HealthRoad Productions is privileged to present the Fibromyalgia Clinic Newsletter from the Fibromyalgia Clinic, Kentfield Rehabilitation Hospital
The Fibromyalgia Clinic accepts patients with fibromyalgia who meet our specific criteria. Patients seen in the Clinic generally
are those who have had severe symptoms of fibromyalgia. Many of them had previously been considered treatment failures elsewhere
following extended and expensive treatment with no significant improvement. The Clinic's patient population represented in this
outcome study consists of a mix of patients with varying degrees of physical and psychological complaints, varying degrees of motivation,
and many who have been on disability for years. Referrals have come from many sources, including physicians, workers compensation
companies, medico-legal referrals, self-referrals, and others.
In assessing the results of a therapeutic program directed towards fibromyalgia, it is important to recognize that fibromyalgia is
not an objective disease, but rather a subjective illness. Laboratory studies and X-rays are of no value in determining the extent of
pain or other symptoms that patients experience. We believe that the effectiveness of a treatment program should be based in large
degree on the patient's perception of whether or not their pain and other symptoms have improved, and the effect on their increased
ability to function in the home and workplace. Patient perception is an important factor in understanding patient satisfaction and
improvement. If a patient perceives that his or her symptoms have improved, this will result in a better sense of well being, a
decrease in disability, fewer visits to the physician's office and a decreased utilization of other medical services.
Our multidisciplinary treatment program is based on the RETRAIN program as first published by Paul Davidson, M.D, a Fellow
of the American College of Rheumatology, in 1985 (1), and again in 1989 and 1996 (2). The Fibromyalgia Team Members are trained
and licensed professionals skilled in Physical Therapy, Biotherapy and Psychological evaluation and counseling. To participate, a
patient must be evaluated and treated as necessary by all three therapeutic disciplines. The progress of all patients attending
the Fibromyalgia Clinic is reviewed at weekly staff meetings, attended by the Team Members, the Case Manager and Dr. Davidson,
Medical Director.
The program consists of visits at least 2 times a week for 8 weeks with all Team Members. Restrictions in therapy are often imposed
by insurance contracts, particularly in the managed care environment. These restrictions can lower the effectiveness of our program.
Follow-up questionnaires were sent to 140 former patients in the late spring of 1998. Eighteen questionnaires were returned
with no forwarding address. A total of 50 responses were received of which 48 were useable resulting in a 39.3% response rate which
was the basis of the current outcome study. Of the 48 participants, 89.6% were female, 10.4% were male. The patients ranged in age
from 25 to 88 years, with an average age of 55.4 years. (Females: age range 25-88, averaging 55.8; males: age range 39-65, averaging
51.4)
The Symptoms most often reported by the by the 48 respondents and the percent who reported "good" to "excellent"
improvement following the program were:
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| Muscle Pain |
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| Stiffness |
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| Fatigue |
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| Stress |
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| Sleep Problems |
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Based on these survey results, our multidisciplinary and
integrated treatment approach continues to evidence the ability
to significantly improve symptoms of the fibromyalgia syndrome.
It must be kept in mind that the majority of the Clinic patients
had severe fibromyalgia, and many had been previously considered
as treatment failures. Our results indicate that the Fibromyalgia
Clinic's well-balanced program can turn a treatment failure into
a treatment success.
"Can't even imagine where I'd be today without you. Many thanks for making my life better." R.E.
1 Are You Sure It's Arthritis: A Guide to Soft Tissue Rheumatism,
Paul Davidson, M.D., Macmillan Publishing Company, 1985.
2 Chronic Muscle Pain Syndrome, Paul Davidson, M.D., Villard Books,
N.Y., 1989. Also paperback by Berkley Books, N.Y., and revised
and updated 1996 in the Berkley 2nd Edition.