FINALLY…

Canadian researchers have released the first set of guidelines to help doctors diagnose and manage Fibromyalgia.

The evidence-based guidelines are the first national set in the English-speaking western world, said Dr John Pereira, a co-author of the guidelines from the University of Calgary’s faculty of medicine and a physician at the Calgary Chronic Pain Centre.

“For many years health-care professionals dismissed fibromyalgia as a non-existent condition. And more recently, while people have accepted that perhaps it does exist, still patients were told there was nothing that could be done for them,” Pereira said.

“In these guidelines we have clearly listed how to diagnose this condition and how to treat it effectively. So while there’s no cure for fibromyalgia, there are now good treatments that patients can consider.”

Main-Picture-Licensed-With-CaptionBecause of the prevalence of the condition, the guidelines recommend that primary care physicians take over the diagnosis and management role that has often been left to specialists.

The guidelines suggest a multi-modal treatment such as exercise, cognitive-behavioural therapy, education, self-management and relaxation techniques as well as medications that target a patient’s most bothersome symptoms: pain being the most serious.

The goal of treatment is to improve symptoms and “optimize function,” according to the guidelines. There is no one ideal treatment, although the guidelines say management should be tailored to each patient’s symptoms.

“Currently, there is no cure for fibromyalgia, but the guidelines set out the most appropriate management strategy,” said rheumatologist Dr Mary-Ann Fitzcharles, a corresponding author from the Research Institute of the McGill University Health Centre.

So, wherever you are in the world, perhaps this is something you can show your doctor/s to help establish your treatment plan.

Fibromyalgia Fighting with Flower Tops

Remember the uproar (about 6 months ago) caused by a report about illegal marijuana use by FM patients? According to that, 1 in 10 of you use marijuana for medicinal relief to combat FM symptoms, such as unexplained fatigue, and insomnia, widespread pain and other somatic symptoms.

marijuanaHerbal cannabis has been used for centuries as a painkiller, but nowadays it is mainly used outside of conventional medicine. According to the experts, because FM pharmacologic pain therapies provide only modest effects, some patients decide to self-medicate with more non-traditional therapies, such as marijuana.

New research published in Arthritis Care & Research, indicates that patients who self-medicate with herbal cannabis have poorer mental health and although experts believe that cannabinoids may have some therapeutic effect, they do warn individuals against the use cannabinoids until any health issues and psychosocial effects are clarified.

Leading researcher, Dr Mary-Ann Fitzcharles, a professor of medicine at McGill University and consulting rheumatologist at Canada’s Montreal General Hospital of the McGill University Health Centre admitted:

Medical studies of cannabinoids in management of disease, including FM, have been limited. Marijuana is the most common form of cannabinoid, but an illegal substance in most countries, making it difficult to investigate without possible prosecution for possessing an illicit substance.

All 457 study participants were being treated at MUHC’s Alan Edwards Pain Management Unit. All study participants self-reported on their cannabinoid use. The team validated the participants FM diagnosis, examining links and trends of participants’ self-medication with medical marijuana, prescription cannabinoids, or both: 13% used cannabinoids and 80% used herbal marijuana to combat their symptoms. An analysis revealed that 24% of the cannabinoid users took prescription cannabinoids, like nabilone and dronabinol, whilst 3% used herbal cannabis and prescription cannabinoids. Those smoking marijuana reported a daily consumption of up to 6 grams, although 72% stated they used 1 gram or less per day.

marijuana-not-crackThe findings further revealed that the use of herbal cannabis was associated with unstable mental illness in 36% of users. The researchers also observed that 77% of cannabis users were unemployed, receiving disability payments, which according to the team may be because of ineffective pain control to improve functionality or more serious functional disabilities.

Dr Fitzcharles concludes, saying: 

While self-medicating with cannabinoids may provide some pain relief to FM patients, we caution against general use of illicit drugs until health and psychosocial issues risks are confirmed. Physicians should be alert to potential negative mental health issues in FM patients using illicit drugs for medical purposes. Some herbal cannabis users may be dishonestly using a FM diagnosis to justify self-medicating with illegal drugs.

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