How is fibromyalgia treated?

Although there is no known cure for fibromyalgia (FM), a multi-disciplinary team effort using combined treatment approaches, including education, aerobic exercise, cognitive behavioral therapy and pharmacologic therapies have been shown to improve symptoms and function in people with FM. Helping people to identify which combination of these therapies makes the most impact on their quality of life can be part of a successful symptom self-management system. Education is paramount to the success of this kind of protocol, both for healthcare professionals as well as the person with fibromyalgia. A team approach is the key to the overall success of this type of program, but it takes time and effort for a busy doctor to create the team and then to monitor its success.

Identifying and treating painful comorbid or overlapping conditions is also an important part of any treatment regimen. If a person’s symptoms include irritable bowel and migraine headaches, then the treating doctor should concentrate on remedies for those disorders. Once their symptomology is under better control, the FM-specific symptoms might be more distinct and easier to treat. The difficulty with this approach is that most people with fibromyalgia have so many different symptoms, the doctor might be overwhelmed and not know where to begin in a successful treatment regimen. This problem accentuates the need for more doctor education which gives the tools necessary to identify overlapping conditions and what to do about them in the treatment of FM.

Along with appropriate medical care it is important for the person with fibromyalgia to recognize the need for lifestyle adaptation. Most people are resistant to change because it implies adjustment, discomfort and effort. However, in the case of FM, change can bring about recognizable improvement in function and quality of life. Becoming educated about the condition gives the person more potential for improvement.

The good news is that since 2007 when the first of three U.S. Food and Drug Administration (FDA) approved FM medications became available, continuing medical education programs focused on primary care doctors and other healthcare professionals have helped to broaden medical awareness about how to make an FM diagnosis and how to initiate effective treatment protocols.
Fibromyalgia (FM) can be hard to treat. It's important to find a doctor who has treated others with FM. Many family doctors, general internists, or rheumatologists can treat FM. Rheumatologists are doctors who treat arthritis and other conditions that affect the joints and soft tissues.

Treatment often requires a team approach. The team may include your doctor, a physical therapist, and possibly other health care providers. A pain or rheumatology clinic can be a good place to get treatment.

The U.S. Food and Drug Administration have not yet approved any medicines to treat FM. Doctors treat FM with medicines approved for other purposes. Pain medicines and antidepressants are often used in treatment.

This answer is based on source information from the National Women's Health Information Center.
Dawn Marcus
Most people with fibromyalgia do get better over time. There's no cure or quick fix, and improvement can take weeks to months -- but you can expect improvement. Fortunately, a wide assortment of effective nondrug therapies, prescription medications, and nutritional supplements are available for the management of fibromyalgia. You will need to experiment a bit to find out which treatment or combination of treatments works best for you. Most people use nondrug therapies, such as aerobic exercise and pain management techniques, but medications often are temporarily necessary and helpful in conjunction with nondrug treatments.
The Woman's Fibromyalgia Toolkit: Manage Your Symptoms and Take Control of Your Life

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The Woman's Fibromyalgia Toolkit: Manage Your Symptoms and Take Control of Your Life

The Woman's Fibromyalgia Toolkit tells readers what they need to know to take control of fibromyalgia symptoms. It includes step-by-step instructions for using effective non-drug treatments,...
Doctors usually recommend a multi-pronged approach to treating fibromyalgia that may include medications to relieve pain, help correct sleep problems and improve overall functioning. Support groups and psychological counseling may also be recommended to help people with fibromyalgia cope with symptoms of their condition. Doctors also encourage people with fibromyalgia to make healthy lifestyle choices such as exercising regularly, maintaining a regular bedtime and using stress-reduction techniques. Alternative therapies, such as massage or acupuncture, can also help manage fibromyalgia symptoms.
Dr. Mehmet Oz, MD
Cardiology (Cardiovascular Disease)

Fibromyalgia is a notoriously challenging condition to treat. However, there are a number of therapies to consider, so look for a doctor who understands the condition and can help you develop an effective treatment regimen. Your plan for managing fibromyalgia may include:

  • Medications. There are three drugs approved by the Food and Drug Administration for treating fibromyalgia. They are pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella). Your doctor may also prescribe antidepressants, which appear to relieve fibromyalgia symptoms even if you aren't depressed. Over-the-counter pain relievers may help, too. Depending on your symptoms, your doctor may prescribe other medications, in addition.
  • Sleep aids. Fibromyalgia can really mess up your shut-eye. Some fibromyalgia medications can help you sleep better. Following good sleep habits, such as avoiding caffeine and alcohol late in the day, can help you get some rest, too.
  • Exercise. Some fibromyalgia patients worry that exercise will worsen their symptoms, but research suggests that the opposite is true. Ask your doctor what level of physical activity is right for you.
  • Alternative treatments. With your doctor's consent, trying acupuncture, chiropractic, and dietary supplements may help you to keep pain and other symptoms under control.
Fibromyalgia can be treated with combined therapy which includes reduction of stress, plenty of rest, physical therapy including daily exercise and adequate nutrition may all be effective. Two newly approved medications: lyrica and cymbalta.
The U.S. FDA recently approved Lyrica (pregabalin) and Cymbalta (duloxetine) for the management of fibromyalgia.

A simple web search should help to identify fibromyalgia support groups.
Jacob Teitelbaum
Integrative Medicine
Five main categories of problems need to be treated - think "SHINE." These are the key areas that need to be treated for fatigue and pain to resolve.

SHINE stands for:
  • (S)leep
  • (H)ormonal deficiencies
  • (I)nfections
  • (N)utritional supplementation
  • (E)xercise as able
Sleep - Take herbal sleep aids. Because the hypothalamic "circuit breaker" that is offline controls sleep, most people with fibromyalgia need a mix of herbal sleep aids and prescription sleep treatments. For you to get well and pain free, it is critical that you take enough of the correct natural and prescription sleep treatments to get 8-9 hours sleep at night. Try using the natural aids first (take just before bedtime).

Hormonal deficiencies - Take adrenal nutrients and DHEA. The hypothalamus is the main control center, via the pituitary, for most of the glands in the body. It is usually necessary to treat with natural thyroid, adrenal, and ovarian and testicular hormones. These natural hormones have been found to be reasonably safe when used in low doses.

Nutrition - Take a multi-nutrient supplement and ribose. Widespread nutritional deficiencies are common, and require dozens of nutrients. In our recently published study, Ribose increased energy an average of 45% after 3 weeks in those with fibromyalgia or chronic fatigue syndrome.

Treat infections - Many studies have shown immune system dysfunction in fibromyalgia, which can result in many unusual infections. These include viral infections, parasites and other bowel infections, chronic Lyme and, most importantly, fungal/Candida infections.

Exercise as able - Do not push to the point of crashing the next day. Start by walking as long as you comfortably can (even if that is only 2 minutes). After 10 weeks on treatment, start to increase your walks by up to 1 minute more each day as able. When you are up to an hour of walking, you can increase intensity.

To find a physician specially trained in treating fibromyalgia, contact one of the Fibromyalgia and Fatigue Centers that are opening throughout the United States.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.