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part_b_-_example_fibro.pptxFibromyalgia: Diagnosis and Treatment
Written by Kenda Plate
Fibromyalgia Symptoms:
sleep disturbances
headaches
anxiety
tender points,
balance problems
tingling and numbness
restless legs syndrome (RLS)
oversensitivity to pain
irritable mood
inability to exercise
long-lasting, widespread musculoskeletal pain
fatigue
temperature sensitivity
flu-like symptoms
cognitive and memory problems
stiffness
depression
irritable bowel syndrome
sensitivity to noise and odor
(Dussias, Kalali, & Staud, 2012; NIH, 2012; Fietta, Fietta, &Manganelli, 2007; Fite & Kopala, 2003)
Diagnosing Fibromyalgia
According to the National Fibromyalgia Partnership (2012), fibromyalgia diagnosis is based on, “A history of widespread pain: Chronic, widespread, musculoskeletal pain lasting longer than three months in all four quadrants of the body. In addition, axial skeletal pain (in the cervical spine, anterior chest, thoracic spine, or lower back) must be present” (Official Diagnostic Criteria)
Diagnosing fibromyalgia must be done by a medical doctor.
[National Fibromyalgia Partnership (2012), Offficial Diagnostic Criteria]
Current Statistics 91% of Fibromyalgia patients are women between the ages of 20-60
Women ages 20-60
The prevalence of fibromyalgia is approximately
2% in the United States 3.3% in Canada
2.9% in European countries.
[Stuifbergen et al. (2012)]
Fibromyalgia Treatment
Pharmacotherapy
Drug Classes
[Dussias, Kalali, and Staud (2010)]
Treatment continued
Pharmacotherapy continued
According to Gallagher (2007), having the food and drug administration specifically approve a medication for the treatment of fibromyalgia gave much needed attention to treating the syndrome
Other medications that are not labeled for treating fibromyalgia are labeled to treat specific symptoms
One of the main purposes for prescribing medication is to help patients manage the pain they are feeling
Once some of the pain is under control, other types of treatments should be added on an individual basis
[Gallagher (2007)]
Mindfulness-Based Stress Reduction
Fibromyalgia is a mind-body syndrome that affects the whole person in biopsychosocial-spiritual manner.
Treating fibromyalgia with mindfulness-based stress reduction (MBSR) techniques will help individuals suffering from fibromyalgia to get some relief from their inappropriate and chronic responses to stress
MBSR techniques such as becoming aware of thoughts, feelings, and behaviors, as well as yoga and breathing, can help individuals focus on the current moment
Reduce blood pressure and bodily responses to stress while it can also diminish ruminating and worrying
Treatment continued
[Friedberg (2010); Lumley et al. (2011)]
Treatment continued
Social Support
Social support is a fundamental ingredient to a healthy lifestyle
Key component to treating the whole person
Social support levels have an inverse relationship with chronic pain symptoms
Clinicians should encourage individuals that are suffering with fibromyalgia to seek positive support
Support could include family, friends, attending church, volunteering, or attending a practitioner led support group for chronic pain
[Friedberg (2011)]
Treatment continued
Massage Therapy
Short-term and long-term benefit can be achieved from receiving massage therapy. Benefits include:
restorative sleep
decreased anxiety and symptoms of depression
reduction in immediate pain
improved well-being
less stiffness
lowered levels of pain
improved sleep and sleepiness
[Kalichman (2010)]
Combining Treatments
Cognitive-Behavior Therapy and
combining treatments
CBT was found effective when combined with other treatments
Since fibromyalgia seems to affect the whole person, clinicians who treat clients with fibromyalgia should be well versed on several different treatment techniques in order to provide appropriate treatment for clients.
[Lera et al., (2009); Friedberg (2010)]
The Counseling Relationship
Women suffering from chronic pain need a safe place to talk about their suffering
The counselor must offer understanding and support in order to build a working rapport with the client
Counseling Relationship continued
Counselors must also build a working relationship with doctors and nurses who are treating the medical side of fibromyalgia syndrome
Counselors may need to coordinate many different aspects of treatment to help the client receive the best possible care
Homework
Breathing and relaxation to help reduce stress
Light forms of physical exercise such as yoga and stretching
If clients have comorbid anxiety with fibromyalgia clients can be taught to “think about their thinking” and modify their thoughts (Seligman and Reichenberg, 2012, p. 196).
Clients that have comorbid depression can keep a gratitude journal and write down five things every day that they are thankful or grateful for
Clients can also join a support group
Take walks several times a week
[Seligman & Reichenberg, (2012); WebMd (n.d)]
Homework continued
Reading a book about fibromyalgia can be hope-inspiring if the client is able to incorporate ideas from the information
visiting a massage therapist once a week
Applying cold and heat packs to provide pain relief can also be done at home
keeping a food journal
a healthy diet
[WebMd, (n.d.)]
Biblical Perspective: Finding Meaning through Suffering
Suffering is not enjoyable and can be viewed as a miserable experience
Individuals suffering from chronic pain may feel overwhelmed, defeated , and hopeless
How does someone find hope and meaning through their suffering?
Biblical Perspective: Finding Meaning through Suffering continued
Christian clients that are suffering from fibromyalgia may find some meaning from their suffering by meditating on Romans 5:1-5, which says,
Therefore, since we have been justified through faith, we have peace with God through our Lord Jesus Christ, through whom we have gained access by faith into this grace in which we now stand. And we boast in the hope of the glory of God. Not only so, but we also glory in our sufferings, because we know that suffering produces perseverance;
perseverance, character; and character, hope. And hope does not put us to shame, because God’s love has been poured out into our hearts through the Holy Spirit, who has been given to us (NIV).
Biblical Perspective: Finding Meaning through Suffering continued
From this passage (Romans 5:1-5) it is clear that suffering can produce hope and personal growth that is both psychological and spiritual
Suffering that is infused with hope can move clients forward instead of allowing them to remain trapped in a hopeless cycle of pain and despair
Christian counselors do not to simply focus on relieving and preventing suffering or soothing symptoms because suffering without hope, meaning, and personal growth is fruitless and meaningless
[Thomas & Sosin (2011)]
Conclusion
Fibromyalgia is difficult to diagnose and treat
Persistent symptoms wax and wane
Stressors and responses to stress can be precursors to the syndrome
Therapies should be combined to treat the individual client based on symptoms and overall assessment
Finally, finding meaning through suffering could help clients turn their suffering into growth and hopefulness
Author Unknown
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References
Dussias, P., Kalali, A. H., & Staud, R. M. (2010). Treatment of
fibromyalgia. Psychiatry, 7(5), 15-18.
Fietta P., P. Fietta, & Manganelli P. (2007). Fibromyalgia and psychiatric disorders. Acta
Biomed. 78(2), 88-95. National Library of Medicine. [PubMed]
Fite, J. & Kopala, M. (2003). Chronic fatigue syndrome, fibromyalgia, multiple sclerosis, and
lupus: Meeting the challenges. In Kopala, M. & Keitel, M. (2003). Handbook of
counseling women. Thousand Oaks, CA: Sage Publications.
Friedberg, F. (2010). Chronic fatigue syndrome, fibromyalgia, and related illnesses: a clinical
model of assessment and intervention. Journal of Clinical Psychology, 66(6), 641- 665. doi:10.1002/jclp.20676
Gallagher, R. M. (2007). Fibromyalgia: New hope for a medical dilemma. Pain Medicine, 8(8), 619-620. doi:10.1111/j.1526-4637.2007.00395.x
Kalichman, L. (2010). Massage therapy for fibromyalgia symptoms. Rheumatology
International, 30(9), 1151-7.
References Continued
Lera, S., Gelman, S. M., López, M. J., Abenoza, M., Zorrilla, J. G., Castro-Fornieles, J., &
Salamero, M. (2009). Multidisciplinary treatment of fibromyalgia: Does cognitive behavior therapy increase the response to treatment? Journal of Psychosomatic Research, 67(5), 433-441. doi:10.1016/j.jpsychores.2009.01.012
Lumley, M. A., Cohen, J. L., Borszcz, G. S., Cano, A., Radcliffe, A. M., Porter, L. S., & ...
Keefe, F. J. (2011). Pain and emotion: a biopsychosocial review of recent research. Journal of Clinical Psychology, 67(9), 942-968. doi:10.1002/jclp.20816
Seligman, L. & Reicherberg, L. W. (2012). Selecting effective treatments: A comprehensive systematic guide to treating mental disorders (4th ed.). Hoboken, NJ: John Wiley & Sons.
Stuifbergen, A. K., Blozis, S. A., Becker, H., Phillips, L., Timmerman, G., Kullberg, V., . . . Morrison, J. (2010). A randomized controlled trial of a wellness intervention for women with fibromyalgia syndrome. Clinical Rehabilitation, 24(4), 305-18. doi:http://dx.doi.org/10.1177/0269215509343247
Thomas, J. C. & Sosin, L. (2011). Therapeutic expedition: Equipping the Christian counselor for the journey. Nashville, TN: B & H Academic.
WebMD (n.d.) Retrieved from
http://www.webmd.com/fibromyalgia/guide/fibromyalgia-the-
diet-connection
