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Category: General

Published on Monday, 11 August 2008 14:19

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Non-pharmacological management
A combination of non-pharmacological and pharmacological treatments are particularly more helpful in managing self-reported fibromyalgia symptoms and daily functioning than pharmacological treatment alone.²⁰

Emotional and behavioural management
Psychosocial factors play an important part in fibromyalgia and its successful treatment. They can also act as predictors for the outcome of intervention. "Yellow flags" is the term used by Waddell et al for psychosocial factors suggesting a poor outcome to intervention.⁸

This is on account of their tendency to augment the experience of pain, establishing a cycle of increasing pain and distress. No individual factor can be used as a reliable predictor of poor outcome, but the following factors in combination tend to do so:

• Belief that pain is harmful or severely disabling
• Fear-avoidance behaviour (avoiding an activity through fear that it will cause pain)
• Emotions – tendency to low mood, withdrawal from normal social interaction
• Expectations of receiving passive treatment rather than active participation in a treatment programme

CBT aimed at helping patients to understand their pain and to develop coping strategies, has been shown to be most effective. CBT differs from psychotherapy, in which the patient tends to be passive while the therapist "interprets" for the patient any underlying psychological blocks. In CBT, patient and therapist collaborate to recognise unhelpful habits and behaviour, and to develop positive strategies for coping with the effects of fibromyalgia.

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