Winkelmann et al (2012) stated that the scheduled update to the German S3 guidelines on fibromyalgia syndrome by the Association of the Scientific Medical Societies was planned starting in March 2011. The development of the guidelines was coordinated by the German Interdisciplinary Association for Pain Therapy, 9 scientific medical societies, as well as 2 patient self-help organizations. Eight working groups with a total of 50 members were evenly balanced in terms of gender, medical field, potential conflicts of interest and hierarchical position in the medical and scientific fields. Literature searches were performed using the Medline, PsycInfo, Scopus and Cochrane Library databases (until December 2010). The grading of the strength of the evidence followed the scheme of the Oxford Center for Evidence-Based Medicine. The formulation and grading of recommendations was accomplished using a multi-step, formal consensus process. The guidelines were reviewed by the boards of the participating scientific medical societies. The authors concluded that low-to-moderate intensity aerobic exercise and strength training are strongly recommended; chiropractic, laser therapy, magnetic field therapy, massage, and transcranial current stimulation are not recommended.
Cortisone injections are extremely safe, but they do still have potential problems. If you are concerned about having a cortisone shot, talk with your doctor. While cortisone is a powerful treatment for many orthopedic conditions, there are usually other options that can also be tried. Many doctors will offer an injection as they are quick, easy, and most often effective. However, your doctor should also be able to offer other treatments for inflammation that may also be effective for those that cannot have, or don't want, a cortisone injection.
I had three injections all of which worked for a few days to two weeks then stopped. The excruciating pain returned and only Vicoden 5 mg 3-4 times a day controlled the pain. Vicoden at that dose is the lowest dose prescribed. it worked perfectly for several years and doctors refused to prescribed opioids for fear of losing their license. My sister recently died of throat cancer and she complained constantly of pain. She died with unrelieved pain. As a cancer patient she was prescribed Morphine 2 mg. every 6 hours. That is beyond ridiculous but keeps our doctor’s license safe. Our doctors are violating their Hippocratic oath – Do No Harm. They had added a caveat “except when the government is breathing down your neck. Then the patient be damned. I am glad this helped you Randy. I don’t know your clinical status but I am sure it differs from mine. Do you have severe and crippling arthritis?