Fibromyalgia Treatment Options
Fibromyalgia is a very mysterious condition. Its causes are still largely unknown, as is how it inflicts damage. No strong evidence indicates that any treatment has any significant effect for most patients. However, the U.S. Food and Drug Administration approved medications as the first drug treatment for fibromyalgia after a study showed the medicine reduced fibromyalgia pain in 63% of patients. A year later, the FDA approved the drug depression meds for fibromyalgia. depression meds has been shown to reduce fibromyalgia pain by more than 30%. Many patients with fibromyalgia are treated first with medication; however, the American Pain Society Fibromyalgia Panel recommends a combined approach using cognitive-behavioral therapy, education, medication, and exercise. Treatments usually involve trial and error:
- Patients may start with physical therapy, exercise, stress reduction techniques, and cognitive-behavioral therapy.
- If these methods fail to improve symptoms, an antidepressant or muscle relaxant may be added to the treatment. Doctors usually prescribe these drugs because they may improve pain tolerance.
- Patient education and programs that encourage coping skills are an important part of any treatment plan.
Preparation for Treatment
Patients must have realistic expectations about the long-term outlook of their condition, and their own individual abilities. It is important to understand that fibromyalgia can be managed, and patients can live a full life. The following tips may be helpful when starting a treatment program for fibromyalgia:
- The goal of therapy is to relieve symptoms, not cure them.
- Treatment must be tailored to each patient, and a combination approach is often needed.
- Patients must begin all treatments with the attitude that these treatments are trial-and-error. There is no clear treatment solution. Patients and doctors need to work together to make the best choices for individual symptoms and concerns.
- Treatments are long-lasting, in some cases life-long, and patients should not be discouraged by the return of symptoms.
- Enlisting family members, partners, and close friends, particularly to help with exercise and stretching programs, can be helpful.
- Becoming involved with support groups also benefits many patients. Support groups may also help family members, particularly parents of children with fibromyalgia. One study noted that the severity of the disorder increased in children whose parents were less able to cope with their pain.
Anti-Seizure Agents (Anti-Convulsants)
Research indicates that Pregabalin may improve sleep quality, fatigue symptoms, and fibromyalgia pain. One study found that it was effective at improving pain and sleep, and all were well tolerated by patients. The most common side effects include mild-to-moderate dizziness and sleepiness. Pregabalin can impair motor function and cause problems with concentration and attention. Patients should talk to their doctor about whether pregabalin may affect their ability to drive.
Doctors prescribe antidepressants to improve sleep and relieve pain in non-depressed patients with fibromyalgia. The dosages used for managing fibromyalgia are generally lower than dosages prescribed for treating depression. If a patient has depression in addition to fibromyalgia, higher doses may be required. Side effects most often reported include:
- Blurred vision
- Difficulty urinating
- Dry mouth
- Heart rhythm disturbances
- Sexual dysfunction
- Weight gain
Pain relief is of major concern for patients with fibromyalgia. Pain relievers for fibromyalgia include:
- pain meds, used alone or in combination with acetaminophen, is commonly prescribed for relief of fibromyalgia pain. Its most common side effects are drowsiness, dizziness, constipation, and nausea. Tramadol should not be used in combination with antidepressants.
- For relief of mild pain, acetaminophen is most often recommended. Anti-inflammatory drugs, which are commonly used for arthritic conditions, are less useful for the pain of fibromyalgia, because the pain is not caused by muscle or joint inflammation. Anti-inflammatory drugs include corticohormones and nonhormoneal anti-inflammatory drugs, such as aspirin and ibuprofen.
- Zostrix is an ointment prepared from the active ingredient in hot chili peppers. Capsaicin is helpful for relieving painful areas in other disorders. It may also have some value for fibromyalgia patients.
- Opioids, or narcotics, may be used occasionally by certain patients with moderate-to-severe pain, or those with significant problems performing everyday tasks. Such patients should use narcotics only if they cannot find relief with other, less potent treatments.