Multidisciplinary Care Reduces Fibromyalgia Symptoms

Patients with severe fibromyalgia experienced significant improvements in several categories of symptoms, according to a recent study, after undergoing eight weeks of multidisciplinary care, including massage therapy, thermal therapy and ischemic pressure on 18 tender points. The study, “Effects of a multidisciplinary treatment program in patients with severe fibromyalgia,” involved 34 people classified with severe fibromyalgia. These subjects were randomly assigned to either the control group or the experimental group.

The control group comprised 17 women, who were instructed to continue their current medical treatments and also participate in four one-hour sessions of patient education. These education sessions covered such topics as relaxation techniques, cognitive behavior therapy, diet and the benefits of exercise for fibromyalgia patients.

The experimental group consisted of 16 women and one man. This group also was instructed to participate in four one-hour sessions of patient education, along with continuing current medical treatment. In addition, subjects in the experimental group received weekly one-hour sessions of multidisciplinary care for a total of eight weeks.

These eight sessions of multidisciplinary care included massage therapy, ischemic pressure on 18 tender points, aerobic exercise and thermal therapy. The massage therapy involved the use of a combination of superficial strokes, deep pressure and kneading upon the spinal column for 15 minutes. The ischemic pressure involved direct and maintained pressure on the 18 tender points for a maximum of one minute per point, during a total time of about 25 minutes.

The aerobic exercise took place using a stationary bike for five minutes and a treadmill for five minutes. The thermal therapy consisted of convective heat transfer with an infrared heat lamp for 10 minutes.

A number of measures were assessed at baseline, at the end of the eight-week intervention period and again one month following the intervention period. Evaluation tools included a questionnaire on 71 symptoms associated with fibromyalgia, a tender-point count, pressure pain threshold, grip-strength test, visual analog scale for pain, a quality of life survey and the Beck Depression Inventory, among others.

Immediately after the eight-week intervention period ended, results of the research showed a significant improvement in the experimental group in terms of vitality, social functioning, grip strength and a six-minute walk test. At the one-month assessment point, the experimental group continued to demonstrate improvements in most of the parameters assessed. These improvements were significant for overall health perception, social functioning, grip strength and the six-minute walk test.

“Our team designed a multidisciplinary intervention program associating the medical treatment with a patient education protocol, massage therapy, ischemic pressure, aerobic exercise and thermal therapy,” state the study’s authors. “In conclusion, patients with severe manifestations of fibromyalgia can obtain improvement with a short-term, low-cost and simple-delivery multidisciplinary program.”

Authors: Beningno Casanueva-Fernández, Javier Llorca, Josep Blanch i Rubió, Baltasar Rodero-Fernández and Miguel A. González-Gay.

Sources: Rheumatology Service at the Specialist Clinic of Cantabria, Santander, Spain; Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, Santander, Spain; Rheumatology Service, Barcelona, Spain; Centro Rodero Neurosciencies Clinic, Santander, Spain; and Rheumatology Service, Hospital Universitario Marqués de Valdecilla, Santander, Spain. Originally published in Rheumatology International.

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