Fibromyalgia Overview and treatment options

Dear Ask The Doctor: Does the disease ever go away or do you have to live with it all your life?

Dear Cindi: Fibromyalgia is an illness that causes chronic pain in muscles and ligaments.  This disorder affects about 4 million Americans - the vast majority of them are women in their mid-30s to late-50s.

In addition to muscular pain and stiffness, this ailment can also cause fatigue, sleep problems, depression and an inability to think clearly.

While there is no known cause for fibromyalgia, recent research has revealed some new facts about the disease. One of the new discoveries is that people with fibromyalgia process pain differently.

The level of chemical in the cerebrospinal fluid (CSF) called substance P, which transmits pain impulses to the brain, is three times higher in people with the disease than in those who do not have the condition. This likely causes someone with fibromyalgia to experience pain more intensely.

Although there is no cure for fibromyalgia, home treatment can relieve some of the symptoms. The most important therapy for muscle pain is regular, low-impact exercise. Keeping muscles conditioned and healthy by exercising three times a week decreases the amount of discomfort. It is important to try low-stress exercises such as walking, swimming, water aerobics, and biking rather than muscle-straining exercises such as weight training. Besides helping with tenderness, regular exercises can also boost energy levels and help with sleep. Biofeedback and relaxation techniques shoudl also be considered.  Besides lessening pain, these therapies also decrease the number of tender points.  Acupuncture has been shown by multiple studies to decrease tender point pain. Massage therapy can help relax and soothe painful muscles.

No single treatment will take away all the symptoms associated with fibromyalgia. But most people do get some relief by trying a combination of therapies including prescrition medications.

The only three drugs approved by the U.S. FDA for the treatment of fibromyalgia are ’Lyrica’, ‘Cymbalta’ and Savella. Lyrica is an antiseizure medication, while Cymbalta and Savella are antidepressants. All three have been shown to reduce the pain of fibromyalgia. "Flexeril", a muscle relaxant not only decreases muscle pain but also improves sleep. "Mirapex", a drug is used in the treatment of Parkinson's disease has shown to reduce pain in 80% of patients when used for managment of fibromyalgia.  Tender point injection with Steroids or Lidocaine injections into a painful area may provide temporary relief.

I hope this helps