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European Treatment for Fibromyalgia

Fibromyalgia is a chronic condition characterized by a number of symptoms including widespread pain. According to the European Network of Fibromyalgia Associations (ENFA), lack of awareness of fibromyalgia and its symptoms hinders diagnosis and treatment of the condition, causing prolonged pain, suffering and economic distress for many affected people. European treatment for fibromyalgia is improving, however, since the 2007 release of treatment recommendations, authored by the European League Against Rheumatism (EULAR), a group of multidisciplinary experts from 11 European countries.

  1. Prevalence and Symptoms

    • ENFA estimates that 14 million people in Europe, most of them women, suffer from symptoms associated with fibromyalgia. Fibromyalgia patients in the European Union typically see as many as four doctors and are prescribed numerous medications before the condition is diagnosed. Many endure pain, debilitating fatigue, decline in memory and cognitive function, and sleep disturbances for up to five years before receiving the diagnosis.

    Focus of Treatment

    • The EULAR protocol focuses on only two aspects of the fibromyalgia experience: pain and function. The nine recommendations outlined in EULAR's report seek to reduce the intensity of pain reported by the patient, improve her ability to function, and provide coping skills for self-management of pain. The recommendations stress that treatment must be individually tailored to address each patient's specific symptoms.

    Non-Pharmacological Treatment

    • Fibromyalgia patients may undergo balneotherapy (heated-pool treatment) for pain reduction. Resistance training and aerobic exercise may be recommended for some people, based on their ability levels. Cognitive-behavioral therapy may be included in the treatment plan to help the patient manage pain. CBT also helps the patient change attitudes and behaviors that lead to unhealthy lifestyle choices. Finally, relaxation skills, rehabilitation and physiotherapy may be recommended in some cases.

    Medication

    • Pharmacological treatment recommendations include analgesics as well as tramadol, an atypical opioid that helps relieve pain. Antidepressants are sometimes employed to help improve mood and sleep quality and reduce pain. Tropisetron, pramipexole, and pregabalin (Lyrica) also are recommended. Lyrica was the first of three drugs approved for fibromyalgia treatment in the United States, followed by Cymbalta and Savella.

    A Multi-Disciplinary Approach

    • The EULAR recommendations state that treatment plans for fibromyalgia patients should consider the individual's particular collection of symptoms and their intensity. In addition to pain and ability to function, physicians are encouraged to investigate the patient's degree of sleep disturbance and level of fatigue, all common symptoms. Patient education is highly recommended.

    Prognosis

    • Fibromyalgia symptoms can be managed, but not cured. It is a lifelong condition. Symptoms lessen and intensify cyclically, but usually are improved with a combination of medical treatment, adequate self-care and good general health.

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