There is no cure for fibromyalgia. Treatments are prescribed to decrease pain, improve muscle and joint function, and help avoid triggers that can worsen the symptoms. While drugs are often the first line of treatment, there are other approaches that people find to be equally effective, or at least helpful. These non-medical treatments focus on preventing flare-ups.
Most people with fibromyalgia use a combination of treatment methods.
A wide variety of drugs are used to treat fibromyalgia. Some reduce pain, some relax tense muscles, some help with sleep, and some seek to correct neurochemical imbalances. Many people take several drugs to relieve symptoms. It can take some time and trial and error to find the right set of medications for an individual patient.
The most commonly used pain-relieving drugs are analgesics and non-steroidal anti-inflammatory drugs (NSAIDs). Most of these are found in both over-the-counter and prescription strengths. They include common drugs like aspirin, ibuprofen (Advil), and acetaminophen (Tylenol).
Another drug used to relieve fibromyalgia pain is tramadol. This is a stronger painkiller available only by prescription.
In rare cases, a doctor may prescribe opioid painkillers for severe pain. These drugs carry a high risk of addiction if used for a long period. Examples of prescription opioid drugs include:
- hydrocodone and acetaminophen (Vicodin)
- oxycodone (Oxycontin)
- oxycodone and acetaminophen (Percocet)
Anticonvulsants are drugs used to prevent seizures. They calm overactive nerves and affect the pain transmission pathway, both of which can help decrease symptoms. Types of anticonvulsants include:
- carbamazepine (Tegretol)
- divalproex (Depakote)
- gabapentin (Neurontin)
- oxcarbazepine (Trileptal)
Side effects of anticonvulsants vary but can include:
- liver damage
Muscle relaxants reduce pain and muscle soreness. They can also help to relax the body and improve sleep. Prescription muscle relaxers include:
- carisoprodol (Soma)
- cyclobenzaprine (Flexeril)
- orphenadrine (Norflex)
- metaxalone (Skelaxin)
- methocarbamol (Robaxin)
Side effects of muscle relaxants include blurred vision, dizziness, and drowsiness.
Benzodiazepines relieve anxiety, relax muscles, and improve sleep. They are usually taken at bedtime because they cause drowsiness. Side effects include drowsiness, confusion, impaired coordination, and depression. It’s important to limit the use of these drugs because they can be addictive. They include:
- clonazepam (Klonopin)
- diazepam (Valium)
- temazepam (Restoril)
- alprazolam (Xanax)
If you have fibromyalgia, your sleep is likely affected. Your doctor may prescribe a sleep aid. Sleep aids not only help you fall asleep, they can also help you stay asleep for longer periods and can also promote deep sleep. Popular sleep aids include Lunesta, Sonata, and Ambien.
Sleep aids can be habit forming. If you take them for a long period and then stop abruptly, you may have anxiety and trouble sleeping. Other side effects include:
Trigger Point Injections
To relieve severe pain, a doctor may inject a local anesthetic such as lidocaine directly into a painful trigger point. This effectively relieves pain, but only works for three to four weeks at most.
Like fibromyalgia, depression is associated with imbalances in brain chemicals. Many drugs that affect these chemicals are used for both depression and fibromyalgia. There are a number of antidepressant groups that can help fibromyalgia symptoms.
These drugs keep levels of serotonin, norepinephrine, and dopamine elevated. They include Elavil and Sinequan, to name a few. Side effects may include drowsiness, dizziness, sexual dysfunction, and weight gain.
Selective Serotonin Reuptake Inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) increase serotonin levels and also keep it circulating in the brain for longer periods. Popular SSRIs include Celexa, Prozac, Zoloft, and Paxil. Side effects of these drugs include:
- sexual dysfunction
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
Serotonin and norepinephrine reuptake inhibitors (SNRIs) work in a similar manner to SSRIs but affect both serotonin and norepinephrine. They include Effexor and Cymbalta. Side effects include:
Making changes to your daily routines can help reduce stress and improve sleep, both of which may reduce symptoms. In people with minor cases of fibromyalgia, lifestyle changes can sometimes relieve symptoms all by themselves. In other cases they changes can complement drug therapy.
Learn to recognize and avoid stressful situations as much as possible. Relieve daily stress with regular habits. Schedule time each day to relax via deep breathing, meditation, or other methods.
Gentle exercise such as walking or swimming is known to reduce stress. It can also help relieve pain by stretching and strengthening muscles. Be careful to keep exercise at moderate levels. Overexertion can make fibromyalgia symptoms worse.
A well-balanced diet and reduction or elimination of caffeine can improve sleep and reduce fibromyalgia pain. Many people find that certain foods aggravate their symptoms. They can reduce flare-ups by getting rid of these foods.
Regular Sleep Pattern
Go to bed and wake up around the same time every day. Improve your sleep environment by regulating temperature, removing distractions, buying blackout shades, or getting a better mattress. Avoid caffeine, alcohol, and sugar before bed.
Cognitive behavioral therapy is a common form of counseling used in fibromyalgia. It teaches people to better recognize and deal with stressful situations. There are many support groups for patients with fibromyalgia that allow them to share their experiences and learn coping techniques.
Physical and Occupational Therapy
Physical therapy reduces muscle pain through stretching and other training methods to strengthen muscles and improve movement. Occupational therapy seeks to teach people new ways to perform everyday tasks that avoid painful movements.
Massage can soothe sore muscles, reduce pain, and improve sleep. Massage for fibromyalgia also often uses light stretching and other physical therapy techniques.