Treatment
Because the cause of fibromyalgia is not understood, treatment options are not as clearly established as for other disorders for which there is an accepted cause. With a chronic condition like fibromyalgia, it is important to establish a strong partnership between doctor and patient with good communication. Treatment will be individualized; there may need to be a period of trialand error and a multi-faceted approach in order to achieve improvement in thepatient's condition.
- Physical Therapy and Exercise: Physical activity increases a sense of well being, and reduces fatigue and pain. Strength training and low-impact aerobic exercise have been proven effective inraising the pain threshold.
- Walking, biking, swimming are all beneficial
- Start slowly and increase the time spent exercising each week
- It is best to work with a physical therapist or other professional to supervise your progress and provide encouragement
- Diet: Eating a healthy, well balanced diet is particularly important for fibromyalgia patients.
- Low animal fat, high fiber
- Plenty of fresh fruits, vegetables, and whole grains
- Eliminating common food allergens and additives has been observed to be helpful for some patients
- Talk to your doctor about adding omega-3 fatty acids supplements to your diet
- Lyrica (pregabalin): On June 21, 2007 the U.S. Food and Drug Administration (FDA) approved Lyrica for adults ages 18 years and older to treat fibromyalgia. This medication was already in use for the treatment of epilepsy and neuropathic pain. Lyrica reduces pain and improves function. Side effects are dizziness and sleepiness
- Gabapentin (Neurontin): This drug is also an anticonvulsant that blocks the neurotransmitter gamma aminobutyric acid (GABA). Gabapentin is used to treat other forms of neuralgia. Clinical trials are being done to test its effectiveness for fibromyalgia
- Selective Serotonin-Reuptake Inhibitors (SSRI): These increase levels of the neurotransmitter serontonin in the brain which increases sleep and asense of well-being while decreasing fatigue. Side effects are nausea and agitation and loss of libido.
- Dual Inhibitors: Dual inhibitors affect uptake in the brain of the neurotransmitters norepinephrine and serontonin. This class of medications may help with the treatment of fibromyalgia by blocking the transmission of pain signals and helping promote sleep.
- Other: Trazadone (Desyrel) is an antidepressant that has been helpful in fibromyalgia. Side effects are priapism, allergy, and mood changes.
- Cyclobenzaprine (Flexeril) is sometimes used to relieve muscle spasms on a short term basis. Side effects are drymouth, dizziness and drowsiness.
- Sleep promoting agents
- Difficulty sleeping or insomnia are typical complaints for fibromyalgia sufferers, contributing to the cycle of fatigue, depression and pain. Zolpidem (Ambien) and Zaleplon (Sonata) may be used short term to promote sleep and help break the cycle.
- Psychotherapy
- Cognitive-Behavioral Therapy (CBT): CBT is asystem for working with one's personal self-limiting thoughts and behaviors to manage a disease condition more effectively
- Sessions may not be covered by insurance
- Sessions are usually 45 minutes to one hour: 6 to 30 sessions may be recommended
- Group Therapy: Supportive sessions managed by a professional therapist with others suffering from fibromyalgia may help you discover new coping techniques.
Alternative Therapies and Self Care Management
Living with fibromyalgia is complex and demanding. But there are things you can do to control the condition rather than allowing it to control your life.
- Exercise Regularly
- Practice good sleep: Go to bed at regular hours and avoid daytime naps. Have a regular sleep plan.
- Reduce stress :Avoid undue stress in your life while remaining active and engaged in the world. Isolating yourself from others is not the answer! Practice deep breathing, relaxation technique, meditation or mindfulness.
- Acupuncture: This Chinese medicine technique has been used for thousands of years. It may be effective in treating fibromyalgia.
- Massage Therapy: Massage helps the body relax and improves local circulation.
- Connect with others: Seek support from others with the same problem or others who are empathetic to your situation.
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