Fibromyalgia Treatments

Medications, therapies, and lifestyle tips. Find what’s best for you.

As we’ve reviewed in our diagnostic overview of fibromyalgia (FM), there is no one test to determine the disease, and because symptoms become so varied among different patients, fibromyalgia is in turn difficult to treat. Like many disorders, treatment aims to manage or stop completely the key symptoms of fibromyalgia, such as the common widespread chronic pain, fatigue, or tenderness of muscles associated with the disease. Also, doctors are tasked with the job of reducing the impact that the condition has on one’s quality of life.

While there are several FDA-approved medications for the direct treatment of fibromyalgia (as well as numerous “off-label” treatment options, meaning they are used for but not FDA-approved for the condition), additional complementary non-medication therapies such as physical therapy, cognitive behavioral therapy (CBT), and acupuncture may also be used. Even self-management of your pain is important!

Thus, comprehensive fibromyalgia treatment usually involves several doctors to find much-needed relief. This team approach is necessary to manage the sometimes debilitating ups and downs of the disease. Being honest and open with your doctors will allow them to work with you to find a treatment plan that is individual to you, and can constantly mold to your needs as time goes on. Since medications are usually prescribed as a first-line treatment for fibromyalgia, discuss with your doctor which ones might be right for you, especially if you are already taking other medications as drug interactions may occur. Even for generic, over-the-counter drugs, this evaluation is important to prevent issues and stay comfortable with your specific treatment plan.

Prescription Medications for Fibromyalgia

According to the American College of Rheumatology (ACR), there are three FDA-approved prescription medications for the treatment of fibromyalgia, as follows:

  • duloxetine (Cymbalta)
  • milnacipran (Savella)
  • pregabalin (Lyrica)

Both Cymbalta and Savella are anti-depressants that change brain chemicals (serotonin and norepinephrine) to help control pain levels. Similar older, off-label, medications that may also be used for this same purpose include amitriptyline (Elavil) and the muscle relaxant cyclobenzaprine (Flexeril), among others. All of these drugs react differently to each patient, so its important to ask your doctor about the various benefits, risks, and side effects of each, as well as assess how well they are doing once you have been prescribed the medication over time.

Lyrica, on the other hand, is an anti-epileptic drug (also called anti-convulsants), that work to block the over-activity of nerve cells involved in the body’s pain transmissions. Another, off-label anti-epileptic drug called gabapentin (Neurontin) is also used for this same purpose. Besides pain, these drugs can help with relieving anxiety and may help certain sleep problems, according to the Arthritis Foundation. However, some side effects may include dizziness, sleepiness, and weight gain.

Other Medication Treatments

Beyond the primary treatment that antidepressants and anti-epileptics have to offer, many other types of prescription medications may be given by a doctor to treat the symptoms of pain and fatigue, including:

  • Over-the-counter medications – Generic pain relievers such as acetaminophen (Tylenol, and generics) and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, and generics) or naproxen sodium (Aleve, and generics) may be helpful, according to the Mayo Clinic, albeit less effective. Therefore, they may be used as a complementary medication used sporadically when necessary.
  • Fatigue medications – According to the Arthritis Foundation, fatigue medications such as modafinil (Provigil) may be prescribed to treat the common symptom.
  • Opioid medications – Prescription strength pain relievers such as the analgesic tramadol (Ultram) may be prescribed for short-term use, although narcotics are not advised as they can lead to dependence and may even worsen pain over time.

Non-Medication Therapies to Implement

Perhaps even more important than medication treatment is the numerous options one has of complementary, non-medication therapy, either by a respective doctor, therapist, or as at-home, self-care treatment. There are many to choose from according to your personal preference and physical ability. Often, complementary and alternative medicine (CAM), or integrative medicine, can be an additional benefit to many fibromyalgia sufferers.

  • Exercise - Research shows that the most effective treatment for fibromyalgia is physical exercise, according to the American College of Rheumatology. Patients seem to benefit most from regular, low-impact aerobic exercises such as Tai Chi or yoga to ease fibromyalgia symptoms. Strengthening exercises are similarly effective if they can be applied, according to the Institute for Chronic Pain.
  • Physical Therapy – Physical therapy can teach patients certain exercises to do at-home that will improve strength, flexibility, and stamina (water-based therapy may be of particular interest). Occupational therapy can help patients make adjustments in their everyday lives that will put less stress on problem areas that tend to flare-up due to the disease.
  • Cognitive Behavioral Therapy (CBT) - To address the psychological aspects of pain, including stress, depression, and anxiety, a psychologist or psychiatrist may be recommended by a doctor. A psychologist may help address the emotional factors and symptoms that come with fibromyalgia. A mental health expert, adept at cognitive behavior therapy, can counsel patients in learning how to make adjustments in their life to accommodate changes that naturally occur when living with a chronic illness such as fibromyalgia, according to the National Fibromyalgia & Chronic Pain Association.
  • Acupuncture/Acupressure - Acupuncture is a Chinese medical system based on inserting very fine needles through the skin to various depths, causing changes in blood flow and levels of neurotransmitters in the brain and spinal cord. Some studies indicate that acupuncture helps relieve fibromyalgia symptoms, while others show no benefit, according to the Mayo Clinic. Acupressure focuses on massaging pressure points throughout the body for the same effect.
  • Massage Therapy – Massages such as myofascial release therapy use different manipulative techniques to move and stretch the body’s muscles and soft tissues. This therapy can reduce one’s heart rate, relax tense muscles, improve one’s range of motion in joints and increase the production of the body's “natural painkillers.” It may also see benefit to help relieve stress and anxiety.
  • Meditation/Relaxation Therapy – Meditative and relaxation therapies such as mindfulness cultivate present moment awareness to reduce stress, which has been shown to significantly improve symptoms of fibromyalgia, according to the American College of Rheumatology.
  • Other complementary therapies – other therapies one may try include hot and cold compress applications, aromatherapy, biofeedback, herbs, hypnosis, nutritional supplements, chiropractic and osteopathic manipulation.

Get Started

Before beginning your fibromyalgia treatment plan, talk to your doctor about your options. Note your symptoms, what medications or therapies may be right for you, and check-in on current medications and therapy to see if any changes need to be made. While you may need to incorporate a variety of treatments to get maximum pain relief, it is usually for the best. The most successful treatment plans combine multiple approaches and doctors, along with consistent communication between you and your healthcare professional, to achieve the best results. Make these professionals a part of your “team” to help improve your fibromyalgia.

Try some of our lifestyle and diet tips for even more help with fibromyalgia, keeping you on the right track to maintaining the disease.

-Additional reporting by Steven Aliano

Updated on: 06/20/18
Continue Reading:
Mental and Emotional Therapy for Fibromyalgia
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