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Fibromyalgia Treatment Options

What's Available & How it Works

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Updated June 12, 2014

A lot of different fibromyalgia treatment options are available, and each of us needs a customized treatment regimen. It's important to work with your doctor(s) to find what works for you. It can take a lot of experimentation to find your ideal combination of treatments.

A Multidisciplinary Approach

Some experts say the best approach is multidisciplinary. That means a team of professionals with different skill and specialties finding what works best for each patient. The suggested team includes:

  • Rheumatologist
  • Medical psychologist
  • Physical therapist
  • Massage therapist
  • Exercise physiologist

Medications

Prescription drugs are often the first treatment people try. However, many of us are sensitive to medications and have a high likelihood of side effects, so experts recommend using the lowest possible dose.

The only medications officially approved for us are Lyrica (pregabalin), Cymbalta (duloxetine) and Savella (milnacipran). Doctors frequently prescribe a variety of other drugs as well.

Treating Sleep Problems

Better sleep is proven to alleviate symptoms, so solving sleep problems is a common part of the treatment regimen and sleep medications are often a part of that.

It's hard enough to sleep when you're in pain, but the sleep problems that can go along with fibromyalgia are more complicated that that. Many of us also have chronic fatigue syndrome and sleep disorders such as insomnia.

Getting treatment for sleep disorders can help alleviate your symptoms. If you suspect you may have a sleep disorder, you should talk to your doctor about getting a sleep study.

Depression:

Researchers aren't sure whether we're often clinically depressed because of our symptoms or because the two conditions have a common physiological cause (or both.) It's important to watch for signs of depression and to talk to a doctor if you think you are depressed. You may benefit from antidepressant drugs, counseling, or both.

Antidepressant drugs are a common fibromyalgia treatment, in people with or without depression.

Treating other symptoms:

Drugs that typically aren't effective:

With the possible exception of steroids, these drugs aren't considered detrimental, they're just generally not effective for fibromyalgia. It is OK to take them for other conditions. Some people with fibromyalgia have bad reactions to steroids, while others do not.

 

Trigger-Point Injections

A trigger point differs from the tender points used to diagnose fibromyalgia. Trigger points are tight, ropy bands of muscle that form when a muscle does not relax properly. They're often formed as a result of physical trauma, but doctors don't yet understand why some people develop them while others do not. The trigger point can irritate or trap nerves and cause what's called referred pain, which is pain felt elsewhere along the nerve. Frequently, you can feel a trigger point just below the skin, and if you push on it you could cause an involuntary twitch.

Trigger-point injections (TPIs) are sometimes used to treat these extremely painful areas. The doctor inserts a small needle directly into the trigger point and injects a local anesthetic such as lidocaine or procaine. (Doctors frequently use corticosteroids as well, but these drugs are not recommended for us.) The injection can cause a twitch or pain that last for up to a few minutes. Patients typically report lasting relief after just a few treatments.

Acupuncture & Bodywork as Fibromyalgia Treatment

Acupuncture is a traditional Chinese technique that has become more popular in the U.S. over the past 20 years. According to the Mayo Clinic, scientists don't fully understand how acupuncture works, but some studies have shown it to be medically beneficial in many ways, including pain reduction. The specific acupuncture technique used to treat pain is sometimes called dry needling and is performed by certified acupuncturists and some physicians.

When performed correctly, acupuncture is considered a low-risk procedure with few side effects, and it can be used either alone or in combination with other treatments. Possible side effects include soreness, bleeding or bruising at the needle sites, and feeling tired after a session. In rare cases, an internal organ could be injured.

Several other alternative/complementary treatments are used as fibromyalgia treatments as well, including massage, reiki and other types of bodywork; and mind-body treatments such as biofeedback, cognitive behavioral therapy and hypnosis. Some of these treatments are supported by scientific evidence, while others are not. Still, even where there's not scientific evidence, many people report success from these kinds of fibromyalgia treatments.

Experimental Protocols

Several doctors and researchers have developed treatment protocols that are backed by little or no scientific evidence. These doctors/researchers and many of their patients claim the protocols work.

Other patients, however, say the protocols weren't successful for them, and some experts say the protocols are little more than placebos and could even harm your health. It's important to involve your doctor in any decisions you make on untested treatments.

Sources:

Healthcommunities.com, Inc., Aug. 8, 2007. All rights reserved. "Trigger Point Injections"

Regina P. Gilliland, MD, Department of Internal Medicine; Division of Rehab Medicine, Mobile Infirmary Medical Center "Fibromyalgia"

Mayo Foundation for Medical Education and Research, June 16, 2006. All rights reserved. "Acupuncture"

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