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 .
Long-term maintenance of the analgesic effects of transcranial magnetic stimulation in fibromyalgia
& NA ; We assessed for the first time the long‐term maintenance of repetitive transcranial magnetic stimulation (rTMS)‐induced analgesia in patients with chronic widespread pain due to fibromyalgia . Forty consecutive patients were r and omly assigned , in a double‐blind fashion , to 2 groups : one receiving active rTMS ( n = 20 ) and the other , sham stimulation ( n = 20 ) , applied to the left primary motor cortex . The stimulation protocol consisted of 14 sessions : an “ induction phase ” of 5 daily sessions followed by a “ maintenance phase ” of 3 sessions a week apart , 3 sessions a fortnight apart , and 3 sessions a month apart . The primary outcome was average pain intensity over the last 24 hours , measured before each stimulation from day 1 to week 21 and at week 25 ( 1 month after the last stimulation ) . Other outcomes measured included quality of life , mood and anxiety , and several parameters of motor cortical excitability .  Thirty patients completed the study ( 14 in the sham stimulation group and 16 in the active stimulation group ) . Active rTMS significantly reduced pain intensity from day 5 to week 25 . These analgesic effects were associated with a long‐term improvement in items related to quality of life ( including fatigue , morning tiredness , general activity , walking , and sleep ) and were directly correlated with changes in intracortical inhibition . In conclusion , these results suggest that TMS may be a valuable and safe new therapeutic option in patients with fibromyalgia . The analgesic effects induced by repetitive transcranial magnetic stimulation of the motor cortex can be maintained over 6 months in patients with fibromyalgia , using monthly stimulation
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 .