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 comes with the disease. In addition, your doctor may recommend physical therapy, moist heat, regular aerobic exercise, relaxation, and stress reduction to help you self-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.

For in depth information, see WebMD's Fibromyalgia Pain.

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 eight 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.

For in depth information, see WebMD's Fibromyalgia and Fatigue.

 

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.

For in depth information, see WebMD's Fibromyalgia and Exercise.

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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 you 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.

For in depth information, see WebMD's Fibromyalgia and Physical Therapy.

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 swelling and weight gain. 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 nausea, dry mouth, and constipation. It can also cause insomnia and dizziness.

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.

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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.

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.

For in depth information, see WebMD’s Fibromyalgia Medications.

 

Can Alternative Treatments Help Fibromyalgia?

With fibromyalgia pain being so debilitating, you may wonder about the effectiveness of alternative treatments to ease your discomfort. Some people with the chronic pain of fibromyalgia do find good relief with alternative treatments, including the following:

  • Acupuncture . Some findings show that acupuncture may alter brain chemistry and help increase pain tolerance.
  • Chiropractic . Chiropractic may improve pain levels, ease low back pain, and increase cervical and lumbar ranges of motion.
  • Deep tissue massage . Deep tissue massage may stimulate circulation and release chronic patterns of muscular tension.
  • Neuromuscular massage. Neuromuscular massage combines the basic principles of ancient Oriental therapies, such as acupressure and shiatsu, with specific hands-on deep tissue therapy to help reduce chronic muscle or myofascial (soft-tissue) pain.
  • Biofeedback. Using electronics to measure stress-related responses in the body, biofeedback helps some people control the stress response and relieves chronic pain, according to the National Institutes of Health.
  • Meditation . Studies show that meditation produces brain waves consistent with serenity and happiness, which help to relieve anxiety.
  • Tai Chi and qi gong. These are two Chinese practices that have been found to be helpful with some fibromyalgia symptoms including pain, sleep troubles, and depression.
  • Herbal remedies. Although there are few studies on herbal remedies and fibromyalgia, some patients report improved sleep or more energy with herbal supplements such as echinacea, black cohosh, lavender, milk thistle, and B vitamins.
  • Natural dietary supplements . While the studies are limited on natural dietary supplements and fibromyalgia, some patients have found relief with over-the-counter natural dietary supplements such as 5-HTP, melatonin, St. John’s wort, L-carnitine, SAM-e, and probiotics. Many of these, including St John’s wort, have drug interactions, so avoid these if you are on any prescription medications or on several supplements. Some may not be safe for you if you have other medical problems.

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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."

Talk to your doctor before trying any alternative or complementary treatments.

To learn more about alternative treatments for fibromyalgia, see WebMD’s Fibromyalgia and Alternative Treatment.

Also see WebMD’s Fibromyalgia and Medical Marijuana.

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, end up doing best.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on December 22, 2016

Sources

SOURCES:
Fibromyalgia Network: "Treatment Studies."
Arthritis Foundation: "Fibromyalgia: Treatment Options."
National Institute of Arthritis and Musculoskeletal and Skin Diseases: "Fast Facts about Fibromyalgia."
McIlwain, H. and Bruce, D. The Fibromyalgia Handbook, Holt, 2007.

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