Fibromyalgia Treatment

by Karen Lee Richards, ChronicPainConnection Expert

Since there is no known cure for fibromyalgia (FM), treatment efforts are directed at relieving symptoms and improving quality of life.  A multi-disciplined approach using prescription medications, alternative therapies, gentle exercise and lifestyle adaptations seems to work best for most patients. 

Unfortunately, what works well for one individual may not work at all for another.  Finding an effective fibromyalgia treatment program is usually a matter of trial and error.  It requires the doctor, patient, and perhaps other health care professionals working together as a team to develop an individualized plan.

Prescription Medications

Thus far three drugs, Lyrica, Cymbalta and Savella have received FDA approval for the treatment of fibromyalgia. A number of other medications are also used to treat fibromyalgia symptoms but must be prescribed off-label.  Because people with FM are sometimes highly sensitive to many drugs, medications should be prescribed with great care. 

Over-the-counter pain relievers such as ibuprofen and acetaminophen can be used to relieve mild pain, however, in many cases stronger medications are needed.  Some of the prescription medications used to treat fibromyalgia symptoms include:

  • Antidepressants – Although sometimes used to treat an overlapping diagnosis of depression, low-dose antidepressants are also prescribed for FM to improve sleep and reduce pain.  Types of antidepressants used include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and tricyclics. The FDA approved drugs Cymbalta and Savella are SNRIs. (Since the development of SSRIs and SNRIs, the use of tricyclic antidepressants to treat fibromyalgia has decreased significantly.)
  • COX-2 inhibitors (like Celebrex)
  • Muscle relaxants
  • Anti-convulsants /drugs used to treat nerve pain. (The FDA-approved drug Lyrica––generic name pregabalin––is in this category.)
  • Sleep medications
  • Non-narcotic pain relievers
  • Narcotic pain relievers – (Generally, narcotic pain relievers are only prescribed in severe cases, when patients do not respond to other treatments. Although many FM patients report that they've had success using opiate treatments, a Danish survey study indicated that the use of opiods by chronic pain patients may not result in a significantly improved quality of life in the long term.)
  • Injections of a local anesthetic or corticosteroid are sometimes used for severe tender point pain.
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