Dr. Don Goldenberg from Tufts University School of Medicine in Boston, Massachusetts has a video and print slide program on Medscape that reviews evidence-based treatments for fibromyalgia.

The emphasis is on drugs, but more interesting is his support for a combined drug/CAM approach to treatment.

Treatment options are divided into primary and tertiary care.

Primary care

• Medications: simple analgesics, antidepressants, anticonvulsants
• Education
• Exercise (low impact, such as walking, water exercises)
• Treatment of mood disturbances

Tertiary care

• Medication: combined antidepressants, anticonvulsants, potent pain drugs
• Cognitive-behavioral therapy, stress management therapy
• Multidisciplinary pain management

The bottom line?

Dr. Goldenberg says all patients should…

• Receive some education in regard to fibromyalgia.
• Be encouraged to exercise, including low-impact cardiovascular exercises such as walking or water exercises.
• Be screened for both mood disturbances and sleep disturbances, and treated appropriately.

“Most of the time,” he says, “multidisciplinary approaches are encouraged, including formal cognitive-behavioral therapy programs, stress management therapies, and multidisciplinary pain management approaches.”

10/3/08 18:45 JR