Doctor's Notes on Fibromyalgia
Fibromyalgia is an illness that causes chronic pain in muscles and ligaments, mainly in women ages mid-30s to late-50s. Signs and symptoms of the disease are widespread pain in the muscles and ligaments, not in the joints, and located most often in the neck, shoulders, back, and hips; the areas can be tender and sensitive, more in the morning hours and maybe burning, throbbing, aching or stabbing. Chronic fatigue is also common; it is not relieved by sleep or rest. Many patients develop “fibrofog”; which means mental haziness with memory loss and depression. Other symptoms may include insomnia, headaches, nervousness, numbness, dizziness, and irritable bowel syndrome.
There is no known cause for fibromyalgia. However, substance P which transmits pain impulses has been found to be 3 times higher in fibromyalgia patients and may explain why they feel more pains. Other researchers suggest the patients lack deep sleep (stage 4 sleep) when the muscles and the body recover from daily activities. Risk factors associated with the illness include fibromyalgia in a close family member, physical or emotional trauma, and having sleep apnea.
What Is the Treatment for Fibromyalgia?
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. Here are some of the treatment options your doctor may offer:
- Gabapentin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella): These are the only three drugs approved by the U.S. FDA for the treatment of fibromyalgia. Lyrica is an antiseizure medication, while Cymbalta and Savella are antidepressants. All three have been shown to reduce the pain of fibromyalgia.
- Cyclobenzaprine (Flexeril): This muscle relaxant not only decreases muscle pain but also improves sleep.
- Pramipexole (Mirapex): This drug is used in the treatment of Parkinson's disease. When used to treat fibromyalgia, it reduced pain in a majority of patients.
- Low doses of antidepressant medication: These medicines improve sleep and decrease pain as well as eliminate depression.
- Biofeedback and relaxation techniques: Besides lessening pain, these therapies also decrease the number of tender points.
- Acupuncture: Multiple studies have shown that acupuncture can decrease tender point pain.
- Tender point injections: Steroid or lidocaine injections into a painful area may provide temporary relief.
- Massage therapy: This can help relax and soothe painful muscles.
Fibromyalgia : What Is Fibromyalgia? QuizQuestion
What characterizes fibromyalgia?See Answer
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.