Fibromyalgia Treatment

Being diagnosed with fibromyalgia is not a dead end. Despite the illness, it is still possible to enjoy a good quality of life. We'll explain the most important treatments below.
Fibromyalgia Treatment

Last update: 16 December, 2022

Even though there’s currently no cure for the disease, there is fibromyalgia treatment. This can help the person cope with the symptoms, understand the disease better, and, of course, enjoy a good quality of life.

Previously, it was commonly believed that people diagnosed with fibromyalgia couldn’t lead an active lifestyle and a normal routine, and that they had to be “always” resting in bed.

However, over time, it has become clear that good fibromyalgia treatment can greatly help a person lead and enjoy a normal life.

Fibromyalgia can be very heterogeneous, and practically no two cases are the same. Each one has their own set of peculiarities and, therefore, the prescribed treatment is completely personalized.

Even so, we can mention some general aspects that you can include in the fibromyalgia treatment to a greater or lesser degree. Keep reading!

Over-the-counter fibromyalgia treatment

Fibromyalgia treatment includes drugs.
Many of the medications for fibromyalgia treatment are easily accessible and with a low risk of adverse effects.

Taking into account that chronic and generalized pain is a very common symptom in fibromyalgia, in some cases it may be necessary to use non-opioid pain relievers (such as paracetamol and non-steroidal anti-inflammatory drugs, such as ibuprofen) to obtain the relief.

Now, pain relievers are not a definitive solution to pain. According to the Patient Guide to Chronic Fatigue Syndrome & Fibromyalgia, the following should be taken into account:

  • No medicine is always helpful.
  • Pain relievers become less effective as the body gets used to them.
  • Non-opioid pain relievers are considered safe for people with fibromyalgia and chronic fatigue syndrome.
  • Opioid or narcotic analgesics should be avoided, given the associated risks that their use entails.
  • Prescription medications that improve sleep can also have a beneficial effect on pain.

Prescriptions

The American College of Rheumatology notes that 3 medications have been approved for the treatment of fibromyalgia by the US Food and Drug Administration.

  • Duloxetine (Cymbalta)
  • Milnacipran (Savella)
  • Pregabalin (Lyrica): This drug helps to block the overactive nerve cells that transmit pain. However, it must be used with caution because it can cause various side effects such as dizziness, bloating, drowsiness, and weight gain.

Both duloxetine and milnacipran change some of the chemicals in the brain (serotonin and norepinephrine) that help control pain levels.

Antidepressants

Since fibromyalgia can lead to sleep problems and mood disorders (such as depression and anxiety), the prescription of antidepressants may be necessary. Specifically, tricyclic antidepressants or cyclobenzaprine. Amitriptyline, fluoxetine (Prozac), and paroxetine (Paxil) are common.

These medications help improve sleep and mood, but must be combined with psychotherapy and other measures to provide real benefits in the medium and long term.

Tricyclic antidepressants contribute to the inhibition of serotonin and norepinephrine reuptake. In addition, they have an antagonistic action on histamine receptors, as indicated by a study published in Elsevier (article in Spanish).

Anticonvulsants

In the previously cited study, it’s also stated that “the most researched anticonvulsant drugs in patients with fibromyalgia and other rheumatic diseases have been gabapentin and pregabalin.” However, the evidence is still limited and it’s necessary to go further to clarify its efficacy in the treatment of fibromyalgia.

It’s important to inform the patient about the possible side effects of the medications prescribed. Nausea, dizziness, headache, and other complaints could be some of the most common.

Muscle relaxants

Muscle relaxants (cyclobenzaprine [Cicloflex, Flexeril, Flexiban]) can help relieve pain and promote relaxation at bedtime. Another muscle relaxant that could be used for the same purpose is Zanaflex (tizanidine).

Non-pharmacological treatment: psychotherapy

Fibromyalgia treatment includes mental therapy.
Cognitive behavioral therapy and other psychotherapy approaches may be helpful in treating fibromyalgia patients.

In relation to the non-pharmacological treatment of fibromyalgia, the American College of Rheumatology states that psychotherapy is valuable, and more specifically, cognitive behavioral therapy because it “focuses on understanding how thoughts and behaviors affect pain and other symptoms “.

  • Addressing anxiety, depression and other psychological problems (or psychiatric, such as bipolar disorder) is essential to ensure the well-being of fibromyalgia patients.
  • In therapy, the patient can learn to manage their thoughts, emotions, and feelings, as well as tools to develop a healthy, beneficial self-dialogue that doesn’t foster distressing and negative thoughts.

Lifestyle and home remedies

It’s important for the person to learn to maintain good sleep hygiene and other healthy lifestyle habits in order to be able to ensure well-being on a day-to-day basis.

When it comes to exercise, the American College of Rheumatology states that:

  • Any drug treatment must be accompanied by an exercise plan and other non-drug strategies that contribute to well-being.
  • Regular aerobic exercises have proven to be the most beneficial.
  • Low-impact physical exercise is also highly recommended. It won’t be harmful even when the person notices some pain.
  • Tai Chi and yoga can alleviate some symptoms, improve postural hygiene, and manage emotional tension better, which in turn contributes to overall well-being.

Some home remedies can be useful as adjuncts in the treatment of fibromyalgia, especially warm compresses as they can provide relief. Massage and physical therapy can also be helpful.

As we have seen, in the treatment of fibromyalgia, it’s usually necessary to combine several therapeutic strategies so that the patient can enjoy a good quality of life.

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