Physical Therapy in Bethesda and Olney for Fibromyalgia
Fibromyalgia has a range of symptoms, from pain to fatigue to difficulty sleeping, among others. This wide variety in how it presents can make fibromyalgia a difficult-to-treat illness as there is no treatment for the illness itself, only the signs and symptoms. In addition, there are other problems that are not uncommon among people with fibromyalgia, including irritable bowel disorder and anxiety disorders.
Doctors have tried treating fibromyalgia with different types of medications and have been seeing some success with gabapentin and pregabalin. These medications, originally for treating seizures, also have pain relieving and anti-anxiety properties. The authors of this article found that there were not many reviews of studies that looked at gabapentin and pregabalin, so they did their own systematic review and meta-analysis of the literature to find what has been studied and how relevant the study findings were.
Researchers found 127 randomized controlled trials that evaluated the effects of the medications on fibromyalgia symptoms. After excluding studies that did not meet their criteria, the researchers were left with six to review. The studies used an 11-point rating scale so patients could indicate their levels of pain. Fatigue was also measured, in four of the studies using a scale called the Multidimensional Assessment of Fatigue (MAF). Sleep, assessed in all studies, was measured by the Medical Outcomes Study, while depressed and anxious mood was measured by the Hospital Anxiety and Depression Scale (HADS) and the Montomery Asberg Depression Rating Rating Scale (MADRS). Health Related Quality of Life (HRQOL) was assessed using the Fibromyalgia Impact Questionnaire or the Short Form Health Survey F-36.
In the end, the researchers determined from the studies that pain was relieved in many cases and that patients reported an improved quality of life, but there was some conflicting evidence here. Depression and fatigue did not seem to be helped in many cases, but there was some relief from fatigue - sleep disturbances were lessened. The doses of medications did not seem to have an effect on pain relief for either medication.
Side effects of the medications resulted in patients withdrawing from the studies happened more often with the medications than with placebos. Side effects included dizziness, drowsiness, weight gain, peripheral edema (swelling of the body tissues, most often in the hands or feet), and neurological effects.
The studies that were reviewed were limited for a variety of reasons, from small groups to limited after-study follow up. Only two studies reported any other illnesses that the patients may have had at the time, which could affect the final outcome. The authors concluded that the two medications may have a role to play in treating fibromyalgia but other illnesses and patient preference should be taken into account before prescribing one or the other medication. They suggest "the usage of gabapentin and pregabalin can be considered for the treatment of pain and sleep disturbances in FMS patients."
The authors also wrote that further testing of the two medications should include if fibromyalgia symptoms continue after treatment has stopped and if treatment reduces the overall cost of fibromyalgia.
Reference: Winfried Hauser, et al. Treatment of fibromyalgia syndrome with gabapentin and pregabalin - A meta-analysis of randomized controlled trials. In Pain. September 2009. Vol. 145. Nos. 1-2. Pp. 69 to 81.