criteria
Stress response in the body
The therapeutic domain and how this relates
Neurosensory disorder – abnormal handling of pain messages
Part 4- Fibromyalgia Medication and Management
In this segment:
Fibromyalgia Management and regaining quality of life
Core muscle strength and fitness – regular incremental aerobic exercise
Endorphin production and pain relief
Fibromyalgia diet – low inflammation foods
Fibromyalgia Medication – Phenergan and getting better sleep
Amitriptyline for pain relief
Tramadol and SSRI’s as medication
Tricyclic antidepressants
Mirapex for fibromyalgia
SAMe for fibromyalgia
No evidence for opioids – ie. methadone being effective for pain relief. In some cases they can make the situation worse
No evidence for NSAIDs – Non-steroidal anti-inflammatories – being useful
Guaifenesin – inconclusive
Part 5 – Fibromyalgia Medication List
In this segment – the Fibromyalgia Medication List :
Paradex treatment
Codine – risks and benefits and dosage
Tramadol – varied results
Morphine, Fentanyl Patches and Oxycodone – large risks and little benefit. Not suitable for fibromyalgia pain relief, and carry the risk of hyperalgesia
Gabapentin, Amitriptyline and Nortriptyline – some good evidence
Cymbalta – some good evidence of pain reduction and quality of life, restorative sleep
The importance of choosing the right dose – this is crucial
Non-evidenced based / alternative treatments: Ayervedic, Bowen, Reflexology, Colostrum
Part 6 – Evidence Based Fibromyalgia Treatment
In this segment:
Importance of evidence based review of ‘miracle’ cures – how effective are they really?
Genetic profiling
The Marshall Protocol
Managing Fibromylgia – giving patients control over their self-medication with a stepped plan and dosage range
Lifestyle changes that improve quality of life
Not all pain is fibromyalgia – how to tell the difference between fibro pain and pain caused by other conditions
Other more wide ranging possible causes of fibromyalgia
Stress, cortisol and circadian rhythm as an underlying cause
Phantom limb pain
Dr Teitelbaum: Re-energising even if you have been diagnosed with Fibromyalgia
