Pain Meds for Fibromyalgia: Poll Results
In a recent poll, I asked what pain meds work for you. The results are interesting, to say the least!
I asked the question in response to a survey that said many of us with fibromyalgia are taking drugs that whose effectiveness is "not supported by evidence."
According to research and online resources for doctors, tricyclic antidepressants are best supported by evidence, followed by SSRIs and SNRIs, with muscle relaxers, NSAIDs (anti-inflammatories) and narcotics (Vicodin, Percocet) shown to be less effective or ineffective.
My poll, however, seems to flip that right on its head! While it's not scientific, the results were pretty much the opposite of what research has shown. As of now, the results are:
- Narcotics - 32%
- Muscle relaxers - 20%
- NSAIDs - 14%
- SSRI/SNRIs - 11%
- Tricyclics - 8%
This reinforces my belief that studies about what works for us are skewed, both by the lack of properly identified subgroups and because those of us with other conditions are excluded. Why would that matter?
The biggest reason, I believe, is the source of pain. Fibromyalgia pain doesn't come from a single source -- it includes amplification of pain that's there from other sources, along with special types of pain that appear to be caused by the condition itself.
Many of us have secondary fibromyalgia -- fibromyalgia that developed because of other pain conditions, which (according to research) have sensitized our nervous systems and caused structural and chemical changes in our brain. We're the ones who started out with rheumatoid arthritis, lupus, or (like me) chronic myofascial pain. Because we have another pain condition, we don't qualify for studies.
For me, and I suspect for many other secondaries, narcotics, NSAIDs and muscle relaxers take away the pain from the primary condition, giving fibromyalgia less to amplify. That results in a major pain reduction that people with primary fibromyalgia may not experience.
I also think researchers need to be identifying subgroups, as many chronic fatigue syndrome researchers are doing. We've got primary, secondary, juvenile, post-traumatic, and post-viral fibromyalgia that all could respond differently to the same treatments. Our symptoms and severities are all over the map, so once you get into genomics, there's no telling how many subgroups we could have.
The moral of this story is: don't let anyone, doctor or not, tell you what pain medications will or won't work for you -- the only true indicator of effectiveness is your own experience.
This is always a contentious topic, so keep those comments coming and let me know what you think!
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Comments
Great post and poll. I agree!