Treating Fibromyalgia
Treatment

Because the symptoms of fibromyalgia wax and wane, treatment (as with that of other chronic diseases) is an ongoing process rather than management of a single episode. You and your doctor must work together to treat your fibromyalgia. Treatment should help ease your symptoms. Your doctor may have you take medicine to help you sleep and to reduce your pain. Good nutrition and regular sleep and mild exercise often help.

Treatment of fibromyalgia is largely your doctor relying on experience with other FMS patients and your imput. Not everyone with FMS is treated in the same manner. What works for one person may not work for you. Some frequently used approaches, such as antidepressants and exercise, have evidence to support their use, others (such as acupuncture) are less well studied.

A total elimination of pain is currently not possible in the majority of fibromyalgia patients.

Traditional treatments are geared toward improving the quality of sleep, as well as reducing pain. Because deep level (stage 4) sleep is so crucial for many body functions, such as tissue repair, antibody production, and perhaps even the regulation of various neurotransmitters, hormones and immune system chemicals, the sleep disorders that frequently occur in fibromyalgia and chronic fatigue patients are thought to be a major contributing factor to the symptoms of this condition. Medicines that boost your body's level of serotonin and norepinephrine--neurotransmitters that modulate sleep, pain and immune system function--are commonly prescribed.

Antidepressant Agents

The dosage of antidepressant must be individualized.

Tricyclics: Amitriptyline hydrochloride ;Doxepin ;Nortriptyline
SSRIs: Citalopram ;Fluoxetine ;Paroxetine;Sertraline
Other: Bupropion; Trazodone; Venlafazine; Nefazodone; Mirtazapime

Benzodiazepines

Temazepam; Aprazolam; Clonazepam; Lorazepam

Other

Cyclobenzaprine; Carisoprodol; Gabapentin; Modafinil; Orphenadrine; Tizanidine; Zaleplon; Zolpidem

Exercise

All fibromyalgia patients should have a home program with muscle stretching and gentle strengthening, and aerobic conditioning. FMS patients must avoid impact loading exertion such as jogging, basketball, aerobics, etc. Regular walking, the use of a stationary exercycle and pool therapy seem to be the most suitable activities for FMS patients to pursue.

Acupuncture

While not curative, acupuncture can enhance the patient's quality of life. The frequency of acupuncture is individualized and may range from weekly visits to visits once every 10 to 12 weeks. American Association of Medical Acupuncture

Opioid Analgesic Therapy

Opiates should never be the first choice for pain relief in fibromyalgia, but they should not be withheld if less powerful analgesics have failed.

Guaifenesin

Guaifenesin (guai) is usually an ingredient in cold preparations. Guai therapy for FMS is not simple. Doctors can’t just prescribe the medication and expect symptom remission. Dr. St. Amand’s website.Details on Guaifenesin therapy, plus a lot of information on fibromyalgia, read the book "What Your Doctor May Not Tell You About Fibromyalgia" by R. Paul St. Amand and Claudia Craig Marek.

Lifestyle Modifications & Education Learn what factors aggravate your symptoms and avoid them if possible. Become informed about your condition, from support groups, reading FMS newsletters & research articles. Your doctor may not always be up to date on the latest research & treatment options. You may have to educate your doctors.

Cognitive Behavior Training

A program of relaxation response training and movement therapy my be helpful to you.

Other Therapies

Growth Hormone Therapy; Chiropractic Treatment

Support Groups and Online Chat Rooms

Support from others like you is essential (in my opinion). You can find support resources here.



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