Fibromyalgia
Fibromyalgia affects about 4 million US adults, about 2% of the adult population. The cause of fibromyalgia is not known and there is no long-term cure, but it can be effectively treated and managed. Treatments tend to suppress or decrease pain, improve muscle or joint function, or help avoid triggers that can worsen the symptoms. Some methods of treatment aim to minimize the symptoms of the disease, such as administration of pain killers or anti-depressants. People with fibromyalgia may be more sensitive to pain than people without fibromyalgia; this is called abnormal pain perception processing. While drugs are often the first line of treatment, there are other approaches that people find to be equally effective. Many non-medical treatments focus on preventing flare-ups or helping decrease painful episodes.
Treatment
Heat, especially moist heat, may relieve soreness and stiffness from fibromyalgia by boosting blood flow to the places where pain or discomfort is felt. Applying a warm, moist cloth to the painful areas, taking a warm shower, or soaking in a bath may abate symptoms. Some patients may also reduce the deep muscle pain of fibromyalgia with a cold pack. Trial and error can be used to determine the best level of comfort in the patient.
Aerobic exercise can improve overall function and quality of life for people with fibromyalgia, Thirty to sixty minutes of low impact exercise such as swimming, bicycling, or walking may improve symptoms.
Diet
Certain foods may cause exacerbation of symptoms in fibromyalgia. These foods include those containing aspartame, caffeine. sugar, MSG, sodium nitrites, dairy and gluten. The direct nature of these factors is not known. Patients should be advised to abstain from foods that cause symptoms to flare up.
Behavioral therapy
Chronic pain may manifest in behavioral issues within a patient. Patients who exhibit altered behavior should receive a full psychological evaluation along with biofeedback and sleep disorder studies.
Drug therapy
Duloxetine
Approved by the FDA for fibromyalgia, duloxetine is an antidepressant that increases the activity of serotonin and norepinephrine, which in turn halt pain signals from reaching the brain. Over half of people who try it will see a reduction in their pain levels by 30% to 40%. It also can help relieve coexisting depression and fatigue. Some side effects of this medication may include nausea, constipation, diarrhea, fatigue, headache, and insomnia.
Milnacipran is very similar to duloxetine. It is an antidepressant, and is the most recent FDA-approved drug for fibromyalgia.
Pregabalin is a seizure medication that reduces the release of pain signals from nerves, and may have spillover benefits on sleep quality. Pregabalin is effective only in some patients; only 30 percent of people treated have a positive response. Side effects may include dizziness, sleepiness, headache, dry mouth, difficulty concentrating, nausea, and vomiting.
All of these medications have serious complications and should be evaluated based on the patient’s needs and other health conditions. If a patient experiences side effects from their medication, they should consult their physician.
References:
Fibromyalgia. (2018). CDC. Retrieved from https://www.cdc.gov/arthritis/basics/fibromyalgia.htm.
Fibromyalgia. Retrieved from https://www.mayoclinic.org/diseases-conditions/fibromyalgia/diagnosis-tr…
Fibromyalgia. Retrieved from https://medlineplus.gov/ency/article/000427.htm.
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