|
| | Nonpharmacologic treatment | Medications |
|
| APS (American Pain Society) and AWMF (Association of the Scientific Medical Societies in Germany) | Strong evidence:
Patient education
CBT
Aerobic exercise
Multidisciplinary therapy | Strong evidence:
Amitriptyline (25/50 mg)
NNT 3,54 (95% CI 2,74, 5,01)
Cyclobenzaprine (10/30 mg)
|
Moderate evidence:
Strength training
Acupuncture
Hypnotherapy
Biofeedback
Balneotherapy
| Moderate evidence:
SNRIs:
Milnacipran (100 mg)
NNT 7.2 (95% CI 5.2, 11.4)
NNH 7.6 (95% CI 6.2, 9.9)
Duloxetine (60/120 mg)
NNT 19 (95% CI 7.4, 20.5)
NNH 14.9 (95% CI 9.1, 41.4)
SSRI:
Fluoxetine (20/80 mg)
Tramadol (200/300 mg)
Anticonvulsant:
Pregabalin (300/450 mg)
NNT 8.6 (95% CI 6.4, 12.9)
NNH 7.6 (95% CI 6.3, 9.4) |
|
| EULAR (European League Against Rheumatism) | Balneotherapy (grade B) | Tramadol (grade A) |
| Individually tailored exercise including aerobic and strength training (grade C) | Analgesics (paracetamol/acetaminophen, weak opioids) (grade D) |
| Cognitive-behavioral therapy (grade B) | Antidepressants (amitriptyline, fluoxetine, duloxetine, milnacipran, moclobemide, pirlindol) (grade A) |
| Others: relaxation, rehabilitation, physiotherapy, and/or psychological support (grade C) | Tropisetron, pramipexole, pregabalin (grade A) |
|
