musculoskeletal

Sleep Remedies and Strategies in Fibromyalgia & Chronic Fatigue Syndrome

San Jose Care Resource Guide: Adrienne Dellwo has an interesting blog on Fibromyalgia, this time the topic is sleep problems  Click Here for link.

San Jose Care Resource Guide:  Here is a link to a study showing some help from  pregabalin (Lyrica)

San Jose Care Resource Guide: On an alternative note Hydrotherapy seems to also help sleep for FS patients, click here for link to Brazilian article in sciencedirect

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Fibromyalgia: Comparative Effectiveness of Drugs

San Jose Care Resource Guide: The study we are linking you to is mostly about  pregabalin (Lyrica) and gabapentin (Neurontin). Study is from the Journal of Pain

The study’s conclusion is not enthusiastic:  “…We conclude that pregabalin and gabapentin are modestly effective for the treatment of fibromyalgia but that their long-term safety and efficacy remain unknown….”

Background:

• Pregablin/Lyrica                       click here for wikipedia article
• Gabapentin/Neurontin        click here for wikipedia article

Another  article from Medscape Today gives more detailed information about what the FDA approved for Fibromyalgia Treatments ”Recent Advances in the Treatment of Pain Associated With Fibromyalgia: FDA-approved Medications” Click here for article

Note the medscape article brings in SNRI ( Serotonin–Norepinephrine Reuptake Inhibitor) like duloxetine, milnacipran

That brings two classes of drug treatment against Fibromyalgia

• anti epileptic
• SNRI
  • The efficacy of SNRI sounds also moderate, click here for expert opinion in PubMed

Conclusions:  Some medicines are there  against fibromyalgia, but with moderate efficacy

Talk to your doctor..

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Does Osteopathy Reduce Musculoskeletal Pain? (Springer-Verlag)

SJCRG:

From the study conducted by Paul Posadzki and Edzard Ernst in “Clinical Rheumatology”

• 5 studies claim positive impact of Osteopathy on Musculoskeletal Pain
• 11  studies claim no impact of Osteopathy on Musculoskeletal Pain

So :”..No compelling evidence that it works..” But it might…

The Osteopath's path

For background on Osteopathy, go to the Wikipedia link

Talk to your Osteopath

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Comments on “FDA clears Cymbalta to treat chronic musculoskeletal pain”

SJCRG:  Good news, more treatment options for chronic musculoskeletal pain! Here is the link to the FDA press release.   “..Cymbalta was first used to treat major depressive disorder in 2004..” 

SJCRG:  Very interesting is the FDA’s philosophy for drug approval for serious illnesses:

Quoting:  “..While these serious side effects have been associated with the use of Cymbalta, they have occurred in less than 1% of treated patients. There are a finite number of drugs available for the treatment of chronic musculoskeletal pain, all of which are associated with rare, serious side effects. There are patients in whom none of the available treatments are effective. ….

So let us do the math: According to the US Govn’t “..An estimated 1.5 million adults had rheumatoid arthritis in 2007….”
…so 15,000 patients are expected to come down with serious side effects.

 But  “..Since its initial approval, about 30 million patients in the United States have used Cymbalta..[for other conditions]..”  Let us do the math now for that larger population: 1% of 30 million= 300,000 patients with serious side effects!  half of the Multiple sclerosis popultation in the US!

Please do a careful risk/reward analysis with your doctor if you need Cymbalta, or any of these potent drugs….

Cymbalta is no free ride…

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