Fibromyalgia Treatments

When it comes to fibromyalgia treatments, there are drugs, alternative remedies, and lifestyle habits that may help decrease pain and improve sleep. Your fibromyalgia specialist may prescribe pain medication or antidepressants to help treat the pain, fatigue, depression, and anxiety that come with the disease. In addition, your doctor may recommend physical therapy, moist heat, regular aerobic exercise, relaxation, and stress reduction to help you manage your symptoms.

There is no one "pill" that treats or cures fibromyalgia. A multidisciplinary approach that uses both medication and alternative or lifestyle strategies seems to work best to treat fibromyalgia symptoms.

Is Fibromyalgia Pain Similar to Arthritis Pain?

Fibromyalgia can cause symptoms similar to arthritis, bursitis, and tendinitis. Consequently, some experts group fibromyalgia with arthritis and related disorders. The pain associated with these other conditions is typically localized to a single area, while the pain and stiffness of fibromyalgia are very widespread and consists of deep muscle pain, morning stiffness, and painful tender points, making it difficult to exercise or be physically active.

How Is Fibromyalgia Fatigue Treated?

Along with deep muscle pain and painful tender points, fatigue is a key symptom of fibromyalgia and it can be debilitating. Not only do you feel exhausted and weak, but bed rest does not seem to help. Many people with fibromyalgia report sleeping 8 to 10 hours at night and feeling as if they haven't slept at all.

Some drugs may help ease the fatigue associated with fibromyalgia. In addition, aerobic exercise can help ease fatigue, minimize pain, improve quality of sleep, and improve mood.

How Does Exercise Help Fibromyalgia Symptoms?

Numerous studies show that exercise is one of the most important treatments for fibromyalgia. Many people with fibromyalgia are not physically fit. They avoid exercise because they fear increased pain. Yet aerobic or conditioning exercise can actually help relieve pain and depression.

Regular exercise increases the body’s production of endorphins, natural painkillers that also boost mood. Starting slowly and gradually increasing the duration and intensity of exercise can help you enjoy the benefits of exercise without feeling more pain.

Regular exercise is an important part of managing your symptoms. Although pain and fatigue can make exercise hard, you can begin with something like a little extra walking. Once you’re comfortable with that, you can move on to things like aerobics, yoga, or swimming. Gyms or community centers often have classes that may help get you started.

How Does Physical Therapy Help Fibromyalgia?

Physical therapy can help relieve fibromyalgia pain and stiffness. Regular visits to a licensed physical therapist can increase confidence with exercise, help relax tense muscles, and teach you more about your body and movement. In addition, physical therapy helps with "new" muscle memory and neuroendocrine changes in a positive way to help your muscles recover.

Your physical therapist will show you the proper way to stretch painful muscles to get optimal relief. In addition, using hydrotherapy (moist heat or ice packs) along with physical therapy may ease pain even more.

Physical therapy can enable you to regain control of your illness. That’s because you can focus on lifestyle changes rather than on the chronic dysfunction. Proper posture, which your physical therapist will help you with, allows efficient muscle function. That way, you can avoid undue fatigue and pain.

An occupational therapist may help you find ways to work and do things around the house that are less stressful on your body.

Which Drugs Treat Fibromyalgia Symptoms?

Antidepressants, such as amitriptyline (Elavil) are sometimes prescribed to treat fibromyalgia symptoms. These medications may affect multiple symptoms -- pain, fatigue, depressed mood, and sleep disturbances.

The anticonvulsant drug pregabalin (Lyrica) has been approved by the FDA for fibromyalgia. Lyrica reduces pain and improves daily function for some people. The drug's most common side effects include mild to moderate dizziness and sleepiness. Lyrica can also cause blurred vision, trouble concentrating, dry mouth, swelling, and weight gain. A small number of people have an allergic reaction to it. The FDA advises patients to talk to their doctor about whether the use of Lyrica may impair their ability to drive. Other anticonvulsants are sometimes used to treat fibromyalgia.

Duloxetine (Cymbalta), an antidepressant, is another drug approved by the FDA for the treatment of fibromyalgia. Cymbalta is an antidepressant that belongs to a class of drugs called serotonin and norepinephrine reuptake inhibitors (SNRIs). Besides fibromyalgia and depression, Cymbalta is also approved to treat generalized anxiety disorder and diabetic nerve pain in adults. Cymbalta’s most common side effects include sleepiness, sweating, nausea, dry mouth, and constipation. It can also cause insomnia and dizziness. In some people, it may lead to suicidal thoughts and actions.

The FDA has also approved milnacipran (Savella) for treating fibromyalgia. Savella -- like Cymbalta -- is in the class of drugs known as SNRIs. But while it acts in the body the same way certain antidepressants do, Savella is not used to treat depression. When used to treat fibromyalgia, Savella has been shown to reduce pain, improve physical function, and bring about overall fibromyalgia improvement for some people. The most common side effect of Savella is nausea. Other side effects include headache, constipation, dizziness, and insomnia. It also may raise your heart rate or blood pressure.

Medications that increase restful sleep may help treat fibromyalgia symptoms. These drugs include low doses of antidepressant medication such as amitriptyline taken before bedtime. Other kinds of sleeping pills are often not very helpful for people who have fibromyalgia.

Anti-inflammatory drugs -- including ibuprofen and naproxen -- are not particularly helpful since there is little to no inflammation with fibromyalgia. However, they may help boost pain relief from other fibromyalgia medications. Anti-inflammatory drugs have many side effects, such as stomach upset and bleeding and may increase blood pressure.

The pain reliever acetaminophen (such as Tylenol) may be helpful, and it is easier on the stomach and less likely to cause drug interactions than anti- inflammatory drugs. However, acetaminophen should only be taken as recommended. Too much acetaminophen can lead to liver problems.

Doctors don’t recommend opioid painkillers, like oxycodone or hydrocodone, for fibromyalgia. These powerful medications don’t work as well for that condition as they do for other problems, and there’s a chance you might start to depend on them.

Muscle relaxants, such as cyclobenzaprine (Flexeril), may provide some relief of muscle pain, especially when taken at bedtime.

Steroids (such as prednisone) used to treat inflammation associated with other rheumatic conditions have been tested in people with fibromyalgia and did not appear to improve symptoms. However, a steroid injection directly into a muscle spasm (trigger point) may sometimes be used when other treatments have failed.

In addition to medication, other treatments, such as cognitive-behavioral therapy, can help develop a sense of self-control and provide education about your condition. With talk therapy, you can learn new self-management strategies that can boost coping skills, particularly in managing symptoms.

Can Complementary and Alternative Treatments Help Fibromyalgia?

With fibromyalgia pain being so debilitating, you may wonder about the effectiveness of complementary and alternative treatments to ease your discomfort.

But the fact that something is called "natural" doesn't mean it's safe, or that it will work. If you want to try holistic or natural treatments, talk with your doctor about it to come up with an overall treatment plan for your symptoms.

Acupuncture

Gently placing thin, dry needles into your skin at specific points may trigger the release of endorphins, your body's natural pain relievers.

Studies show that acupuncture may change your brain chemistry so you have a higher pain tolerance. One session might ease pain for weeks.

Chiropractic

People use it to treat pain at pressure points, in their back, neck, shoulders, and other joints, and from headaches and injuries. It may make you hurt less and help you move your neck and lower back.

Chiropractors use gentle pressure or stretching, multiple gentle movements of one area, or specific quick thrusts to help return bones (often in your spine) to a more normal position or to move as they should. These adjustments can help your body work better mechanically and help nerve signals travel more easily.

Massage

Massage is one of the complementary therapies most highly rated by people with fibro. It can help ease pain, boost your mood, and lessen the need for pain medicines so you can feel and live better.

There are different styles, such as Swedish, deep-tissue, and neuromuscular. All involve stroking and pressing on muscles to release tension and soreness and improve blood circulation.

Biofeedback

The idea behind biofeedback is that you can use information about your body to learn to control stress.

Sensors detect muscle tension, heart rate, breathing patterns, how much you're sweating, or body temperature. When you make yourself relax, those readings change. And after you master this skill in the therapist's office, you can do the same thing in the "real world."

Biofeedback has been shown to help lessen tender point sensitivity and to improve functioning for people with fibromyalgia.

Herbal medicine

Some people do sleep better or have more energy when they take herbal supplements. Studies on whether they're safe and effective for fibromyalgia have been mixed.

Check with your doctor to make sure the specific supplement you want to use won't cause problems with any medication you're taking.

Meditation

When you meditate, your body switches from an alert "fight or flight" readiness to a calmer, more peaceful mood. Studies show that the practice produces brain waves associated with serenity and happiness.

Meditation gives you a break from daily stresses and can put you in touch with your spiritual side. It may help you feel more focused and less distracted.

In addition, people with fibromyalgia often wonder if medical marijuana, which can be prescribed by physicians in some states, can help their chronic pain and fatigue. While medical marijuana doesn’t cure diseases like fibromyalgia, some pain experts say it may work against pain, help people sleep better, and improve mood. Other pain specialists see no role for medical marijuana in pain management and express concern that people don’t know what they’re getting when they buy it."

How Can I Take Better Care of Myself?

You can do a few other things to make living with fibromyalgia easier:

• Stress can make your symptoms worse. Better sleep and relaxation techniques can help with that. Try to get 7 to 8 hours each night, and take time to relax every day.
• Massage therapy may relax your muscles, lower your heart rate, and ease stress.
• A support group can help you learn more about your condition and connect with other people who are going through the same thing.
• If you feel sad or anxious, a counselor or therapist may help you deal with those emotions.

What Is the Long-Term Outlook for People With Fibromyalgia?

As with many conditions, people with fibromyalgia often have good days and bad. With proper fibromyalgia treatment, including regular exercise, most people have good symptom relief. However, typically the pain will come back, especially when life is stressful. Over time, you will learn what helps you work through these painful episodes and how to help prevent them.

People who continue to stay active socially as well as physically, despite their pain, often end up doing best.

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