Multidisciplinary approach to fibromyalgia: what is the teaching?

Piercarlo Sarzi-Puttini, Fabiola Atzeni, Fausto Salaffi, Marco Cazzola, Maurizio Benucci, Philip J Mease

Rheumatology Unit, L. Sacco University Hospital, Ospedale L. Sacco, Via GB Grassi 74, Milan, Italy. sarzi@tiscali.it

Best practice & research. Clinical rheumatology 2011 Apr

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Fibromyalgia (FM) is a rheumatic disease that is characterised by chronic musculoskeletal pain, stiffness, fatigue, sleep and mood disorder. FM patients demonstrate dysregulation of pain neurotransmitter function and experience a neurohormone-mediated association with sleep irregularities. There are currently no instrumental tests or specific diagnostic markers for FM, and many of the existing indicators are only significant for research purposes. Anti-depressants, non-steroidal anti-inflammatory drugs (NSAIDS), opioids, sedatives, muscle relaxants and antiepileptics have all been used to treat FM with varying results. It has been shown that interdisciplinary treatment programmes lead to greater improvements in subjective pain and function than monotherapies. Physical exercise and multimodal cognitive behavioural therapy are the most widely accepted and beneficial forms of non-pharmacological therapy. Copyright © 2011. Published by Elsevier Ltd.

Citation

Piercarlo Sarzi-Puttini, Fabiola Atzeni, Fausto Salaffi, Marco Cazzola, Maurizio Benucci, Philip J Mease. Multidisciplinary approach to fibromyalgia: what is the teaching? Best practice & research. Clinical rheumatology. 2011 Apr;25(2):311-9