There is no cure for fibromyalgia, but treatment aims to ease your symptoms as much as possible and to improve your quality of life. The symptoms of fibromyalgia tend to vary widely from person to person, so you may be treated for your condition by several different healthcare professionals. For example, you may be treated by your GP, a rheumatologist (a specialist in conditions that affect the muscles and joints), or a neurologist (a specialist in conditions of the central nervous system).
Fibromyalgia can be treated in several different ways, and it is likely that you will need more than one kind of treatment to ease your condition. However, all types of treatment may not be effective for everyone with fibromylagia. In most cases, fibromyalgia is treated using a combination of medicines, complementary therapies and lifestyle changes. See the ‘self help’ section for more information about treating your condition by changing your lifestyle. You may also find that joining a fibromyalgia support group can be a tremendousÂ source of comfort and support. See the ‘selected links’ section to find your nearest fibromyalgia support group.
Medicines for fibromyalgia
You may need to take several different types of medicines for fibromyalgia, including painkillers, antidepressants, and medicines to help you sleep. Painkillers: If you have fibromyalgia, you can treat your pain using simple painkillers, such as paracetamol. If paracetamol is not effective in easing your pain, your GP, or healthcare professional, may prescribe a stronger painkiller, such as codeine. You may also be prescribed a painkiller called tramadol, or one called nefopam. Both of these painkillers have been found to be effective in treating pain that is caused by fibromyalgia.
In some cases, in addition to your main painkiller, you may also be prescribed a non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen. However, you should avoid taking NSAIDs if you have asthma, high blood pressure, or kidney, or heart, problems. They are also unsuitable for you if you have, or have had, a stomach problem, such as a peptic ulcer. As well as easing pain, NSAIDs help to reduce inflammation. However, as fibromyalgia does not cause inflammation, they are not effective in treating the condition when taken on their own.
Antidepressant medicines for fibromyalgia are not prescribed specifically to treat depression. They are used to boost the levels of certain hormones, such as serotonin, noradrenaline (also known as norepinephrine), and dopamine. It is thought that low levels of these hormones may be a factor in causing fibromyalgia, and that raising their levels may help to treat the condition and ease the pain of your symptoms.
If you have fibromyalgia, there are many different types of antidepressant medicines that you may be prescribed. The choice of medicine may depend on the type of fibromyalgia that you have, and severity of your symptoms, plus any side effects that the medicines may cause. Antidepressants used to treat fibromyalgia include:
Tricyclic antidepressants (amitriptyline, nortriptyline and dosulepin) – these
are usually the first choice of antidepressant and raise levels of serotonin
and noradrenaline (norepinephrine) in order to ease pain and help you
Serotonin-norephinephrine reuptake inhibitors (venlafaxine and duloxetine) –
which raise levels of serotonin and noradrenaline (norepinephrine).
Venlafaxine also raises levels of dopamine, as well as serotonin and
Selective serotonin reuptake inhibitors (citalopram, fluoxetine and
paroxetine) – these only raise serotonin levels, so they are not often used.
There are also two other types of medicine that affect the levels of hormones which are sometimes used to treat fibromyalgia – a dopamine agonist called pramipexole, and a serotonin 5-HT3 receptor antagonist called tropisetron. Muscle relaxants and medicines to help you sleep. If you have stiffness, or spasms, in your muscles as a result of fibromyalgia, your GP, or health professional, may prescribe a muscle relaxant to help ease your symptoms. Muscle relaxants that are often used for fibromyalgia include medicines called tizanidine and carisoprodol. Tricyclic antidepressants (see above) can also help to relax your muscles. Muscle stiffness and spasms can also affect your ability to sleep, but even if you sleep all night, you may find that you still wake up feeling tired. This is because fibromyalgia can prevent you from sleeping deeply enough to fully refresh you.
If this is the case, your GP, or health professional, may recommend, or prescribe, an over-the-counter (OTC) sleep medicine, or herbal supplement, in order to help you sleep more deeply. If these medicines do not help, using one of the muscle relaxant medicines mentioned above may help you to sleep more deeply at night because they have a sedative (sleep-inducing) effect. There are also stronger medicines, such as zopiclone and zolpidem, which can help you sleep. However, you may only be able to use one of these medicines forÂ a short period of time because long-term use can end up disrupting your sleeping patterns even further.
Pregabalin is an anti-seizure medicine that has been found to be effective in treating several fibromyalgia symptoms, including pain and sleeping problems. You may be able to take pregabalin as a brand called Lyrica. However, pregabalin can cause a number of side effects, such as dizziness, blurred vision, and weight gain, so it may not be suitable for everyone.Complementary therapies for fibromyalgia.
There are a number of complementary therapies which may help to ease your symptoms of fibromyalgia. However, it is important to remember that there is little medical evidence to back up the effectiveness of these therapies, and that they may not work for everyone. Warm water therapy, such as swimming, gentle exercises in a warm pool, or simply having a warm bath, is a popular complementary therapy for people with fibromyalgia.
Some people also find that complementary therapies help to ease their pain, or fatigue, and help them to relax and manage their condition more effectively. Examples of complementary treatments that may help to ease symptoms ofÂ fibromyalgia include acupuncture (where thin needles are inserted into certainÂ points around the body to help relieve pain), aromatherapy (where essential oils are used for a therapeutic effect), massage, and osteopathy (which aims to healÂ your body by applying pressure).
There are also complementary therapies for fibromyalgia that focus on the mental and emotional aspects of the condition. Relaxation therapy, anxiety management techniques, counselling, cognitive behavioural therapy (CBT), or other ‘talking treatments’, can sometimes help some people to cope better with pain, fatigue, or other symptoms. If you decide to use a form of complementary therapy, always ensure that your therapist is a fully qualified and accredited member of the appropriate organisation – for example, the British Acupuncture Council (BAC).
Though hypnosis is not listed as a âcomplementary therapy for treating Fibromyalgia, in the self help section you will see that hypnosis can assist the client to deal with their condition by helping them to do what is best for them.