Opioids being used widely for fibromyalgia treatment
Chronic widespread pain is the cardinal symptom of fibromyalgia, so many strategies and treatments are directed towards the ease of pain. The pain can be in one place or all over the body. Various conventional pharmacological treatments for the management of pain are focused on NSAIDs, analgesics and opioids. However, opioids other than tramadol have never been studied as a therapeutic modality in fibromyalgia.
Despite the lack of evidence supporting the clinical effectiveness of opioids in fibromyalgia, opioids are frequently incorporated into treatment for patients with this painful condition and has increased significantly owing to pain burden of patients and the more widespread availability of a range of long-acting opioid preparations.
Pain related to fibromyalgia consist of a complex mechanism, but does not appears to cause interference in the functions of opioid analgesics. There has been concern about the possible health consequences from exposure of opioids. However, in the most common type of fibromyalgia, the causes are not known, there is a no proof that opioids are effective in fibromyalgia treatment, but there is some evidence that opioids with additional steps on the norepinephrine-related pain modulatory pathways, such as tramadol, can be useful in some patients with this severe disease.
Available evidence suggests that the low-dose opioid antagonists may lead to better understanding of the role of opioids in fibromyalgia treatment.