Manejo da dor e qualidade de vida em pacientes com fibromialgia: intervenções farmacológicas e não farmacológicas

Abstract

Fibromyalgia is a complex syndrome characterized by chronic widespread pain, fatigue, sleep disorders, and functional symptoms, affecting approximately 1–5% of the world population, mainly women between 30 and 35 years of age. The condition has a strong genetic component and still generates controversy regarding its pathophysiology, due to the absence of specific biomarkers. Despite advances in the management of fibromyalgia, with promising pharmacological and non-pharmacological approaches, the lack of consensus and variability in patient response highlight the need for a critical and integrated assessment of treatment options. Therefore, this review aims to identify the most effective strategies for pain relief and improvement of patients' quality of life. This is a qualitative descriptive literature review to analyze pain management and quality of life in patients with fibromyalgia, considering pharmacological and non-pharmacological interventions. The research was conducted through a systematic search in academic databases such as PubMed and Scopus, and included original articles in Portuguese or English, excluding incomplete or repeated works. The review was conducted in September 2024, with a focus on obtaining a comprehensive and up-to-date overview of the topic. The management of fibromyalgia faces challenges due to limited understanding of its causes and the variable efficacy of available therapies. The condition is viewed through a biopsychosocial model that suggests multiple peripheral and central factors influencing treatment. Medications targeting the central nervous system, such as duloxetine and pregabalin, show variable efficacy, while analgesics and anti-inflammatories are generally ineffective. Non-pharmacological interventions, such as physical exercise, cognitive behavioral therapy, and patient education, have shown significant benefits in reducing pain and improving quality of life. Digital and emerging approaches, such as neuromodulation and virtual reality, show promising results but require further research. A personalized combination of pharmacological and non-pharmacological strategies appears to be the most effective approach to optimize the management of fibromyalgia.