Study Seeks Strategies For Fibromyalgia Treatment

By Aaron Stroud

The alarm sounds softly at first. It gets louder, but my body is dead weight, so my husband reaches for the snooze button. Even the muscles on my skull and those of my little toe feel overworked. Restless impulses in my body and random spasms throughout my back, arm, and legs kept me up for more than an hour last night. I knew working in the yard could be a healthy workout, but for the last few months even a forty-minute walk can make me painfully sore.

Approximately 3 to 6 million Americans begin their day with an experience similar to the one described above. Most sufferers are women, outnumbering men more than six to one. Many of these individuals' conditions go undiagnosed because they are unaware that such symptoms are attributed to a syndrome known as fibromyalgia.

The last three decades have seen the acknowledgement of fibromyalgia as a medical condition, and many treatments have been successful for limited numbers of patients. Unfortunately, fibromyalgia's cause is still unknown and no treatment has proven to be effective for a majority of sufferers.

This mystery is the impetus for the research of Dennis Turk, who holds the John and Emma Bonica professor of anesthesiology and pain research in the University of Washington School of Medicine. Turk's five-year study seeks to identify which treatments work for specific sufferers and situations. The focus will be on lifestyle changes and awareness instead of medication. Last summer, Turk received a $2.6-million grant for the study from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, part of the National Institutes of Health.

People suffering from fibromyalgia often struggle with the reality of the diagnosis. For many, day-to-day life becomes a challenge, and yet they may be reluctant to accept the mysterious diagnosis.

One of the most ironic aspects of the syndrome is that physical activity contributes to the severity of the suffering. With other ailments, one of the best ways to minimize aches, pains, and soreness may be to exercise. With fibromyalgia, physical fitness may help to minimize these sensations in the long term, but in the short term, exercise is rewarded with more pain, discouraging sufferers from further exercise. This causes a sort of downward spiral: "I do less; become more physically deficient; things become more painful and difficult to do, so I do even less and become even more disabled and depressed," Turk explains.

Turk believes that educating patients will improve their attitudes toward physical exercise. With knowledge, patients may be better able to cope with the short-term pain after exercising in order to improve overall health in the long term. Ellie Stein, a researcher at Canada's Burke Institute for the Rehabilitation of Chronic Illness, echoes that view. It is "one of the most challenging aspects of recovery," says Stein.

Turk's study aims to address this challenge by observing patients' responses to four treatment strategies.

Participants will be randomly assigned to one of four groups. The first group will receive exercise training and supportive counseling and encouragement. The second group will learn relaxation and imagination techniques and work with a physical trainer to help them work through activities they have been avoiding. The third will rely on the same techniques as the second group; however, they will learn about how their fear of activity has intensified the situation. The fourth group will receive exercise and general information about fibromyalgia.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, categorizing patients' responses to treatment is a promising avenue for future research because some patients respond positively to treatments that other patients find unhelpful. Turk's study aims to meet this need, providing strategies matched to the patients' characteristics.

For more information about the study, visit http://depts.washington.edu/fibroctr/

Aaron Stroud is pursuing a master's degree in technical communication at the University of Washington.