The Pros and Cons of Fibromyalgia Treatments
There are many treatments for fibromyalgia (FMS). Some treatments are medicinal, some are physical, and others are psychological. They all have their good points and drawbacks. Here are the pros and cons of some of the most common treatments.
Pros: Aerobic exercise can improve overall function and quality of life for people with fibromyalgia but the key is to start slowly and build up to 30 to 60 minutes a day of low-to-moderate intensity aerobic exercise. This may mean you might only be able to do five minutes of exercise at one time or each day at first. That is fine. There are no rules to say how much you need to begin with. The main idea is to start somewhere and build up from there. Types of exercises that are beneficial include water aerobics, walking, and biking.
Cons: Although studies suggest that exercise can improve pain, the pain may get worse before it gets better because your muscles have to adjust to the increase in activity. This is why you should start slowly and work from there. Also stay hydrated because dehydration will cause muscle cramping.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a type of counseling that focuses on changing the way people react to life circumstances. In the case of fibromyalgia, that would include how people respond to pain or other triggers.
- Pros: CBT can help improve sleep, overall function, and coping skills. In addition, studies have shown that Cognitive Behavioral Therapy can reduce depression.
- Cons: CBT can take as many as 20 sessions to see results. Insurance coverage can vary according to location and some communities might not have therapists who have experience treating FMS patients. Pain centers are a good place to start looking.
With biofeedback, sensors help you learn how to control body processes such as blood pressure or heart rate.
- Pros: Biofeedback can help you control some fibromyalgia symptoms such as tension headaches and help you relax. It may also ease pain and morning stiffness.
- Cons: Biofeedback is usually done in conjunction with Cognitive Behavioral therapy. On its own, there is not as much evidence for its effectiveness. It can also be costly and insurance won’t always foot the bill. Moreover, it can take as many as 10 sessions before you start to see results.
Duloxetine (depression meds)
This antidepressant is approved by the FDA for fibromyalgia. It increases the activity of serotonin and norepinephrine, which halt pain signals from reaching the brain.
- Pros: Fifty percent of the people who try it will have a reduction in their pain of at least 30% to 40%. It also relieves coexisting depression and fatigue symptoms.
- Cons: It doesn’t appear to help much in the other fifty percent and a pain reduction of 30% to 40% may still not cut it for some. Plus, all drugs can have side effects and depression meds’s may include nausea, constipation, diarrhea, fatigue, headache, and insomnia.
Milnacipran (Savella) is an antidepressant and the most recent drug to be approved by the FDA for fibromyalgia.
- Pros: Milnacipran works in a similar manner to depression meds and is about as effective. It can also help with pain and depression.
- Cons: This antidepressant is not effective in everyone and pain reductions, while meaningful, is not complete. Side effects may include nausea, constipation, stomach pain, headache, and insomnia.
Physical therapy is a great way to learn how to gently work those muscles to reduce pain.
- Pros: Physical therapy can improve strength and range of motion, and teach you ways to relieve muscle pain. You’ll also learn how to pace activities to avoid making pain and fatigue worse.
- Cons: It’s highly therapist-dependent. If the physical therapist isn’t familiar with fibromyalgia, it could make pain worse, especially early on. It is important to be sure you have a therapist who is familiar with FMS before you go them.
Sometimes, seizure drugs help with fibromyalgia.
- Pros: FDA approved for fibromyalgia, pregabalin (medications) reduces the release of pain signals from nerves, and may also benefit sleep quality.
- Cons: Pregabalin is not effective in everyone, and when it does work, it often reduces pain by only 30% to 40%. Side effects may include dizziness, sleepiness, headache, dry mouth, difficulty concentrating, nausea, and vomiting.
This ancient form a martial arts is marked by slow, gentle movements and deep breathing.
- Pros: Tia Chi was recently reported to reduce fibromyalgia pain, depression, and anxiety, and improve sleep quality.
- Cons: There are no known side effects of Tai chi. However, not everyone is motivated to try this exercise and finding an experienced teacher can be a challenge. It also isn’t helpful for everyone who tries it. A small 2010 study found that Tai chi improved fibromyalgia symptoms in about 80% of patients. This is an improvement, though, compared with 50% of patients who did only stretching exercises.
The treatments for fibromyalgia are varied. Not everyone is helped by each treatment and they have their benefits and drawbacks. Talk to your doctor and try different treatments to find the ones that will benefit you.