13.05.2014

Traditional psychological treatment fibromyalgia

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A number of researchers have linked bipolar disorder with chronic pain syndromes like fibromyalgia and migraine headaches. Although exercise is beneficial for most people, in patients with chronic pain, traditional therapy or exercise rehabilitation may worsen symptoms. Manual massage, heat, and cold therapy have been widely recognized to have therapeutic benefits for more than a millennium. Although there is much to be said for symptomatic improvements, treatment from a rehabilitation standpoint emphasizes efficacy in outcome measurements. Chronic, intractable pain is a real disease, and its incidence is 10 to 150 times greater in patients with bipolar disorder than in the general population. Fears that practitioners may have regarding treating the bipolar patient is warranted because bipolar patients are difficult to treat and present certain risks because of their affective disorder. Do you recommend using technology (smartphone apps, Fitbits, etc) to help your patients become more active? Vertical Health Media, LLC does not, by publication of the advertisements contained herein, express endorsement or verify the accuracy and effectiveness of the products and claims contained therein. Practical Pain Management is sent without charge 10 times per year to pain management clinicians in the US.
Clinicians need to treat exercise as a “therapy,” monitoring patients’ progress and providing dosing guidelines and instructions. Other adjunct therapies, such as pet and music therapy, may be beneficial to patients and aid in soothing bipolar symptoms. Simple measurement techniques, such as monitoring standing, sitting, and walking times, are useful to measure treatment response. For patients with both chronic pain and bipolar disorder, disability can be severe and pervasive; therefore, the pain medicine specialist’s approach to chronic pain should be guided to improve the patient’s function. However, understanding the disease process, coordinating treatment with a team of specialists, and employing risk management strategies will improve the chances of successful treatment outcome.
Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative.
Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R).
Results of the National Depressive and Manic-Depressive Association 2000 survey of individuals with bipolar disorder. Psychiatric diagnoses in patient with fibromyalgia are related to health-care seeking behavior rather than to illness. Hypothesis: bipolar illness with complaints of chronic musculoskeletal pain is a form of pseudofibromyalgia. Substance P and affective disorders: new treatment opportunities by neurokinin 1 receptor antagonists? The prevalence and impact of migraine headache in bipolar disorder: results from the Canadian Community Health Survey.
Monitoring opioid adherence in chronic pain patients: assessment of risk of substance misuse. The effectiveness of cognitive behavioral group therapy in treating bipolar disorder: a randomized controlled study. Vertical Health Media, LLC disclaims any liability for damages resulting from the use of any product advertised herein and suggests that readers fully investigate the products and claims prior to purchasing. Pet or animal-assisted therapy promotes interaction between pet and patient, which patients find comforting; over time this relationship bond may help patients feel more connected to the outside world. To obtain optimal response in a patient, the treatment should be tailored to the individual patient’s symptoms, examination findings, and testing data. Bipolar patients can present with pseudo-fibromyalgia, which does not respond to traditional fibromyalgia treatments.
These patients need to start with small and limited exercise programs, making changes in the exercise program very slowly over time. Music therapy should be individualized to a patient’s musical preference to help promote relaxation, which has the potential to reduce bipolar episodes of depression and mania. It is important to measure response to treatment by the improvement in quality of life for these patients. In fact, there is a risk that SSRI and SNRI medications may exacerbate mania in some bipolar patients.
Too much exercise tends to flair the patient’s condition and lead to poor exercise compliance. Intervention results are best appreciated when a practitioner’s perspective is to view the whole patient and to observe goals to optimize quality-of-life measures. However, the atypical antidepressants have proven efficacy in both chronic pain control and bipolar treatment. As goals are met and symptoms change, the rehabilitation prescription should be modified to meet the individual’s current needs.



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