Mayo Clinic Study Finds Brief Fibromyalgia Treatment Program Reduces Some Symptoms

The results of this study should help physicians develop a beneficial and convenient treatment program for patients with fibromyalgia. The study appears in the April issue of Mayo Clinic Proceedings.

Fibromyalgia is characterized by a cluster of symptoms that include: diffuse pain, stiffness and fatigue. The 1990 American College of Rheumatology criteria for diagnosing fibromyalgia are widespread pain and tenderness at 11 of 18 specific tender points. Fibromyalgia is perceived by many people as a disabling condition. Almost 20 percent of fibromyalgia patients have applied for disability benefits, and more than seven percent have received such benefits.

Fibromyalgia is a frustrating condition without a known cause or a widely accepted treatment, and current therapeutic practices are often inadequate.

"Knowing that brief interdisciplinary treatment programs for fibromyalgia are effective is important for tertiary care centers whose patients often do not live nearby," says Lois Krahn, M.D., a Mayo Clinic psychiatrist and one of the authors of the study. "Brief, intense programs provide an approach for treating patients who stay in the area for only a few days."

This study evaluated the efficacy of the Fibromyalgia Treatment Program (FTP) at Mayo Clinic. This program contains the traditional medical, educational, self-management and occupational/physical therapy components. Unlike most interdisciplinary treatment programs that are carried out over many weeks with one meeting or more per week, this program is consolidated into one-and-one-half days. The FTP is a three-part interdisciplinary program. The first half-day involves evaluation of patients by a nurse and a physician, including medical, physical, psychological, educational and pharmacological assessments. The second half-day segment consists of a nurse-led course with an emphasis on self-management. The third half-day portion includes both physical and occupational therapy components led by physical and occupational therapists.

The study assessed 100 patients after they were referred to and evaluated in the Fibromyalgia Treatment Program from Feb. 14, 2000, to May 9, 2000.

Pain, number of bad days per week, morning and daytime fatigue, stiffness, nervousness and anxiety and overall effect of this condition on patients’ lives were all shown to improve at the one-month follow-up analysis, the study’s authors reported.

Conflicting information in the literature combined with the results from this study suggest that predicting which fibromyalgia patients will benefit from an interdisciplinary treatment program is difficult. "Simply put, all patients have the potential to benefit from these programs," the study’s authors write.

The study also showed that patients with a history of depression were more affected by fibromyalgia than those without a history of depression. Although no data exists to indicate whether these patients were depressed at the time of treatment, these findings suggest that properly identifying and treating depression is important in treating fibromyalgia.

Mayo Clinic Proceedings is a peer-reviewed and indexed general internal medicine journal, published for 75 years by Mayo Foundation, with a circulation of 130,000 nationally and internationally.