Nonpharmacologic Therapies for Fibromyalgia and Lumbar Spinal Stenosis
Written by Editor   
Thursday, July 30, 2015 11:00 AM
For Fibromyalgia and Lumbar Spinal Stenosis, Nonpharmacologic therapies have effects the same as or superior to surgical intervention or drug therapy new studies report.

Observations:  Note that these medical reports state that for fibromyalgia "nonpharmacologic therapies may provide greater benefits than opioids and narcotic analgesics.”  Also that “the majority of patients with fibromyalgia can see improvement in their symptoms and lead normal lives with the right medications and extensive use of non drug therapies.”  Surely the extensive promotion of nonpharmacologic therapies for other conditions is the next step.  

Potential actions: 

  • Research fibromyalgia and lumbar spinal stenosis their potential treatments to determine if nonpharmacologic therapies that you provide might fit within your practice.

  • Share with the public that once again physical medicine may be equivalent or superior to the outcomes achieved through surgery or drugs.

 

Nonpharmacologic therapies may be most effective at treating fibromyalgia pain.  Given that fibromyalgia pain stems primarily from the central nervous system (CNS), nonpharmacologic therapies may provide greater benefits than opioids and narcotic analgesics, according to a presenter at the 2015 American Pain Society Annual Scientific Meeting.

The condition is believed to be associated with how the brain processes pain and other sensory information, so opioids and narcotic analgesics are usually not effective because they do not reduce the neurotransmitter activity in the brain, according to the presenter.  “These drugs have never been shown to be effective in fibromyalgia patients, and there is evidence that opioids might even worsen fibromyalgia and other centralized pain states,” he said.

“Sometimes the magnitude of treatment response for simple and inexpensive nondrug therapies exceeds that for pharmaceuticals. The greatest benefit is improved function, which should be the main treatment goal for any chronic pain condition. The majority of patients with fibromyalgia can see improvement in their symptoms and lead normal lives with the right medications and extensive use of non drug therapies.”

Physical medicine is just as effective as surgery for treating lumbar spinal stenosis (LSS), a new study suggests.

LSS can lead to significant pain and reductions in functioning. A multisite, randomized controlled trial to compare the efficacy of surgery and nonsurgical treatment included 169 surgical candidates with LSS, aged 50 years or older, who consented to and had no prior surgery for stenosis. Patients were randomized to receive surgical decompression or physical medicine twice a week for six weeks combined with home exercise programs. A 24-month follow-up was completed for 74 patients in the surgery group and 73 patients in the physical medicine group. 

The researchers found that mean physical function improvement was 22.4 in the surgery group and 19.2 in the physical medicine group. Intention-to-treat analyses did not show any difference between the groups at 24 months.


Source:  http://www.medpagetoday.com/PainManagement/PainManagement/52718