1
|
Galvani C, Caramaschi P, Mura P, Paladini A, Piroli A, Arnaudo E, De Franceschi L, Evangelista M, Pari A, Ongaro G, Finco G, Ciannameo A, Carletto A, Varrassi G, Biasi D. Postural counseling represents a novel option in pain management of fibromyalgia patients. J Pain Res 2019; 12:327-337. [PMID: 30666151 PMCID: PMC6333156 DOI: 10.2147/jpr.s164714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Chronic pain is a key symptom in fibromyalgia (FM), and its management is still challenging for rheumatologists in daily practice. FM patients show psychological and psychiatric manifestations, going from mood and emotional disorders to depression and alexithymia that negatively impact their quality of life, limiting their daily activities. Since pharmacological strategies have a limited efficacy in FM pain, alternative or complementary non-pharmacological approaches have been introduced in the clinical management of FM. Patients and methods This is a retrospective study on FM patients (n=52) treated with a novel integrated postural counseling (PC) rehabilitation program carried out by a counselor physiotherapist. The clinical impact of PC was evaluated by 1) a semi-structured interview using an ad hoc modified questionnaire McGill Illness Narrative Interview (MINI) 1 to obtain data on pain management by highlighting everyday experience of living with pain and 2) an FM impact questionnaire (FIQ) total score. Results Two main structures of narrative emplotment of FM illness were recognized: 1) the cumulative life narrative structure (46.15%) and 2) the broken life (53.85%) narrative structure. Baseline FIQ score was 77.38±7.77, and it was significantly reduced after PC to 39.12±13.27 (P<0.0001). Although well-being still requires further definition as outcome in pain management, it is important for FM patients, dealing with pain-related sensations, thoughts and feelings and limiting their daily activities. In our study, 87.5% of interviewed FM patients reported an improvement in their well-being after PC. Conclusion Our data suggest that an integrated PC program positively impacts chronic pain and fatigue based on self-management strategies. PC allows FM patients to resume their own life and regenerate their own image. Finally, we propose the introduction of the evaluation of the ability to resume daily activities as the target of rehabilitation programs in FM.
Collapse
Affiliation(s)
- Carla Galvani
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy,
| | - Paola Caramaschi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy,
| | - Paolo Mura
- Anesthesia, Intensive Care and Pain Therapy Unit, Department of Medical Science "M. Aresu", University of Cagliari, Cagliari, Italy
| | | | - Alba Piroli
- Department of MESVA, University of L'Aquila, L'Aquila, Italy
| | - Elisa Arnaudo
- Department of Internal Medicine, University of Bologna, Bologna, Italy
| | - Lucia De Franceschi
- Internal Medicine Unit, Department of Medicine, University of Verona, Verona, Italy
| | - Maurizio Evangelista
- Emergency Department, Institute of Anesthesia, Resuscitation and Pain Medicine, Catholic University of Sacred Heart, Rome, Italy
| | - Alice Pari
- Department of Internal Medicine, University of Bologna, Bologna, Italy
| | - Giovanna Ongaro
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy,
| | - Gabriele Finco
- Anesthesia, Intensive Care and Pain Therapy Unit, Department of Medical Science "M. Aresu", University of Cagliari, Cagliari, Italy
| | - Anna Ciannameo
- Department of Internal Medicine, University of Bologna, Bologna, Italy
| | - Antonio Carletto
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy,
| | - Giustino Varrassi
- Department of MESVA, University of L'Aquila, L'Aquila, Italy.,Paolo Procacci Foundation, Rome, Italy
| | - Domenico Biasi
- Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy,
| |
Collapse
|