There are a number of different treatment options for fibromyalgia that try to ease some of your symptoms so that you have a better quality of life. In this article we will look at the various different fibromyalgia treatment options available, including holistic and complementary therapies, as well as conventional medicine.
What is Fibromyalgia?
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The National Institute of Arthritis and Musculoskeletal Diseases estimates that five million people in the U.S. suffer from fibromyalgia.
A high percentage of people who have a fibromyalgia diagnosis are women between the ages of 20 to 50, however, men and children can also be diagnosed with this condition.
Fibromyalgia (also known as ‘FM’ or ‘FMS’ (Fibromyalgia Syndrome)), is a complex condition that has over 200+ co-existing symptoms and conditions within it, and individuals with fibromyalgia will experience varying symptoms.
Although each person who experiences fibromyalgia will have unique symptoms, fibromyalgia is characterized by:
- Widespread chronic pain
- Cognitive difficulties (brain fog)
- Sleep problems such as insomnia
- Digestive issues such as IBS
- Depression and/or anxiety
What Causes Fibromyalgia?
The cause of fibromyalgia is still unclear, and fibromyalgia symptoms can be just as varied and complex. If you suffer from widespread pain, fatigue, and mental issues, though, you could be suffering from fibromylagia.
People experience varying degrees of this condition, ranging from bed-bound and in a state of extreme pain and fatigue, to functioning and holding down employment – albeit in many cases managing fibromyalgia symptoms can be difficult.
There are a variety of different studies regarding the cause of fibromyalgia, which point to a problem with pain signals causing hypersensitivity due to issues with:
One of the hallmarks of this condition is what is know as fibromyalgia flare-ups or ‘fibro flares’.
This is where the symptoms, specifically pain, fatigue and brain fog can go from manageable to unmanageable, leaving the person struggling to cope.
A ‘fibro flare’ can last from a day to several weeks, with varying degrees of intensity. Some people refer to being in remission when they are not in a flare-up.
Getting a diagnosis for fibromyalgia isn’t easy. The average length of time it can take to get a diagnosis is 2 years.
The reason for this lengthy amount of time to get a diagnosis is due to healthcare professionals ruling out other health issues via tests, in addition to the referral times to see the various experts.
Fibromyalgia Mimics Other Conditions
Fibromyalgia can mimic several other conditions such as multiple sclerosis (MS) and Lupus. Furthermore, it is not uncommon for people with fibromyalgia to also have arthritis, contributing to even more pain.
As there are no lab tests for fibromyalgia, a diagnosis is not straightforward. As mentioned above, fibromyalgia is complex, with so many different symptoms with varying severity making it difficult to diagnose.
Previously, there was the 18 tender point or trigger point test that was used, however, that has been outdated for a decade.
The 18 Tender Point/Trigger Point Test (is Outdated…)
The ‘Trigger Point Test’ (otherwise known as the ‘Tender Point Test’) was originally the only method used for diagnosing fibromyalgia. In stating this, many healthcare professionals who have not kept up with the American College of Rheumatology Fibromyalgia Diagnosis Criteria (which was originally published in 2010 with an updated version in 2016), still use this method for diagnosing fibromyalgia.
The newer Fibromyalgia Survey Diagnostic Criteria (FSDC), as outlined by the American College of Rheumatology includes the:
Is it Fibromyalgia or Chronic Fatigue Syndrome (CFS/ME)?
Fibromyalgia and chronic fatigue syndrome (CFS), also known as myalgic encephalomyelitis (ME) are often classed together.
Furthermore, fibromyalgia and CFS/ME both tend to share very similar symptoms, with the biggest difference between the two being that the main characteristic of fibromyalgia is pain, whilst for CFS it is fatigue.
It isn’t uncommon for patients to be diagnosed with both fibromyalgia and CFS/ME together.
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Working Together with Your Healthcare Professional
Your GP will play an important role for your care and treatment.
Although some people may choose functional medicine (1) as a holistic (non-pharmaceutical, natural) approach, in most cases this treatment option for fibromyalgia tends to occur after patients feel that they have exhausted conventional medicine options first.
Different Healthcare Professionals
You may find that your GP will refer you to other healthcare professionals who may be involved in your diagnosis and subsequent treatment. These may be a:
- Rheumatologist – a specialist in conditions that affect joints and muscles
- Psychologist – a specialist in mental health and psychological treatments such as CBT (2)
- Neurologist – a specialist in central nervous system conditions
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Different Fibromyalgia Treatment Options
It isn’t uncommon for many people living with fibromyalgia to have gone through a gamut of different prescriptions in attempts to help reduce their symptoms, particularly with:
Unfortunately, in many instances people with fibromyalgia feel frustrated, unheard and that they are not getting the help, support and treatment that they need to help improve their symptoms.
Furthermore, the experience of being sent ‘from pillar to post’ between healthcare professionals, sometimes with long referral and waiting times can exacerbate stress, anxiety, depression – and pain.
Finding a Fibromyalgia Treatment That Works For You
It isn’t uncommon for many people living with fibromyalgia to want to give up looking for treatment options that work. It is all too common a story of people going through a range of side effects from medications that seem to cause or increase the symptoms of fibromyalgia.
Sadly, this means people stop searching for the right treatment option that can help to alleviate and reduce the symptoms of fibromyalgia.
There are a range of treatment options for fibromyalgia both within and outside of conventional medicine. They are:
- Conventional Medicine – GPs, neurologists, psychotherapists, rheumatologists, pain clinics etc. They generally prescribe pharmaceutical medications for the treatment of symptoms
- Holistic Medicine – Naturopaths, functional health practitioners, chiropractors etc, using non-pharmaceutical treatment options
- Self-Management – using supplements, yoga, meditation and mindfulness, exercise, breathing techniques, heat, ice, weighted blanket, CBD oil, etc.
Most Healthcare Professionals Don’t Know….
Most healthcare professionals know very little about fibromyalgia, particularly GPs, as they generally are not experts in any specific health condition.
Conventional medicine will rely on what’s available to them as ‘approved medications’ and psychotherapy. In many cases these treatment options do not provide the symptom relief that fibromyalgia patients really need.
It is really important to not give up hope in finding treatments that can help improve your symptoms! This can take time (and money) and exploring outside of what’s available from your health service and/or provider It also can mean using a variety of different treatment options together.
Never give up searching for what may work! For example, some people with fibromyalgia find relief by avoiding certain foods and this can cause a dramatic improvement in symptoms. Normally, the best course of treatment when dealing with fibromyalgia will include a combination of medication and/or supplements and lifestyle changes.
Fibromyalgia Information & Support
Possibly two of the most important things you can do once you have a fibromyalgia diagnosis is:
- Reach out
- Become involved in the fibromyalgia community
Researching About Fibromyalgia
Researching fibromyalgia can help you improve your understanding, as well as help you find a huge range of information outside of what you will most likely receive from your healthcare professional.
Furthermore, through your own research, you are going to be more empowered to take more control of your health and more able to self-manage your fibromyalgia symptoms better.
Connecting with other people who have fibromyalgia can certainly help you feel like you are not so alone and isolated. There are numerous support groups available in most places so you can meet and talk with people. And online there are hundreds if not thousands of forums, chat groups and Facebook pages and groups – including our own – Fibromyalgia, CFS/ME & Chronic Pain Life.
Be Involved in the Fibromyalgia Community
One of the best things that you may consider doing is becoming more involved in the fibromyalgia community.
This could mean:
- Setting up a support group
- Volunteering for existing support networks/fibromyalgia charities
- Writing blogs
We can highly recommend the International Support Fibromyalgia Network (ISFN) as an incredibly positive, proactive and progressive group of people. ISFN is dedicated to education, advocacy and support. Heck, ISFN hit Washington in 2019 to push for more funding for advocacy, education and support. You can visit their Facebook page here.
At FibroMapp Pain Manager+ we are absolutely thrilled and delighted to be working together with the International Support Fibromyalgia Network. Watch this space! 🙂
Check out our fibromyalgia CFS/ME Resource page which includes US, UK and international links for fibromyalgia support groups and charities.
You may be prescribed several different types of medication for treating the different symptoms you experience with fibromyalgia. These medications may include painkillers and antidepressants.
Medications Approved for Fibromyalgia Treatment
The US Food and Drug Administration (FDA) certifies drugs that have been proven to be efficacious and safe.
There are currently 3 drugs that have FDA approval for the treatment of fibromyalgia, which are:
- Milnacipran (Savella) – an antidepressant medication similar to duloxetine. It is only approved for fibromaylgia treatment.
- Duloxetine (Cymbalta) – this medication is also approved for use in the treatment of depression, neuropathic pain associated with diabetic peripheral neuropathy and generalized anxiety disorder
- Pregabalin (Lyrica) – this medication has also been approved for the treatment of neuropathic pain associated with diabetic peripheral neuropathy and postherpetic neuralgia as well as for partial onset seizures
It is important to understand that just because these medications have been approved by the FDA for the treatment of fibromyalgia it doesn’t mean that they are necessarily the best option for everyone.
With these medication many people experience almost immediate improvement in their symptoms, which can then disappear quite quickly, only to have their doses increased – all of a sudden finding themselves on the maximum dose, without the relief of symptoms, and numerous side effects.
It is important to make sure that you inform your doctor of these possible side effects, which may include:
- Significant weight gain
- Manic episodes – including reckless behaviour, talking more than usual, increased energy
- Severe sleep problems
- Vision changes
- Bruising and unusual bleeding
- Severe depression including suicidal thoughts
- Pounding heartbeats
- Dry mouth
- Painful urination
Other Medications for Treating Fibromyalgia
Chances are that your doctor may prescribe you other medications for treating some of your most prevalent fibromyalgia symptoms.
These may include:
Some painkillers that are available over the counter from a pharmacy, such as ibuprofen or acetaminophen, can help to relieve the pain assoicated with fibromyalgia. If over the counter painkillers aren’t effective, you should speak to your GP or healthcare professional regarding prescribing something stronger.
No To Opioids
In addition to the highly concerning opioid crisis, most healthcare practitioners have cracked down massively on prescribing opiate painkillers.
Opioids might not be a good fit for FM; as one study found that the opioid receptors in fibromyalgia patient’s brains were already filled, therefore suggesting that adding opioids wouldn’t help much, and that paradoxically, going off them might help relieve pain. Opioids also target pathways in the brain (opioid pathways) that don’t appear to play a major role in fibromyalgia.
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Antidepressant medications not only can boost certain levels of chemicals that carry messages to and from your brain (neurotransmitters), they can also help to relieve pain for some people with fibromyalgia.
As low levels of neurotransmitters may be a factor in fibromyalgia, it is believed that by increasing their levels the widespread pain associated with fibromyalgia may be eased..
Different Types of Antidepressants
- Tricyclic antidepressants, such as amitriptyline (which can also help improve sleep)
- Seratonin-noradrenaline reuptake inhibitors (SNRIs), such as duloxetine and venlafaxine
- Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and paroxetine (Seroxat)
A medication called pramipexole, which is not an antidepressant but also affects the levels of neurotransmitters, is sometimes used as well.
Antidepressants can cause a number of side effects, including:
- Feeling sick
- Dry mouth
- Feeling agitated, shaky or anxious
- Weight gain
- Depression and/or suicidal thoughts (yes, antidepressants can cause this side effect)
Always make sure that you read up on the side effects that medications may cause by thoroughly reading through the patient information pamphlet provided with the medication. If you have any questions or concerns, always make sure that you ask your pharmacist or doctor.
It is important to understand that in many cases medications can cause a range of side effects. One medication may not work as well for you as it does for others.
You may also be prescribed an anticonvulsant (anti-seizure) medicine, as these can be effective for those with fibromyalgia.
The most commonly used anticonvulsants for fibromyalgia are pregabalin (which has been approved for fibromyalgia treatment by the FDA) and gabapentin.
These medications are also used to treat epilepsy, however, some research has shown that these medications can improve the pain associated with fibromyalgia for some people.
Some common side effects of pregablin and gabapentin include:
- Swelling of your hands and feet (oedema)
- Weight gain
- Depression and anxiety
- Suicidal thoughts
There have recently been quite a few concerns about gabapentin (Neurontin) and pregabalin (Lyrica) regarding how they can have an extremely adverse affect on our brain synapses. It is always best to do your own research before taking any medication and discuss any concerns with your healthcare professional.
One of the main symptoms of fibromyalgia is sleep disturbances. This can range from insomnia to not being able to get into a deep (and healing) REM sleep, to waking up frequently throughout the night. Furthermore, there is a direct correlation to a poor sleep, pain and depression/anxiety.
This is known as the Pain-Sleep-Depression Cycle.
If you’re sleeping better your fibromyalgia symptoms such as pain, brain fog and obviously fatigue will likely be less severe. Therefore, if you’re struggling to sleep on a regular basis, it may be worth discussing this with your doctor to see if they can either recommend an over the counter remedy or prescribe a short course of stronger medication.
Many sleep medications can be habit forming. Therefore, you should only take them on a short-term basis to help you get back into a proper sleep routine. Some antidepressants may also improve your sleep quality.
A Great Non-Prescription Option for Helping You to Sleep
Chronic insomnia is characterized by a consistent lack of sleep 3 or more nights a week. Lack of sleep, whether it’s medically related or anxiety-driven, can throw off your normal functioning during the day.
Symptoms of insomnia are:
- Difficulty concentrating (hello brain fog)
- Shortness of breath
- Reduced productivity at work or school
- Stiffness (pain)
- Heart palpitations
- Anxiety and depression
When you’re tossing and turning all night, unable to get into (or stay in) a comfortable position due to pain, and or anxiety, the likelihood of you getting a good, restorative sleep is going to be limited.
How Weighted Blankets Work
In using a therapy known as deep pressure touch stimulation, or DPTS, weighted blankets filled with glass or ceramic beans place a gentle pressure over the body that stimulates serotonin production, which naturally converts to melatonin, a hormone that helps you sleep.
Weighted blankets are being used successfully for children and adults with autism, ADHD, anxiety, PTSD and depression. Furthermore, they are also used for people with dementia.
Basically, a weighted blanket gives you a secure hug! Pretty cool, right?!
Not All Weighted Blankets Are Made The Same
Some weighted blankets are not manufacturered very well, and as they are heavy, if the seams aren’t properly sewn they can split. Furthermore, the beads may not be properly distributed – which is very important!
Your weighted blanket should be 10% of your body weight to provide you with the proper weight needed to help you sleep.
You can buy a great weighted blanket from Amazon with excellent reviews here.
Medical Cannabis & CBD Oil
These past few years have been SO exciting regarding the legalization of medicinal (and in some places recreational) cannabis. And for good reason. There is an incredble amount of mounting evidence to show the effectiveness of cannabis and CBD (cannabidiol) for the treatment of many diseases, including cancer, improved sleep, pain relief, digestive health, anxiety and depression.
The Difference Between Cannabis & CBD
- Cannabis contains THC – which is the psychoactive ingredient, which in itself can offer a range of health benefits. However, in some countries and States, cannabis is illegal.
- CBD – is the chemical compound cannabidiol, which does not have THC in it. CBD oil is legal in many countries where cannabis is still illegal, simply because it doesn’t have THC. CBD oil is most often made from industrial hemp, which has a negligible amount of THC.
As cannabis isn’t legal in some countries or States, we are going to focus on CBD as a treatment for several main fibromyalgia symptoms.
CBD oil and other CBD products will not get you high! And it is legal in many countries where cannabis is still illegal. CBD comes in a range of products, from oils, tinctures, pain relief creams – even gummies.
- Alleviating pain and inflammation – CBD is well-known for its ability to reduce pain sensation and inflammation, which makes this supplement a highly sought after alternative remedy when it comes to the chronic pain issues associated with fibromyalgia.
- Providing relief for mental health issues – For people that struggle with anxiety and depression as a result of fibromyalgia, CBD may help alleviate symptoms of both disorders by interacting with serotonin receptors in the brain.
- Improving sleep – The discomfort that comes with fibromyalgia can make it difficult to fall asleep, and stay asleep, which can make you feel fatigued the next day. CBD has many relaxation benefits that can make it easier for you to get a restful night’s sleep.
- Promoting optimal functioning – People with FM often suffer from something known as “fibro fog”, meaning they have difficulty focusing and/or struggle with memory issues. CBD oil is also known to help regulate many bodily functions which may in turn improve cognitive processes and mental clarity.
A Few (of Many) CBD Studies…
CBD for Pain Relief
According to many promising studies, cannabinoids could potentially become a new class of painkillers, which some researchers believe may help millions of people with chronic pain. In a large analysis of 18 clinical trials, the authors concluded that cannabinoids strongly and safely reduced various types of chronic pain: neuropathic, arthritis, fibromyalgia, HIV, and multiple sclerosis pain.
CBD for Anxiety
A single CBD dose of 400 mg was linked to reduced anxiety in a brain imaging study of 10 people with seasonal affective disorder (SAD). In a study of 10 healthy volunteers, those who took CBD felt less anxious after the stressful task of public speaking. In 24 patients with social anxiety, taking CBD before public speaking was linked to reduced anxiety and discomfort and improved cognition.
It’s important to note than many healthcare professionals are unwilling and disinterested in the health benefits of this all-natural fibromyalgia treatment alternative. However, luckily, you can easily access CBD to buy online!
Importnat to Note: Not all CBD products are the same quality! It has been reported that many of these products available from 3rd party sellers (on eBay and Amazon), are not very high quality and have questionable authenticity. Only buy from repuatable manufacturers, preferably organic where possible! We highly recommend Joy Organics for this reason.
Other fibromyalgia Treatment Options
Alternative/Complementary Therapies for Fibromyalgia
There are a vast range of alternative therapies for the treatment of fibromyalgia.
Functional health practitioners, such as naturopaths and homeopaths may carry out tests to see if you have any food and chemical intolerances, vitamin and mineral deficiencies and much more. They treat root problems vs symptoms (unlike conventional medicine).
You may find that you get a lot more answers (and help) in working with an alternative health practitioner alongside your conventional doctor – or on their own. In addition to functional medicine practitioners there are other readily accessible altnernative therapies, such as:
Make sure you do your research before working with any practitioner, to understand how much they know about the treatment of fibromyalgia, and how their particular therapy may be of benefit to you.
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Other Treatments for Fibromyalgia
In addition to medication and/or alternative therapies, there are other treatment options for fibromyalgia to consider.
- An individually tailored exercise programme – which may be available through your healthcare provider
- Cognitive behavioural therapy (CBT) – a talking therapy that aims to change the way you think about things, so you can tackle problems more positively
- Psychotherapy – a talking therapy that helps you understand and deal with your thoughts and feelings
- Relaxation techniques – such as yoga, mindfulness and meditation
- Swimming, sitting or exercising in a heated pool or warm water (known as hydrotherapy or balneotherapy)
- Psychological support – any kind of counselling or support group that helps you deal with issues caused by fibromyalgia
See self-help for fibromyalgia for more information about exercise and relaxation techniques.
Your GP or healthcare professional may be able to provide guidance and even contacts regarding the above. Ask them! They will most likely be very happy to know that you are interested and willing to self-manage your fibromyalgia symptoms.
Many Fibromyalgia Treatment Options Are Available to You!
It is important to know that there are a variety of different fibromyalgia treatment options available to you that go way beyond medication!
The most important thing is your willingness to continue to try different options, Never give up! Whether it is a change of diet, medication, using CBD oil, functional health…keep trying until you find a fibromyalgia treatment plan that works for you. There’s so many options to choose from!