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NMU 33 – Fibromyalgia: New Medical Treatment Recommendations

Nutrition / Natural Medicine Update No.33 (December 7, 2106)

with Dr. James Meschino


Research Topic: Fibromyalgia: New Medical Treatment Recommendations

Source: Medscape Article: Fibromyalgia: Evidence-based Management (Jonathon Kay, MD)


Our research topic today highlights the November 2016 revised medical recommendations for the common arthritic-like condition known as fibromyalgia. Fibromyalgia is one of the most challenging and frustrating conditions for doctors to treat. It affects 2% of the population, which would include 5 million Americans and over 1.5 million Canadians. The condition affects more women than men by a 7:1 ratio. Most of these cases are diagnosed during middle age and prevalence increases with age. Patients with fibromyalgia have generalized pain, fatigue, and the sensation of feeling unrefreshed upon awakening. They often experience migraine-type headaches, shooting pains in their extremities, and have increased sensitivity to light touch. They also often have intestinal symptoms such as diarrhea and constipation as well. Fibromyalgia is not a disease, per se, but rather a constellation of clinical symptoms.

In 2007 The European League Against Rheumatism published recommendations for treatment of Fibromyalgia. In 2016, in the Annals of Rheumatic Diseases, a group of 18 rheumatologists, other health professionals, and patients from 12 European countries published revised recommendations for the treatment of this condition, based on an extensive literature review and meta-analysis of the available data. Their findings confirmed the fact that pain-killing drugs, like tramadol, as well as anti-inflammatory drugs, narcotic drugs, and anti-depressant drugs, are not effective treatments in most cases of fibromyalgia.

The most important conclusion that came out of these revised recommendations was that, based upon very strong evidence, both aerobic exercise and strength training exercises are the most effective methods to treat fibromyalgia. Researchers stated that they now we have very strong evidence from the literature that suggests that a supervised exercise program for aerobic conditioning and strength training is the basis for the treatment of this symptom complex. I will tell you that in my own clinical practice I often took fibromyalgia patients onto the gym floor and showed them exactly how to do a strength training exercise to reprogram their muscles and break up stubborn adhesions and fibrotic nodules within their muscles and connective tissues. I saw over the years how helpful it was to them. In addition to a basic strength training program, the aerobic exercise portion helps to improve endurance strength and calms the nervous system, which in turn, improves sleep quality and often improves intestinal tract symptoms.

I’m really pleased that these findings were presented to Rheumatologists at the American College of Rheumatology (ACR) 2016 Annual Meeting in November of 2016. I hope it will prompt more physicians to prescribe exercise as the foundational treatment for these conditions, as it has been shown to be the most effective treatment for Fibromyalgia patients. By the way, the researchers of the study also noted that other natural therapies, such as acupuncture, tai chi, and meditation, were also very helpful adjunctive measures to include, in addition to exercise.

I have included a link to the studies and the Medscape Review article in the text below for your consideration. If you have fibromyalgia or know someone who does, then I think you’ll find the studies and recommendations of great value.


Carville SF, Arendt-Nielsen S, Bliddal H, et al. EULAR evidence based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis. 2007;74:536-541.

Macfarlane GJ, Kronisch C, Dean LE, et al. EULAR revised recommendations for the management of fibromyalgia. Ann Rheum Dis. 2016 Jul 4. [Epub ahead of print]

Medscape Review:

Fibromyalgia Details:


Eat Smart, Live Well, Look Great

Dr. Meschino

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