Fibromyalgia Treatment Overview
Because there is no known cure for fibromyalgia, treatment efforts are generally centered around relieving symptoms and improving quality of life. A multi-disciplined approach, which includes a combination of medication, alternative/complementary therapies, nutritional supplements, exercise and lifestyle adaptations, seems to work best for most patients.
In treating FM, it's important to remember that what works well for one individual may not work at all for another. Finding an effective FM treatment plan is usually a matter of trial and error. It's essential for the doctor, patient, and other health care professionals to work together as a team to develop an effective individualized treatment plan.
There are currently three FDA-approved drugs for the treatment of fibromyalgia:
- Lyrica (pregabalin)
- Cymbalta (duloxetine)
- Savella (milnacipran)
A number of other drugs are also prescribed off-label for FM. They typically fall into these categories:
- Muscle relaxants
- Anti-anxiety medications
- Sleep aids
- Narcolepsy medications
For more detailed information, see Medications for Fibromyalgia.
Alternative/complementary therapies have become very popular among fibromyalgia patients seeking better, more effective and more natural methods to reduce their pain, fatigue and other FM symptoms. Numerous complementary therapies have been studied and have proven to be effective in helping some FM patients manage their symptoms. These include:
- Massage Therapy
- Myofascial Release Therapy
- Tai Chi
For more detailed information, see Alternative and Complementary Therapies for Fibromyalgia.
Many fibromyalgia specialists recommend nutritional supplements for their patients. In his book Fibromyalgia: Up Close & Personal
, Dr. Mark Pellegrino says, "Over the years I've used a lot of supplements in the treatment of fibromyalgia, and I believe they are effective in many patients. Not all patients benefit, but in general supplements are safe to try and, if they help, are relatively inexpensive to continue. Today nutritional supplements are one of the most important treatments I recommend for fibromyalgia."
Some supplements commonly recommended for the four primary symptoms of FM include:
- Pain - Magnesium and malic acid, vitamin D3, 5-HTP, MSM, Boswellin, Curcumin, White Willow Bark and Glucosamine and Chondroitin.
- Fatigue - CoQ10, Vitamin B12, NADH, D-Ribose and Bovine Colostrum.
- Sleep Problems - Melatonin, Valerian, Lemon Balm, Passion Flower and GABA.
- Cognitive Problems (Fibro-fog) - Ginkgo biloba, acetyl-l-carnitine, vinpocetine and phosphatidyl serine.
For more detailed information, see Nutritional Supplements for Fibromyalgia.
Numerous studies done over many years have repeatedly found that exercise helps reduce fibromyalgia pain and fatigue and improve overall quality of life. But because of that pain and fatigue, many FM patients find it difficult to even think about exercising.
The problem is that without exercise, muscles become deconditioned, causing the pain and stiffness to get worse. The best solution seems to be a very gentle, slowly graded exercise program. With the right approach, it is possible for people with FM to develop a successful exercise plan.
Some keys to developing your own fitness plan include:
- Choose an activity that you enjoy and that is fibro-friendly.
- Start very slowly and increase your activity gradually.
- Set goals that are right for you.
For more detailed information, see Exercise for Fibromyalgia.
Lifestyle changes are essential for the effective management of fibromyalgia. Making positive lifestyle changes lays a good foundation upon which other treatment plans can be built. Some suggested lifestyle adaptations include:
- Get more rest. However, it's best to avoid complete bed rest if at all possible because it will lead to deconditioned muscles, which will increase pain and stiffness.
- Learn to pace your activities and follow a manageable daily routine.
- Reduce physical and emotional stress as much as possible.
- Improve your nutrition. It is generally recommended that FM patients avoid alcohol, caffeine, sugar and food additives. Many fibromyalgia patients find a high protein, low carbohydrate diet to be most effective.
- Remember to breathe deeply and practice relaxation techniques.
In addition, take note of which things you do that cause you to have a flare. Consider keeping a log or journal. Jot down what you do and your pain and fatigue levels each day so you can watch for patterns.
The Fibromyalgia Diet: HELP! I Don't Know What to Eat - By Sue Ingebretson
Pacing: What It Is and How to Do It - By Bruce Campbell, PhD