Improving outcome for people with chronic widespread pain and fibromyalgia

Macfarlane, Gary John (2021) Improving outcome for people with chronic widespread pain and fibromyalgia. DSc thesis, University of Glasgow.

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Abstract

Chronic widespread pain is characteristic of fibromyalgia, a condition which also includes features such as cognitive dysfunction, sleep problems, fatigue and mood disorders. The lack of objective measures of the disorder has proved challenging in terms of diagnostic criteria, and thus timely diagnosis and access to effective management. Although there is a perception that the aetiology of the condition is not known and that there is no effective treatment, this is not the case. Over the past decades understanding of the pathophysiology and aetiology of the condition has improved and management that results in improved symptoms for many patients, has been identified. This thesis addresses important components in relation to improving outcome for patients with chronic widespread pain and fibromyalgia.

The thesis focuses on three areas (over seven published manuscripts): effective management for persons with chronic widespread pain and fibromyalgia; investigating excess mortality in people with chronic widespread pain; Identifying and managing fibromyalgia when it occurs in the context of inflammatory arthritis. It includes seven manuscripts.

The results of the manuscripts show that there is good evidence for the non-pharmacologic therapies of exercise and a cognitive behaviour informed approach to managing people with chronic widespread pain/fibromyalgia, that the excess mortality in such patients could be addressed by focussing on lifestyle factors (diet and exercise). When fibromyalgia occurs in the context of axial spondyloarthritis, such patients do (as a group) respond to biologic therapy but that specific aspects of their conditions (high somatic symptom burden) predict non-response and the likely need for additional (non-pharmacologic approaches) to management.

Item Type: Thesis (DSc)
Qualification Level: Doctoral
Subjects: R Medicine > R Medicine (General)
Colleges/Schools: College of Medical Veterinary and Life Sciences
Supervisor's Name: ., . not applicable
Date of Award: 2021
Depositing User: Mrs Marie Cairney
Unique ID: glathesis:2021-82044
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 04 Mar 2021 08:07
Last Modified: 08 Apr 2022 17:05
Thesis DOI: 10.5525/gla.thesis.82044
URI: http://theses.gla.ac.uk/id/eprint/82044
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