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

Resumen

Fibromyalgia is a complex syndrome characterized by chronic widespread pain, fatigue, sleep disorders and functional symptoms, affecting around 1-5% of the world's population, mainly women between the ages of 30 and 35. The condition has a strong genetic component and still generates controversy about its pathophysiology, due to the lack of specific biomarkers. Despite advances in the management of fibromyalgia, with promising pharmacological and non-pharmacological approaches, the lack of consensus and the variability in patient response highlight the need for a critical and integrated evaluation of treatment options. Therefore, this review aims to identify the most effective strategies for relieving pain and improving patients' quality of life. This is a descriptive qualitative literature review to analyze pain management and quality of life in patients with fibromyalgia, considering pharmacological and non-pharmacological interventions. The research was carried out 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 the limited understanding of its causes and the variable effectiveness of available therapies. The condition is viewed through a biopsychosocial model that suggests multiple peripheral and central factors influence 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 more research. A personalized combination of pharmacological and non-pharmacological strategies seems to be the most effective approach to optimize the management of fibromyalgia.