Treating Fibromyalgia Pain

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Alternative Treatments for Fibromyalgia

How well do they work?

By Jeanie Lerche Davis
WebMD Feature

Reviewed by Brunilda Nazario, MD

To get relief from fibromyalgia pain, more and more people are trying alternative treatments. It's often instinctive -- putting an icepack on a painful spot or reaching for the heating pad when muscles hurt. Or it feels good – like a massage. Even acupuncture is becoming a mainstream pain treatment, with endorsements from the NIH and the World Health Organization.

Now, researchers are honing in on how these various home remedies and alternative treatments work.

"In all these therapies, we're stimulating pressure points... we think there may be a similar underlying mechanism in how they work," says Tiffany Field, PhD, director of the Touch Research Institute at the University of Miami School of Medicine.

Pressure applied to the right spot triggers all sorts of changes in the body -- in a good way, she explains. The pressure points have nerve connections to major nerves in the body that affects physiological processes.”

This reduces flow of stress hormones and pain-inducing chemicals -- and ramps up production of mood-related brain chemicals such as serotonin, she says. The result: The body slows down, you feel calmer, sleep is more restful -- and you are able to tolerate the pain of fibromyalgia better.

Massage and Fibromyalgia Treatment

For the past three decades, Field has conducted more than 80 studies looking at massage's effects on various conditions. Her research team looks deeply at the underlying physiological processes involved in sleep -- especially as it relates to fibromyalgia pain.

Researchers tracked patients' sleep patterns, also measuring "substance P," a brain chemical that is central to fibromyalgia pain. People with fibromyalgia pain have higher levels of substance P in the spinal fluid. They also have lower than normal levels of mood-boosting serotonin.

When they get a massage, all that changes. Field's studies have shown less substance P in patients' saliva -- and they report less pain. They also have fewer painful tender points.

The studies typically involve 20-minute massages -- which is only practical if a significant other is trained to do it, she says. One bonus for the family masseuse: People who give massages have lower stress hormone levels, too.

To get the most benefit, it's important to apply moderate pressure. "It doesn't matter whether you're rubbing, kneading, or stroking -- it's the pressure that makes the difference," Field says. "You have to move the skin, actually see finger indentations in the skin. It doesn't hurt, but it's more than light stroking. We've found that light stroking doesn't help."

Massage also helps relieve depression, Field adds. "Depression is related to low serotonin, low dopamine, and increased cortisol. We can jazz that up with massage. There are a lot of positive benefits from massage."

Acupuncture and Fibromyalgia Treatment

Acupuncture, a traditional Chinese treatment, also helps ease fibromyalgia symptoms. Acupuncture works on brain chemicals to decrease anxiety, depression, insomnia, stress, and pain.

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Do You Have Fibromyalgia Pain?

Cymbalta is approved for the management of fibromyalgia.

Important Safety Information About Cymbalta

Antidepressants can increase suicidal thoughts and behaviors in children, teens, and young adults. Suicide is a known risk of depression and some other psychiatric disorders. Call your doctor right away if you have new or worsening depression symptoms, unusual changes in behavior, or thoughts of suicide. Be especially observant within the first few months of treatment or after a change in dose. Approved only for adults 18 and over.

What should I talk about with my healthcare provider?

Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few months of antidepressant treatment or whenever there is a change in dose.

Who should NOT take Cymbalta?

You should not take Cymbalta if:

You have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI)
You have uncontrolled narrow-angle glaucoma (increased eye pressure)
You are taking Mellaril® (thioridazine)

What other important information should I discuss with my healthcare provider?

Before starting Cymbalta, talk with your healthcare provider:

about all of your medical conditions, including kidney or liver problems, glaucoma, diabetes, seizures, or if you have bipolar disorder. Cymbalta may worsen a type of glaucoma or the control of blood sugar in some patients with diabetes
about your alcohol use
if you are taking nonprescription or prescription medicines, including those for migraine, to address a possible life-threatening condition
if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk
if you are pregnant, plan to become pregnant during therapy, or are breastfeeding an infant

While taking Cymbalta, talk with your healthcare provider:

if you have itching, right upper belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported
if you have high fever, confusion, and stiff muscles to address a possible life-threatening condition
before stopping Cymbalta or changing your dose
if you experience dizziness or fainting upon standing, especially when first starting Cymbalta or when increasing the dose.
about your blood pressure. Cymbalta can increase your blood pressure. Your healthcare provider should check your blood pressure prior to and while taking Cymbalta
if you experience headache, weakness, confusion, problems concentrating, memory problems, or feel unsteady while taking Cymbalta which may be signs of low sodium levels
if you develop problems with urine flow

If you have any questions, talk to your healthcare provider before taking Cymbalta.

What are the possible side effects of Cymbalta?

In clinical studies of depression, the most common side effect of Cymbalta was nausea. Other common side effects included dry mouth, constipation, decreased appetite, fatigue, sleepiness, and increased sweating. This is not a complete list of side effects.