Treatment

In general, treatments for fibromyalgia include both medication and self-care. The emphasis is on minimizing symptoms and improving general health. No one treatment works for all symptoms.

Medications

Medications can help reduce the pain of fibromyalgia and improve sleep. Common choices include:

  • Pain relievers. Over-the-counter pain relievers such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others) may be helpful. Your doctor might suggest a prescription pain reliever such as tramadol (Ultram). Narcotics are not advised, because they can lead to dependence and may even worsen the pain over time.
  • Antidepressants. Duloxetine (Cymbalta) and milnacipran (Savella) may help ease the pain and fatigue associated with fibromyalgia. Your doctor may prescribe amitriptyline or the muscle relaxant cyclobenzaprine to help promote sleep.
  • Anti-seizure drugs. Medications designed to treat epilepsy are often useful in reducing certain types of pain. Gabapentin (Neurontin) is sometimes helpful in reducing fibromyalgia symptoms, while pregabalin (Lyrica) was the first drug approved by the Food and Drug Administration to treat fibromyalgia.

Therapy

A variety of different therapies can help reduce the effect that fibromyalgia has on your body and your life. Examples include:

  • Physical therapy. A physical therapist can teach you exercises that will improve your strength, flexibility and stamina. Water-based exercises might be particularly helpful.
  • Occupational therapy. An occupational therapist can help you make adjustments to your work area or the way you perform certain tasks that will cause less stress on your body.
  • Counseling. Talking with a counselor can help strengthen your belief in your abilities and teach you strategies for dealing with stressful situations.

Alternative medicine

Complementary and alternative therapies for pain and stress management aren't new. Some, such as meditation and yoga, have been practiced for thousands of years. But their use has become more popular in recent years, especially with people who have chronic illnesses, such as fibromyalgia.

Several of these treatments do appear to safely relieve stress and reduce pain, and some are gaining acceptance in mainstream medicine. But many practices remain unproved because they haven't been adequately studied.

  • Acupuncture. Acupuncture is a Chinese medical system based on restoring normal balance of life forces by inserting very fine needles through the skin to various depths. According to Western theories of acupuncture, the needles cause changes in blood flow and levels of neurotransmitters in the brain and spinal cord. Some studies indicate that acupuncture helps relieve fibromyalgia symptoms, while others show no benefit.
  • Massage therapy. This is one of the oldest methods of health care still in practice. It involves use of different manipulative techniques to move your body's muscles and soft tissues. Massage can reduce your heart rate, relax your muscles, improve range of motion in your joints and increase production of your body's natural painkillers. It often helps relieve stress and anxiety.
  • Yoga and tai chi. These practices combine meditation, slow movements, deep breathing and relaxation. Both have been found to be helpful in controlling fibromyalgia symptoms.
Aug. 11, 2017
References
  1. Fibromyalgia. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Fibromyalgia/default.asp. Accessed Oct. 19, 2016.
  2. Clauw DJ, et al. Fibromyalgia and related conditions. Mayo Clinic Proceedings. 2015;90:680.
  3. Goldenberg DL. Clinical manifestations and diagnosis of fibromyalgia in adults. http://www.uptodate.com/home. Accessed Oct. 19, 2016.
  4. Goldenberg DL. Initial treatment of fibromyalgia in adults. http://www.uptodate.com/home. Accessed Oct. 19, 2016.
  5. AskMayoExpert. Fibromyalgia. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2016.
  6. Goldenberg DL. Pathogenesis of fibromyalgia. http://www.uptodate.com/home. Accessed Oct. 19, 2016.
  7. Goldenberg DL. Treatment of fibromyalgia in adults not responsive to initial therapies. http://www.uptodate.com/home. Accessed Oct. 19, 2016.
  8. Fibromyalgia. National Center for Complementary and Integrative Health. https://nccih.nih.gov/health/fibromyalgia. Accessed Oct. 19, 2016.
  9. Barbara Woodward Lips Patient Education Center. Fibromyalgia: The road to wellness. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
  10. Fleming KC (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 10, 2017.