Below are perspectives on key reports presented at the recent national meeting of the American College of Rheumatology:
Fibromyalgia (formerly known as fibrositis) is a chronic condition that causes pain, stiffness, and tenderness of the muscles, tendons, and joints. Fibromyalgia is also characterized by restless sleep, awakening feeling tired, fatigue, anxiety, depression, and disturbances in bowel function. While fibromyalgia is one of the most common diseases affecting the muscles, its cause is currently unknown. The painful tissues involved are not accompanied by tissue inflammation. Therefore, despite potentially disabling body pain, patients with fibromyalgia do not develop body damage or deformity. Fibromyalgia also does not cause damage to internal body organs. Therefore, fibromyalgia is different from many other rheumatic conditions (such as rheumatoid arthritis, systemic lupus, and polymyositis). In those diseases, tissue inflammation is the major cause of pain, stiffness, and tenderness of the joints, tendons, and muscles, and leads to joint deformity and damage to the internal organs or muscles. Since the symptoms of fibromyalgia are diverse and vary among patients, treatment programs must be individualized. Treatment programs are most effective when they combine patient education, stress reduction, regular exercise, and medications. Recent studies have verified that the best outcome for each patient results from a combination of approaches that involves the patient in customization of the treatment plan.
Researchers from Toronto, Canada found that very low doses (1-4mg) of cyclobenzaprine (Flexeril) reduced muscle and joint pain, decreased fatigue, and improved sleep patterns in patients with fibromyalgia.
Dr. Shiel's Perspective: Good news, especially if it becomes available in the U.S. for similar purposes (currently it is available only as a 10mg tablet). This medication can commonly cause drowsiness, even the next day, at standard 10mg doses. Perhaps these very low doses will open new avenues of treatment for the many afflicted with fibromyalgia.
For more, please see Fibromyalgia Center.
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