What is fibromyalgia?
Sandra Miller, MD, is the assistant director of the Banner – University Medical Center Phoenix Family Medicine Residency.
Question: I was recently diagnosed with fibromyalgia. What treatment options are available?
Answer: Fibromyalgia is a condition of chronically sore and tender muscles, usually diagnosed in women. Although there are theories about the cause, no one really knows why it occurs. Fatigue and poor sleep are part of the syndrome. The muscle soreness is made worse by over-exertion, causing many people with this condition to become inactive. While people do not usually “recover” from fibromyalgia, they can manage it and live better with certain treatments.
Activity is the cornerstone of treatment. Those who consistently follow daily low-grade exercise such as walking, swimming or biking, do better. To avoid triggering more pain, though, the exercise program must be started very slowly, as little as five minutes twice a day, and built up gradually. Because depression can become part of fibromyalgia (whether the depression comes first or is a result of the condition is not clear), cognitive behavioral training with a competent psychologist can be very beneficial.
If there are any signs that sleep apnea or a sleep disorder is present, this should be investigated. Treatment of sleep disorders can improve fibromyalgia symptoms.
Several medications have been proven helpful, though medication should not replace daily activity. The “muscle relaxant” cyclobenzaprine (brand name Flexeril) has been proven to help. Other commonly used and often effective medications include amitriptyline, gabapentin (Neurontin), pregabalin (Lyrica), and duloxetine (Cymbalta). All prescription treatments have potential side effects and need to be monitored. While no treatment eliminates all the symptoms of fibromyalgia, many people can function better and feel better while taking these medications. Medications that are often used, but which do not improve symptoms, include narcotic pain medications and benzodiazepine relaxants (such as Valium, Ativan and Xanax).
Fibromyalgia does not harm the body or shorten life, even though it may feel miserable if untreated. Combination treatment with low-grade daily exercise, cognitive training and medication will allow many people with fibromyalgia to live a higher quality of life and remain functional at work and at home.
Reviewed May 2010