Balneotherapy helps Fibromyalgia?

Head to your nearest thermal mineral water spa !

 

selfmanagechronicpain with balneotherapy

Enjoying the Therapeutic effects of Balneotherapy and Hydrotherapy

Therapeutic Effect of Balneotherapy and Hydrotherapy in the Management of Fibromyalgia Syndrome

Fibromyalgia syndrome (FMS) is a debilitating condition of almost unknown etiology and pathogenesis that is characterised by widespread musculoskeletal pain and tenderness, as well as secondary symptoms like fatigue, depression, irritable bowel syndrome and sleep disturbances.

A standard therapy regimen is lacking. Patient-tailored approaches are emphasised recommending non-pharmacological and pharmacological interventions according to individual symptoms. Self-management strategies involving active patient participation should be an integral component of the therapeutic plan.

Balneotherapy (thermal mineral water spas) and Hydrotherapy are commonly used interventions.

A qualitative systematic review and meta-analysis of randomised controlled trials showed that:

For Hydrotherapy with exercise, at the end of treatment, there was:

  • Moderate-to-strong evidence for a small reduction in pain
  • Moderate-to-strong evidence for a small improvement in health related quality of life (HRQOL)
  • No effect seen for depressive symptoms and Tender Point Count (TPC).
  • Follow-up data provided moderate evidence for maintenance of improvement with regard to pain.
  • No group difference was found when comparing water-based exercise to land-based exercise.

For Balneotharapy in mineral / thermal water, at end of treatment, there was:

  • Moderate evidence for medium-to-large size reduction in pain and TPC
  • Moderate evidence given for a medium improvement of HRQOL
  • No significant effect was found for depressive symptoms.
  • Moderate evidence for maintenance of improvements was found at follow-up, with smaller effects.

Pain may be relieved by the hydrostatic pressure of the water and the effects of the temperature on the nerve endings, as well as by muscle relaxation. It has been shown that thermal mud baths increase plasma levels of beta-endorphin, which explains their analgesic and anti-spastic effect.

The beneficial effects of water treatments are probably the result of a combination of specific (for example, buoyancy, aquatic resistance, heat) and unspecific effects (for example, change of environment, spa-scenery).

Source:

Therapeutic Benefit of Balneotherapy and Hydrotherapy in the Management of Fibromyalgia Syndrome: Johannes Naumann, Catharina Sadaghiani

Arthritis Res Ther. 2014; 16(R141) © 2014 BioMed Central, Ltd. http://medscape.com

 

Share on Facebook

A New Name for Chronic Fatigue Syndrome

 

Managing Systemic Exertion Intolerance Disease (SEID)

A New Name for Chronic Fatigue Syndrome.

An article in Medscape caught my eye last week. If you suffer from Chronic Fatigue Syndrome, you may find it interesting too.

 

problems with movement?

do you experience fatigue, perhaps sleep difficulties, and brain fog?

Dr Paul Auwaerter is based at the Johns Hopkins Division of Infectious Diseases, Johns Hopkins University in Baltimore, Maryland. He reports that some of his most challenging outpatient visits are with patients who describe long-standing problems that include fatigue, perhaps sleep difficulties, and brain fog.

 Often they may not be functioning well, perhaps experiencing problems in school or at work. Most of these patients are quite bright; they are analytical and sophisticated. They are hoping that something can be found to explain their fatigue and symptoms.

He explains that patients want to embrace something that makes sense. In fact, science has determined that the human brain likes distinct answers, and that uncertainty seems to amplify problems.

The term “chronic fatigue syndrome” or “myalgic encephalomyelitis” was developed and the defining criteria included:

  • more than 6 months of symptoms
  • an inability to perform customary activities.

The term resulted in a fair amount of controversy and sometimes even stigma because many clinicians believe this could be a psychosomatic illness; while others believe it is quite real. There is also symptom overlap with other syndromic problems, including fibromyalgia and irritable bowel syndrome.

“Within this context, the Institute of Medicine (IOM) was charged by several federal agencies to come up with a new name, some subcategories, and other aspects. In sum, the IOM committee decided that it would be important to rename chronic fatigue syndrome something that captures the nature of this. They have called it “systemic exertion intolerance disease,” or SEID.”

The criteria for SEID include:

  • substantial decline in functional activities for at least 6 months
  • post-exertional fatigue
  • non-restorative sleep.

And then at least one of the following:

  • cognitive impairment or orthostatic intolerance
  • gastrointestinal issues
  • pain
  • stimuli hypersensitivity
  • lymphadenopathy
  • sore throat

Some patients may develop SEID / chronic fatigue syndrome after having an authentic infection from which they never seem to recuperate and for others, there seems to be no precipitating factor. The condition afflicts a large number of people, children and young adults included, and the best treatment strategies -compiled by Simon Wessely and colleagues, (who did a fair amount of work on chronic fatigue syndrome and Gulf War syndrome), and others include:

  • graded exercises
  • conditioning to build up tolerance
  • cognitive-behavioral therapy.

Once again, a graduated approach to increasing physical activity is one of the most beneficial interventions.

What are your thoughts about these recommendations?

 

Reference:

Dr Paul Auwaerter

Medscape Infectious Diseases © 2015  WebMD, LLC

Cite this article: Managing Systemic Exertion Intolerance Disease (SEID). Medscape. Mar 03, 2015.

 

Share on Facebook

What Is The Most Effective Weapon For Fibromyalgia?

Aerobic Exercise !

aerobic exercise is the most effective ‘weapon’ that we have

People with fibromyalgia benefit from continuous physical exercise.

 

A recent article in www.medscape.com by Alice Goodman summarised an overview of research on fibromyalgia treatment that was presented at the Paris 2014 European League Against Rheumatism Congress.

Winfried Häuser MD, from Technische Universität Munchen is an expert in the field of fibromyalgia. He believes that treatment for people with fibromyalgia should be individualised and include non pharmacalogical approaches, as these are often more effective than drugs. He explained that aerobic exercise is the most effective ‘weapon’ that we have and both healthy people and people with fibromyalgia benefit from continuous physical exercise.

He and his colleagues recently published a network meta-analysis which was an indirect comparison of all available therapies for fibromyalgia. They were unable to find any significant differences in effectiveness between drug and non-drug therapies. While the effects of drugs are lost once the patient stops taking them, the effects of aerobic exercise and multicomponent therapy are sustained but declining at 1 or 2 years.

Dr Häuser advocates a graduated approach to treating fibromyalgia.

Mild fibromyalgia: can be managed with reassurance from the doctor and encouragement to engage in regular physical and mental activities.

Moderate fibromyalgia: should be managed with aerobic exercise and the temporary limited use of drugs.

Severe fibromyalgia: can be managed with aerobic exercise, drugs and the psychological and/or psychopharmalogic treatment of mental comorbidities.

Dr Mary-Ann Fitzcharles, a rheumatologist at McGill University in Montreal who treats people with fibromyalgia, agreed with the patient-tailored approach outlined by Dr Häuser. She cautioned about overmedicating people, and keeping them on continued medications which have side effects. Non Pharmalocological therapies have no risks, she explained.

Dr Fitzcharles went on to say that non pharmacologic therapies are probably the most important ones for people with fibromyalgia. In her experience, every person with fibromyalgia should be managed with exercise, promotion of an internal locus of control and education.

Activity pacing is the key, in order to not overdo or avoid exercise.

Non Pharmacological therapies include:

  • Aerobic exercise
  • Acupuncture
  • Psychotherapy

Pharmacologic / drug therapies include:

  • GABA analogues
  • Serotonin-norepinephrine reuptake inhibitors (SNRIs)
  • Tricyclic antidepressants
  • Serotonin-specific reuptake inhibitors (SSRIs)

References:

  1. Aerobic Exercise ‘Most effective weapon’ for Fibromyalgia. Medscape. June19, 2014. Annals of the Rheumatic Diseasesard.bmj.com
  1. Comparative efficacy of pharmacological and non-pharmacological interventions in fibromyalgia syndrome: network meta-analysis

          Eveline Nüesch, Winfried Häuser, Kathrin Bernardy, Jürgen Barth, Peter Jüni

               Ann Rheum Dis 2013;72:955-962 doi:10.1136/annrheumdis-2011-201249

 

 

Share on Facebook