Fibromyalgia is difficult to treat because symptoms are so varied. Treatment typically involves addressing key symptoms of fibromyalgia, including widespread chronic pain and debilitating fatigue. Fortunately, there are several treatment options that can help you find relief from fibromyalgia symptoms.
Treatment for fibromyalgia usually requires a team approach. The team may include your doctor, a physical therapist, and perhaps even a psychologist.
This team approach is important because you may need a comprehensive plan to treat your fibromyalgia.
In-depth Articles on Fibromyalgia Treatments
- Alternative treatments
- How what you eat can help your fibromyalgia: the fibromyalgia diet
- Lifestyle changes
- Physical therapy
- Mental and emotional therapy
Medications are generally the first line of treatment. But before starting any medication—even if it's an over-the-counter medication—discuss it with your doctor. It may have side effects or interactions with other medications you're taking.
Prescription Medications for Fibromyalgia
Fibromyalgia has no known cure, but there are many prescription medications that can address your symptoms. Your doctor will explain your medication options to you and will find the best option for you.
Three prescription medications are FDA-approved to treat fibromyalgia: pregabalin (Lyrica), duloxetine (Cymbalta, others), and milnacipran (Savella).
Lyrica is an anti-epileptic, and Cymbalta and Savella are anti-depressants. However, these medications are not your only options for treating fibromyalgia—there are a variety of medications that can treat your symptoms.
- Anti-depressants: These medications work to block pain messages from getting to your brain. There are 3 different categories of anti-depressants: tricyclic anti-depressants, serotonin and norepinephrine reuptake inhibitors (SNRIs), and selective serotonin reuptake inhibitors (SSRIs). They each work in different ways.
Some examples of tricyclic anti-depressants for fibromyalgia are: amitriptyline hydrochloride (Elavil) and nortriptyline (Pamelor). Examples of SNRIs for fibromyalgia are: duloxetine (eg, Cymbalta) and milnacipran (eg, Savella). And examples of SSRIs for fibromyalgia are: fluoxetine hydrochloride (Prozac) and sertraline hydrochloride (Zoloft).
- Anti- epileptics (anti-convulsants or anti-seizures): These medications slow down nerve signals going to your brain, so the pain message isn't transmitted as well. Other than Lyrica, another example of an anti- epileptic for fibromyalgia is gabapentin (Neurotontin, Gralise, Horizant).
- Muscle relaxants: These medications are used to relax tense muscles and promote quality sleep. Muscle relaxants may also help reduce other aches and pains associated with fibromyalgia. An example of a muscle relaxant for fibromyalgia is cyclobenzaprine (eg, Cycloflex and Flexeril).
- Over-the-counter medications: Non-steroidal anti-inflammatory drugs (NSAIDs)—ibuprofen and aspirin—are not effective in treating fibromyalgia symptoms when used alone, but they may help decrease pain when used with another fibromyalgia medication. Acetaminophen can also be used to treat "ordinary" pains of fibromyalgia, such as headaches.
Other Treatments for Fibromyalgia
Besides medications, there are several other treatments for fibromyalgia. Aerobic exercise (especially water aerobics) and strength training can help reduce symptoms and improve conditioning.
Chiropractic treatment can work to reduce your pain, while physical therapy may help you manage pain and other symptoms as well.
To address the psychological aspects of pain, your doctor may recommend you visit a psychologist or psychiatrist. Because fibromyalgia can lead to anxiety and depression, a psychologist may help address these emotional factors. Cognitive behavioral therapy has been shown to be effective in decreasing emotional distress.
Complementary and alternative medicine (CAM) can also help treat your pain and other symptoms. Common CAM treatments are: acupuncture, massage, and meditation/relaxation training.
Additionally, other lifestyle tips can help with fibromyalgia:
- Get enough sleep: Aim for at least 8 hours every night.
- Exercise regularly: Physical activity increases your energy, strengthens your muscles, and helps you sleep better.
- Eat a variety of healthy foods: Eat plenty of fruits, vegetables, and whole grains.
Before beginning your fibromyalgia treatment plan, talk to your doctor about all of your treatments options. You may need to incorporate a variety of treatments to get maximum pain relief. The most successful treatment is one that combines multiple approaches and may include more than one doctor.