Currently, there is no cure for fibromyalgia, but there are many steps you can take to understand your condition and manage your symptoms. Treatment is focused on managing pain, fatigue, depression, and other symptoms common in fibromyalgia in an attempt to break the cycle of increased sensitivity to pain and decreased physical activity. Every person may respond to a different combination of treatments.

Treatment may include:

• Medicines to help you sleep better, relax muscles, or relieve muscle and joint pain. Medicines your doctor may suggest include tricyclic antidepressants, SSRIs, SNRIs, muscle relaxants such as cyclobenzaprine (Flexeril), anticonvulsants (also called antiepileptics) such as pregabalin (Lyrica), mixed (or dual) reuptake inhibitors or, less often, nonprescription pain relievers.
• Exercise therapy to relieve sore muscles and increase energy.
• Cognitive-behavioral therapy to help you learn to manage your pain.

Home treatment is also a vital part of managing fibromyalgia. Your efforts to get regular exercise, improve your sleep habits, and reduce stress are as important to your treatment as any medicine your doctor may prescribe.

Initial treatment

If you have just been diagnosed with fibromyalgia, your initial treatment goals might include:

• Starting a program of regular physical exercise. Getting consistent exercise, especially cardiovascular exercise, is one of the best ways to manage fibromyalgia. Pool exercise has been found to be particularly effective for many people.⁴ It's important to progress your exercise program slowly so you don't get sore muscles that cause you to want to stop exercising; working with a physical therapist familiar with fibromyalgia may be helpful.¹
• Identifying sleep problems, if you have them, and learning about ways to get more restful sleep.
• Relieving pain and stiffness with medicines and heat.
• Identifying "triggers" that seem to make your symptoms worse and learning to avoid or manage them. A trigger can be anything you've noticed that increases your symptoms. Triggers may relate to the weather, particular activities, stressful events, or lack of sleep.
• Starting a program of cognitive-behavioral therapy to help you learn to relax, reduce stress, and manage your pain. This can help decrease pain and fatigue, and it can improve your mood and ability to function.⁴

With some guidance and instruction, you will be able to start working on most of these goals at home. You may have a team of health professionals to help you. The team may include your family medicine doctor, a rheumatologist or endocrinologist, a physical therapist, and a psychologist.

Ongoing treatment

Exercise, sleep, and stress reduction can be extremely helpful in controlling your symptoms. Symptoms of fibromyalgia come and go repeatedly, so it is important to maintain your home treatment efforts over the long term.

Prescription medicines can be helpful for certain symptoms, including pain and sleep problems. Talk with your doctor if you think the medicines you are taking are not helping. There may be other alternatives. Remember that your need for medicine may change over time.