Yesterday I attended a lecture by the most popular rhumatologist in town. The doctor was presenting on fibromyalgia and osteoporosis. In a community like Lake Havasu City, a popular snowbird roosting spot, these are two conditions shared by many. He described fibromyalgia taking delight and pride in the fact that it was recognized by the AMA in 1987 and received drug prescription approval by the FDA in 1997. So now people are given a name and a drug if they can prove “ membership” in the fibromyalgia club (as described by the physicians.)
The presentation included a chart graphing the most popular new drug, as it was tested against a stronger version of the same drug, and against a placebo. What I saw were three lines, descending in roughly the same pattern down the pain scale. Our doctor told us that because the two versions of the same drug had insignificant differences that the milder form was recommended. I raised my hand and asked, “But doctor, isn’t the line that represents the placebo in just about the same pattern and distance between as the other two drug lines?”
Instead of answering my question, he proceeded to describe the placebo effect and its history, leaving me still wondering why, if the difference between the two drugs was not considered significant, the same small difference between placebo and drug was the justification for prescribing this new “wonder” drug (which by the way, as you might guess, is very expensive).
The presentation continued to detail the prescription and traced the history of other, less effective drugs which were now being discarded in favor of this latest breakthrough. When the talk began to wind down, I raised my hand again. “ Are you going to talk about some non-pharmacological treatments for fibromyalgia, such as exercise, stress reduction, counseling, massage, physical therapy, yoga, water exercise, and diet?”
“No” was the curt reply, and the session was open to questions, all of which were related to prescription names and labels and comparisons of dosages.
Later on the same day, I was reading my latest Prevention magazine and came across a study, done in a hospital in Boston, with 135 women fibromyalgia sufferers. The protocol involved strength training, stretching, and aerobic exercise combined in a single exercise program. The vast majority of participants reported that this program, which lasted for 16 weeks, alleviated chronic pain symptoms, and that they experienced physical and mental improvements that had not diminished 6 months later.
So what to make of this? How to interpret the fact that there are at least two options for those who suffer from fibromyalgia: one an expensive drug, which admittedly has side effects and may have long term effects that have not been discovered yet, and the other, a simple program of exercise, designed to improve strength, flexibility, cardiovascular fitness and reduce stress, the side effects of which include; increased energy, decrease in body fat, improvement of daily living skills, alleviation of depression, and a more positive attitude towards life.
I leave you to draw your own conclusions. If given the option for your own treatment, which would you choose, and/or which are you choosing right now?