Daily Archives: May 21, 2012
As most of us know, current therapies leave most fibromyalgia patients still living with considerable pain. So it is reassuring to know that there is new and continuing research into our condition, and into ways that may reduce our daily pain.
In a media release from the University of Rochester (NY) Medical centre and the University of Washington School of Medicine (Seattle) have received a $5.5 million grant from the National Institutes of Health, to evaluate the ability of behaviour-change therapy added to the pain drug tramadol to ease fibromyalgia’s chronic, widespread pain.
The trial will enrol approximately 250 patients in Rochester and Seattle over the next four years, with enrolment likely to begin this (Northern hemisphere) summer. (So, anyone we know in this area?)
“Overall, current treatments for fibromyalgia are only partially effective: No more than half of patients get relief, and the other half stop therapy because they don’t get relief or they don’t like the side effects,” says Robert H. Dworkin, PhD, a professor in the University of Rochester’s Centre for Human Experimental Therapeutics. “Of those patients who do get relief, their pain doesn’t decrease dramatically; it goes down by a third, a half at most, so they are still living with considerable pain.”
And no other studies have looked at the combination of medication and behavioral treatment in any chronic pain condition, he suggests.
This will be a combined effort between Dr. Dworkin and lead investigator Dennis C. Turk, PhD, a professor in the department of anesthesiology and pain research at the University of Washington, who specialises in the study of fibromyalgia.
Drs Turk and Dworkin will study the effects of tramadol combined with either cognitive-behavioral therapy or health education treatment – both of which work to change the way people think about their condition to ultimately improve the way they act and feel. Their objective? To determine if a drug plus one of the behavioural health treatments could be better than either one alone.
Quality of Life
Past research, and Drs Dworkin and Turks’ own experience studying fibromyalgia, suggest that increasing activity is critical in helping patients get better. Researchers are not only interested in the combo’s influence on pain, but on patients’ ability to carry out the activities of daily life, as well.
“When you are more active and can do the things you want to do – go to the movies with your family, walk around the mall, do housework – it takes your mind off the pain and makes you feel better about your life overall,” says Dr Dworkin.
Major goals will be to measure both physical activity and enhanced sleep quality. “I liken it to a virtuous circle or a positive loop, says Dr Dworkin, “When you are more physically active you sleep better, and when you sleep better you have less pain, and when you have less pain you can do more of the things you love to do.”
Specially Designed Behavioural Treatments
The behavioural health treatments that will be used in the study were designed specifically for fibromyalgia patients, says the University of Rochester’s Prof Ellen Poleshuck, PhD, who will help run the trial. Participants will learn about fibromyalgia and various strategies for improved coping.
The researchers will measure pain reduction using daily pain diaries completed just prior to and at the end of each treatment.
Patients will be provided with an ActiGraph, a wrist watch-like device that includes an accelerometer to provide an objective measure of changes in activity level. The device also determines sleep patterns and circadian rhythms so will be used to measure the quality of participants’ sleep as well.
Bring on more research and a cure!