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Fibromyalgia Health Center

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What Is Fibromyalgia?

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What Tests Are Used to Diagnose Fibromyalgia? continued...

Other laboratory tests used to rule out serious illnesses may include Lyme titers, antinuclear antibodies (ANA), rheumatoid factor (RF), erythrocyte (red blood cell) sedimentation rate (ESR), prolactin level, calcium level, and vitamin D level.

Your doctor may see if your symptoms satisfy the diagnostic criteria for fibromyalgia syndrome outlined by the American College of Rheumatology. These criteria include widespread pain that persists for at least three months. Widespread pain refers to pain that occurs in both the right and left sides of the body, both above and below the waist, and in the chest, neck, and mid or lower back. The criteria also include the presence of tender points at various spots on the body.

The doctor will evaluate the severity of related symptoms such as fatigue, sleep disturbances, and mood disorders. This will help measure the impact FMS has on your physical and emotional function as well as on your overall health-related quality of life.

What Is the Standard Treatment for Fibromyalgia?

There is no fibromyalgia cure. And there is no treatment that will address all of the fibromyalgia symptoms. Instead, a wide array of traditional and alternative treatments has been shown to be effective in treating this difficult syndrome. A treatment program may include a combination of medications, exercises -- both strengthening and aerobic conditioning -- and behavioral techniques.

What Drugs Are Used to Treat Fibromyalgia?

According to the American College of Rheumatology, drug therapy for fibromyalgia primarily treats the symptoms. The FDA has approved three drugs to treat fibromyalgia: Lyrica, Cymbalta, and Savella. The FDA says Lyrica -- which is also used to treat nerve pain caused by shingles, diabetes, and spinal cord injuries -- can ease fibromyalgia pain for some patients. Cymbalta and Savella are in a class of drugs known as serotonin and norepinephrine reuptake inhibitors (SNRIs).

Low doses of tricyclic drugs such as Flexeril and amitriptyline have been found effective in treating the pain of FMS. In addition, positive results have been shown with the antidepressants known as dual reuptake inhibitors (Effexor). Ultram is a pain-relieving medicine that can be helpful.

Your doctor may prescribe an antidepressant such as Prozac, Paxil, or Zoloft. These drugs may help relieve feelings of depression, sleep disorders, and pain. Recently, researchers have found that the antiepileptic Neurontin is promising for fibromyalgia treatment.

The nonsteroidal anti-inflammatory drugs (NSAIDs), including Cox-2 inhibitors, have not been found to be effective for treating FMS pain. It's usually best to avoid opioid pain medications because they tend not to work well in the long-run and can lead to problems with dependency.

Are There Alternative Treatments for Fibromyalgia?

Alternative therapies, although they are not well-tested, can help manage the symptoms of fibromyalgia. For instance, therapeutic massage manipulates the muscles and soft tissues of the body and helps ease deep muscle pain. It also helps relieve pain of tender points, muscles spasms, and tense muscles. Similarly, myofascial release therapy, which works on a broader range of muscles, can gently stretch, soften, lengthen, and realign the connective tissue to ease discomfort.

The American Pain Society recommends moderately intense aerobic exercise at least two or three times a week. They also endorse clinician-assisted treatments, such as hypnosis, acupuncture, therapeutic massage, and chiropractic manipulation for pain relief.

Along with alternative therapies, it's important to allow time each day to rest and relax. Relaxation therapies -- such as deep muscle relaxation or deep breathing exercises -- may help reduce the added stress that can trigger fibromyalgia symptoms. Having a regularly scheduled bedtime is also important. Sleep is essential to let the body repair itself.

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WebMD Medical Reference

Reviewed by David Zelman, MD on June 06, 2013
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