What Really Works for the Treatment of Fibromyalgia?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Generalized pain, migraines, increased sensitivity to light touch, fatigue, not waking up feeling rested . . . that’s what folks with fibromyalgia are dealing with. For years patients have asked: what really works for fibromyalgia? Primary care doctors and their patients are frustrated there are no quick solutions and options for treatment.

Well, the Annals of Rheumatic Diseases just published a review of what works, and what doesn’t work for the treatment of fibromyalgia. Here goes.

Strong evidence this works:

Go Eastern:

Evidence is weak—don’t waste much time on these:

Recommendation AGAINST. Doesn’t work, and could be harmful:

How do I know if I have or don’t have Fibromyalgia?

The Fibromyalgia Rapid Screening Tool (FiRST) is a self-administered questionnaire developed by the French Society of Rheumatology. It can quickly detect fibromyalgia with a sensitivity of 90.5% and a specificity of 85.7% in the general population.

FiRST consists of questions covering: fatigue, pain characteristics, non-painful abnormal sensations, sleep problems, and so on. Each question requires only a “yes” or “no” answer, with a “yes” being worth one point and a “no” worth zero points. The highest possible score is 6, with a cutoff of 5 or more associated with the highest sensitivity and specificity for fibromyalgia.

Dr O.

Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2016 Jul 4. [Epub ahead of print]

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