There is no cure for fibromyalgia. Treatments are
prescribed to decrease pain, improve
muscle and joint function, and help avoid triggers that can worsen the
symptoms. While drugs are often the first line of treatment, there are other
approaches that people find to be equally effective, or at least helpful. These
non-medical treatments focus on preventing flare-ups.
Most people with fibromyalgia use a combination of treatment
A wide variety of drugs are used to treat fibromyalgia.
Some reduce pain, some relax tense muscles, some help with sleep, and some seek
to correct neurochemical imbalances. Many people take several drugs to relieve
symptoms. It can take some time and trial and error to find the right set of
medications for an individual patient.
The most commonly used pain-relieving drugs are
analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). Most of these
are found in both over-the-counter and prescription strengths. They include
common drugs like aspirin, ibuprofen (Advil), and acetaminophen (Tylenol).
Another drug used to relieve fibromyalgia pain is tramadol. This is a stronger
painkiller available only by prescription.
In rare cases, a doctor may prescribe opioid painkillers
for severe pain. These drugs carry a high risk of addiction if used for a long
period. Examples of prescription opioid drugs include:
- hydrocodone and acetaminophen (Vicodin)
- oxycodone (Oxycontin)
- oxycodone and acetaminophen (Percocet)
Anticonvulsants are drugs used to prevent seizures. They
calm overactive nerves and affect the pain transmission pathway, both of which
can help decrease symptoms. Types of anticonvulsants include:
- carbamazepine (Tegretol)
- divalproex (Depakote)
- gabapentin (Neurontin)
- oxcarbazepine (Trileptal)
Side effects of anticonvulsants vary but can include:
Muscle relaxants reduce pain and muscle soreness. They
can also help to relax the body and improve sleep. Prescription muscle relaxers
- carisoprodol (Soma)
- cyclobenzaprine (Flexeril)
- orphenadrine (Norflex)
- metaxalone (Skelaxin)
- methocarbamol (Robaxin)
Side effects of muscle relaxants include blurred vision,
dizziness, and drowsiness.
Benzodiazepines relieve anxiety, relax muscles, and improve
sleep. They are usually taken at bedtime because they cause drowsiness. Side
effects include drowsiness, confusion, impaired coordination, and depression.
It’s important to limit the use of these drugs because they can be addictive. They
- clonazepam (Klonopin)
- diazepam (Valium)
- temazepam (Restoril)
- alprazolam (Xanax)
If you have fibromyalgia, your sleep is likely affected.
Your doctor may prescribe a sleep aid. Sleep aids not only help you fall
asleep, they can also help you stay
asleep for longer periods and can
also promote deep sleep. Popular sleep aids include Lunesta, Sonata, and
Sleep aids can be habit forming. If you take them for a
long period and then stop abruptly, you may have anxiety and trouble sleeping.
Other side effects include:
Trigger Point Injections
To relieve severe pain, a doctor may inject a local
anesthetic such as lidocaine directly into a painful trigger point. This
effectively relieves pain, but only works for three to four weeks at most.
Like fibromyalgia, depression is associated with
imbalances in brain chemicals. Many drugs that affect these chemicals are used
for both depression and fibromyalgia. There are a number of antidepressant
groups that can help fibromyalgia symptoms.
These drugs keep levels of serotonin, norepinephrine,
and dopamine elevated. They include Elavil and Sinequan,
to name a few. Side effects may include drowsiness, dizziness, sexual
dysfunction, and weight gain.
Selective Serotonin Reuptake Inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) increase
serotonin levels and also keep it circulating in the brain for longer periods.
Popular SSRIs include Celexa, Prozac, Zoloft, and Paxil.
Side effects of these drugs include:
- sexual dysfunction
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
Serotonin and norepinephrine reuptake inhibitors (SNRIs)
work in a similar manner to SSRIs but affect both serotonin and norepinephrine.
They include Effexor and Cymbalta. Side effects include:
Making changes to your daily routines can help reduce
stress and improve sleep, both of which may reduce symptoms. In people with minor cases of
fibromyalgia, lifestyle changes can sometimes relieve symptoms all by
themselves. In other cases they changes can
complement drug therapy.
Learn to recognize and avoid stressful situations as
much as possible. Relieve daily stress with regular habits. Schedule time each
day to relax via deep breathing, meditation, or other methods.
Gentle exercise such as walking or swimming is known to
reduce stress. It can also help relieve pain by stretching and strengthening
muscles. Be careful to keep exercise at moderate levels. Overexertion can make
fibromyalgia symptoms worse.
A well-balanced diet and reduction or elimination of
caffeine can improve sleep and reduce fibromyalgia pain. Many people find that
certain foods aggravate their symptoms. They can reduce flare-ups by getting
rid of these foods.
Regular Sleep Pattern
Go to bed and wake up around the same time every
day. Improve your sleep environment by regulating temperature, removing distractions, buying
blackout shades, or getting a better mattress. Avoid caffeine, alcohol, and
sugar before bed.
Cognitive behavioral therapy is a common form of counseling
used in fibromyalgia. It teaches people to better recognize and deal with
stressful situations. There are many support groups for patients with
fibromyalgia that allow them to share their experiences and learn coping techniques.
Physical and Occupational Therapy
Physical therapy reduces muscle pain through stretching
and other training methods to strengthen muscles and improve movement.
Occupational therapy seeks to teach people new ways to perform everyday tasks
that avoid painful movements.
Massage can soothe sore muscles, reduce pain, and
improve sleep. Massage for fibromyalgia also often uses light stretching and
other physical therapy techniques.