Fibromyalgia
Lifestyle modifications
PHYSICAL ACTIVITY
Regular physical activity / exercise is the only therapy with a strong recommendation (2). Also activities that combine exercise with relaxation is effective (1). Both aerobic exercise and resistance training are associated with improved pain and physical function (2). Both land based and water based exercise are effective (3).
Pain may increase in the beginning of an exercise program. Thus, it is important to motivate the patient to continue the program, preferrably sligt to moderate intensity 2-3 times per week (3).
Regular aerobic exercise may possibly also reduce fatigue and stiffness (4).
NUTRITION
Vitamin D: En metaanalyse har vist reduserte symptomer ved tilskudd (2)
Plantebasert kosthold: Enkelte behandlingsstudier har vist å redusere smerter
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References
https://bestpractice.bmj.com/topics/en-gb/187/treatment-algorithm
Macfarlane, Gary J., et al. "EULAR revised recommendations for the management of fibromyalgia." Annals of the rheumatic diseases 76.2 (2017): 318-328. (Link)
Häuser, Winfried, et al. "Efficacy of different types of aerobic exercise in fibromyalgia syndrome: a systematic review and meta-analysis of randomised controlled trials." Arthritis research & therapy 12.3 (2010): 1-14. (Link)
Bidonde, Julia, et al. "Aerobic exercise training for adults with fibromyalgia." Cochrane Database of Systematic Reviews 6 (2017). (Link)
Resources
Figure: Evidence pyramid
EXPLANATION TO EVIDENCE PRESENTATION
Recommendations based on guidelines and evidence based Clinical Decision Systems are written in BOLD
Recommendations based on meta analysis or systematic reviews are written in BOLD and CURSIVE
Recommendations based on randomized controlled trials are written in plain font
Recommendations based on observational / cohort studies are written in CURSIVE