Moist hot compresses and massage may also be comforting to the patient after discharge. Inform the patient that after trigger point injection there may be a transient painful rebound. Anti-inflammatory analgesics will help to reduce this potential discomfort. Provide followup care for patients in the event their symptoms do not clear and they require further diagnostic evaluation and therapy. For example, hypothyroidism and polymalgia rheumatica coexist with or predispose to fibromyalgia, or the patient may develop dermatomyositis.
Results are generally unsatisfactory.
Do not prescribe narcotic analgesics or systemic steroids. They are no more effective and add side effects and the risk of dependence. Although the pathophysiology of fibromyalgia is unknown it is a very real syndrome. Treatment may provide only partial symptomatic relief. True fibromyalgia syndrome is a chronic conditio requiring long term management that may include physical therapy, exercise, patient education and reassurance along with sleep-enhancing medications like low dose tricyclic antidepressants.