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As with many other disorders, there is no universal cure for fibromyalgia. However, a steady interest in the disorder on the part of academic researchers as well as pharmaceutical interests has led to improvements in its treatment, which ranges from symptomatic prescription medication to alternative and complementary medicine.
Traditionally, low doses of sedating antidepressants (e.g. amitriptyline and trazodone) have been used to reduce the sleep disturbances that are associated with fibromyalgia, which are believed by some practitioners to exacerbate the symptoms of the disorder. Because depression often accompanies chronic illness, these antidepressants may provide additional benefits to patients suffering from depression. Amitriptyline is often favoured as it can also have the effect of providing relief from neuralgenic or neuropathic pain. Some doctors advise against using narcotic sleep aids ("hypnotics"), since these can lead to dependence.
Another treatment being researched is the use of dextromethorphan, which is sold over the counter as a cough suppressant.
Standard clinical doses of newer anti-depressants (SSRIs) like Celexa are being used. Anti-seizure drugs are also sometimes used.
New drugs that have shown significant efficacy in the treatment of fibromyalgia pain and other symptoms include milnacipran, gabapentin, and pregabalin. Milnacipran belongs to a new series of drugs known as serotonin-norepinephrine reuptake inhibitors (SNRIs) and is available in parts of Europe where it has been safely prescribed for other disorders. As of August 2005, Milnacipran is the subject of a Phase III study and, if ultimately approved by the FDA, will be distributed in the United States.
The newest drug for treating the extreme pain of Fibromyalgia is Lyrica, pregabalin, originally used for the nerve pain suffered by diabetics.
Studies have found gentle exercise, such as warm-water pool therapy, improves fitness and sleep and may reduce pain and fatigue in some people with fibromyalgia. Stretching is recommended to allay muscle stiffness and fatigue, as is mild aerobic exercise. Because strenuous activity can exacerbate the muscle pain and fatigue already present, patients are advised to begin slowly and build their activity level gradually to avoid inducing additional pain. Exercise may be poorly tolerated in more severe cases with abnormal post-exertional fatigue.
Cognitive behavioral therapy has been shown to improve quality of life and coping in fibromyalgia patients and other sufferers of chronic pain.
Neurofeedback has also shown to provide temporary and long-term relief.
Many patients find temporary relief by applying heat to painful areas. Those with access to physical therapy and/or massage may find them beneficial. Chiropractic care can also help relieve pain due to fibromyalgia.
A holistic approach — including managing diet, sleep, stress, activity, and pain — is used by many patients. Dietary supplements, massage, chiropactic care, managing blood sugar levels, and avoiding known triggers when possible means living as well as it is in the patient's power to do.
Treatment for the "brain fog" has not yet been developed, however biofeedback and self-management techniques such as pacing and stress management may be helpful for some patients. The use of anti-depressants, which improves sleep, helps some patients, as does supplementation with folic acid and ginkgo biloba.
Among the more controversial therapies in common use among some patients involves the use of the expectorant guaifenesin. The use of this agent originated from the thoughts of Dr. R. Paul St. Amand, hence the name St Amand's protocol. Many patients report improvement on this treatment, which in turn has inspired health care providers to incorporate it in their practice. However, the efficacy of guaifenesin in treating fibromyalgia has not been proven in properly designed research studies. Indeed, a controlled study conducted by researchers at Oregon Health Science University in Portland failed to demonstrate any benefits from this treatment.
A number of practitioners are attracted to the treatment of fibromyalgia, especially because its cause has yet to be identified and, due to its permanent nature, ongoing treatments can be very profitable. While this interest may promote legitimate medical research, patients should be wary: Treatments of dubious validity exist in the meantime.
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Important notice:
The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other
qualified health provider with any questions you may have regarding a medical condition.
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