Don't overlook obvious in fibromyalgia Tx. (Exercise, Analgesics).

LOS ANGELES -- Don't overlook the simple and obvious in treating fibromyalgia, Dr. Andrew F. Leuchter said at a psychopharmacology update sponsored by the University of California, Los Angeles.

No cure for this disorder has been found, but all of its symptoms can be ameliorated, greatly improving patients' lives.

The goal of treatment is first of all to control pain and then to enhance the quality of sleep, improve mood, increase energy, and improve overall functioning, he said.

Fibromyalgia leads to terrible disabilities in some patients, but others are able to work full time, despite chronic pain, said Dr. Leuchter, who is director of the division of adult psychiatry at the university. "You really have to look at the level of function in a patient and determine which type of treatment is most appropriate."

Pain is the defining characteristic of fibromyalgia, and this pain has some unusual characteristics. Patients will report multiple trigger points on their bodies that are exquisitely sensitive to stimulation. Moreover, they experience a phenomenon known as "wind-up," in which repeated stimulation results in steadily increasing levels of pain. People without fibromyalgia, on the other hand, tend to report pain as reaching an asymptote with repeated stimulation.

With that in mind, one treatment for fibromyalgia pain is to get people with the disorder to recognize the point at which the pain begins while they are performing a repetitive task. Advise them to stop and rest for a time so they can unwind from the painful stimulus.

Simple analgesics also tend to work well. "Simply because someone has chronic pain doesn't mean that Tylenol is not going to help," Dr. Leuchter ...