Fibromyalgia and Chronic Pain

Biography

Biography: Samreen Ahmed

Abstract

Fibromyalgia, a condition in which there is stiffness and pain in soft tissues, such as muscles and tendons, has an unknown etiology. However, arterial spasm caused by stress hence hampering the oxygen supply can precipitate the pain. The pain in fibromyalgia is accompanied with fatigue, anxiety, and insomnia. The areas most affected comprises of cervical, and thoracic areas, however any part of the body can be affected.  Females are more commonly affected. Fibromyalgia, often present in depression patients, lack any pathognomonic laboratory findings. The purpose of this review is to elaborate the effects of different interventions for fibromyalgia, particularly with psychiatric symptoms. A literature review of various articles is conducted on MEDLINE, PSYCH Info, and PUBMED to evaluate the role of different treatment options in fibromyalgia patients, accompanying psychiatric symptoms. Literature review revealed aspirin and acetaminophen may be useful in treating pain, whereas, NSAIDS may also give effective response in some cases. Although, first -line of treatment, shown by evidence is cognitive-behavioral therapy, and exercise. However, amitriptyline, is the proven solid pharmacologic intervention, for short durational pain periods. Interestingly, Transcranial Magnetic Stimulation, also has potential in being helpful for chronic neuropathic pain syndromes, based on current data. tDCS, in combination with aerobic exercise is helpful significantly for anxiety, and pain.  In patients suffering from Fibromyalgia with depression, SSRI can be considered for managing depression, however, there is no fair evidence that SSRI are superior to placebo in intervening fibromyalgia’s key symptoms like fatigue, and sleep disturbance. Based on some evidence, amitriptyline should be considered when choosing for the first- line therapy. Different treatment options, such as aspirin and acetaminophen can help with the pain. Although stress reduction techniques, and message can also be helpful.  We suggest accessing patients with fibromyalgia thoroughly to look for psychiatric symptoms so that they could be addressed accordingly. TMS, CBT, and tDCS have potential in treating pain although there is insignificant data, hence we recommend more research in this field.