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This article contains an overview of various fibromyalgia treatments.
Fibromyalgia Treatments
When it comes to fibromyalgia treatments, there are medications, alternative remedies, and lifestyle habits that may help decrease fibromyalgia pain and improve sleep. Your fibromyalgia specialist may prescribe pain medication or antidepressants to help end the pain, fatigue, depression, and anxiety. In addition, your doctor may recommend regular physical therapy, moist heat and exercise, relaxation, and stress reduction to help you self-manage your symptoms.
There is no one “pill” that treats or cures fibromyalgia. And 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 include it in this group of arthritis and related disorders. But unlike the pain with these other conditions that is localized to a single area, the feelings of pain and stiffness with fibromyalgia are very widespread with 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 with weakness, but bed rest does not seem to help. Many people with fibromyalgia tell of sleeping 8 to 10 hours at night and feeling as it they haven't slept at all.
Some medications may help ease the fatigue 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.
Does exercise help ease fibromyalgia symptoms?
Numerous studies show that exercise is one of the most important treatments for fibromyalgia. Many people with fibromyalgia are unfit. They avoid exercise because they fear increased pain. Yet aerobic or conditioning exercise helps relieve pain and depression.
Regular exercise increases the body’s production of endorphins, natural opioids that boost mood and decrease pain. Starting slowly and gradually increasing the duration and intensity of exercise can help you enjoy the benefits of exercise with fibromyalgia without feeling more pain.
For in depth information, see WebMD’s Fibromyalgia and Exercise.
How does physical therapy help fibromyalgia symptoms?
Physical therapy can help relieve fibromyalgia pain and stiffness. Regular visits with a licensed physical therapist can increase confidence with exercise, help relax tense muscles, and teach you more about your body and movement.
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 medications treat fibromyalgia symptoms?
According to guidelines from the American Pain Society, antidepressants are recommended as first-line treatment for fibromyalgia. These medications can affect multiple symptoms -- pain, fatigue, depressed mood, and sleep disturbances.
According to the guidelines, older tricyclic antidepressants as well as newer antidepressants can provide effective symptom relief. They won’t, though, eliminate all the pain.
The anti-convulsant drug, 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 anti-convulsants are sometimes used to treat fibromyalgia.
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 most common side effects include nausea, dry mouth, and constipation. It can also cause insomnia and dizziness.
The FDA has also approved Savella for treating fibromyalgia. Savella -- like Cymbalta -- is in the class of drugs known as SNRIs.
Medications that increase restful sleep may help treat fibromyalgia symptoms. These medications include low doses of antidepressant medication such as amitriptyline taken before bedtime. Other kinds of sleeping pills are 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 Tylenol (acetaminophen) 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 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 therapies, 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.
Fibromyalgia Treatments
Can alternative treatments help fibromyalgia?
With fibromyalgia pain so debilitating, you may wonder about the effectiveness of alternative therapies to ease your discomfort. Some people with the chronic pain of fibromyalgia do find good relief with alternative therapies, 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 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.
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.
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 believe 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 “you don’t know what you’re getting when you buy it.”
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.
Reviewed by Matthew Hoffman, MD on April 30, 2008
© 2008 WebMD, LLC. All rights reserved.
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