While no clinical trial to date has specifically targeted fatigue , r and omized controlled trials , systematic review s , and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue .
Fatigue is a disabling , multifaceted symptom that is highly prevalent and stubbornly persistent .
Although fatigue is a frequent complaint among patients with fibromyalgia , it has not received the same attention as pain .
Reasons for this include lack of st and ardized nomenclature to communicate about fatigue , lack of evidence -based guidelines for fatigue assessment , and a deficiency in effective treatment strategies .
Fatigue does not occur in isolation ; rather , it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain , unrefreshing sleep , anxiety , depression , cognitive difficulties , and so on .
Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms .
Effects of unilateral repetitive transcranial magnetic stimulation of the motor cortex on chronic widespread pain in fibromyalgia.
Non-invasive unilateral repetitive transcranial magnetic stimulation ( rTMS ) of the motor cortex induces analgesic effects in focal chronic pain syndromes , probably by modifying central pain modulatory systems . Neuroimaging studies have shown bilateral activation of a large number of structures , including some of those involved in pain processing , suggesting that such stimulation may induce generalized analgesic effects . The goal of this study was to assess the effects of unilateral rTMS of the motor cortex on chronic widespread pain in patients with fibromyalgia . Thirty patients with fibromyalgia syndrome ( age : 52.6 + /- 7.9 ) were r and omly assigned , in a double-blind fashion , to two groups , one receiving active rTMS ( n = 15 ) and the other sham stimulation ( n = 15 ) , applied to the left primary motor cortex in 10 daily sessions . The primary outcome measure was self-reported average pain intensity over the last 24 h , measured at baseline , daily during the stimulation period and then 15 , 30 and 60 days after the first stimulation . Other outcome measures included : sensory and affective pain scores for the McGill pain Question naire , quality of life ( assessed with the pain interference items of the Brief Pain Inventory and the Fibromyalgia Impact Question naire ) , mood and anxiety ( assessed with the Hamilton Depression Rating Scale , the Beck Depression Inventory and the Hospital Anxiety and Depression Scale ) . We also assessed the effects of rTMS on the pressure pain threshold at tender points ipsi- and contralateral to stimulation . Follow-up data were obtained for all the patients on days 15 and 30 and for 26 patients ( 13 in each treatment group ) on day 60 . Active rTMS significantly reduced pain and improved several aspects of quality of life ( including fatigue , morning tiredness , general activity , walking and sleep ) for up to 2 weeks after treatment had ended . The analgesic effects were observed from the fifth stimulation onwards and were not related to changes in mood or anxiety . The effects of rTMS were more long-lasting for affective than for sensory pain , suggesting differential effects on brain structures involved in pain perception . Only few minor and transient side effects were reported during the stimulation period . Our data indicate that unilateral rTMS of the motor cortex induces a long-lasting decrease in chronic widespread pain and may therefore constitute an effective alternative analgesic treatment for fibromyalgia
While no clinical trial to date has specifically targeted fatigue , r and omized controlled trials , systematic review s , and meta-analyses indicate that treatment modalities studied in the context of other fibromyalgia symptoms could also improve fatigue .
Fatigue is a disabling , multifaceted symptom that is highly prevalent and stubbornly persistent .
Although fatigue is a frequent complaint among patients with fibromyalgia , it has not received the same attention as pain .
Reasons for this include lack of st and ardized nomenclature to communicate about fatigue , lack of evidence -based guidelines for fatigue assessment , and a deficiency in effective treatment strategies .
Fatigue does not occur in isolation ; rather , it is present concurrently in varying severity with other fibromyalgia symptoms such as chronic widespread pain , unrefreshing sleep , anxiety , depression , cognitive difficulties , and so on .
Survey-based and preliminary mechanistic studies indicate that multiple symptoms feed into fatigue and it may be associated with a variety of physiological mechanisms .