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How to Treat Fibromyalgia



The Best Treatment for Fibromyalgia

There is no cure for fibromyalgia, but a meaningful and functional life is possible with the right combination of strategies tailored to you.


When you have fibromyalgia, you have centralized sensitization. In layman's terms, central sensitization is when the nervous system is on high alert even when there is no danger present.


Treatments like surgery and opioids generally don’t work for people with centralized pain/central sensitization. Instead, centrally acting analgesics and non-medical treatment are much more effective.


Research has found the most effective fibromyalgia treatment to include:

  • A patient/fibro fighter invested in the planning and implementation of the various treatment strategies

  • Consideration of both medication options and non-medication options

  • A multi-disciplinary team (this could include the primary physician, rheumatologist, physical and occupational therapists, dietitian, psychologist, etc.)

When fibromyalgia symptoms are debilitating and unmanageable, there is often a focus to find a pain-relieving medication. Once pain is more manageable, it's important to consider implementing additional non-medication options and lifestyle changes to see what is helpful for you.

Medication Options

Several drugs or classes of drugs have strong evidence to support symptom improvement in fibromyalgia, including:

  • Tricyclic compounds (amitriptyline and cyclobenzaprine)

  • Gabapentinoids (pregabalin and gabapentin)

  • Serotonin-norepinephrine reuptake inhibitors (duloxetine and milnacipran)

  • Gamma-hydroxybutyrate

Several drugs or classes of drugs have fair evidence to support symptom improvement in fibromyalgia, including:

  • Older selective serotonin reuptake inhibitors with greater noradrenergic activity when used at higher doses (fluoxetine, paroxetine, and sertraline)

  • Low dose naltrexone

  • Esreboxetine

  • Cannabinoids

  • Memantine

The following classes of drugs are not effective at treating fibromyalgia symptoms:

  • Non-steroidal anti-inflammatory drugs (NSAIDs)

  • Opioids

  • Corticosteroids

Non-Medication Options

There are many options for non-medication strategies and tools for managing fibromyalgia. The three most researched beneficial strategies are education, cognitive behavioral therapy, and exercise. In fact, these strategies often exceed the effectiveness of medication options. The non-medication strategies highlighted in this guide are associated with improved function, well-being, and quality of life.


Remember when we talked about your nervous system being heightened and sensitive? The goal of these strategies is to calm your system down. We encourage you to read about your options and choose just one to implement in your daily routine for the next month. If you need some guidance on how to introduce these strategies in a safe and self-paced way, check out this resource. Consistency is key with these strategies. Strategies don't work when you only do them during flares.

  • Education: You need to learn about fibromyalgia to recover from it. To learn more about the science behind fibromyalgia, head over to this blog post: How to Reduce Your Fibromyalgia Pain in 30 Minutes.

  • CBT: Cognitive behavioral therapy, or CBT, helps address beliefs and expectations of managing pain and pain stressors. Those engaged in CBT show improvement in pain, function, and mood.

  • Exercise: Moderate aerobic and resistance training is beneficial for fibro fighters. However, all exercise programs should be paced to your current abilities. We offer a free guide on how to pace exercise without flaring.

  • Diet: Diet affects fibromyalgia symptoms as there are foods to embrace/eat more of and foods to avoid. We offer a free printable covering the basics of fibro friendly nutrition.

  • Social: Having strong social support is essential for fibro fighters, whether in-person or virtually. It can be both helpful and harmful to have relationships with other fibro fighters—be cautious about engaging in session after session of venting.

  • Relaxation: Relaxation strategies like diaphragmatic/belly breathing, progressive muscle relaxation, guided imagery, and meditation improve overall pain, mood, sleep, and ability to handle stressful events.

  • Mind-Body: Body-based or mind-body practices like yoga, Pilates, and Tai Chi improve physical function (flexibility, strength, and balance). They are also known to improve pain and mood.

  • Music: Listening to classical music is shown to provide temporary pain relief. Try listening to calming music with another relaxation technique, like belly breathing, for double the effect.


Check It Out

We've created a free e-book with science-backed information for all fibromyalgia warriors. Instead of spending hours and hours searching Google for answers on how the diagnosis process works, best treatment options, and causes of your pain, it's all right here!

 

Sources

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Boomershine C. S. (2015). Fibromyalgia: the prototypical central sensitivity syndrome. Current rheumatology reviews, 11(2), 131–145. https://doi.org/10.2174/1573397111666150619095007

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Malfliet, A., Van Oosterwijck, J., Meeus, M., Cagnie, B., Danneels, L., Dolphens, M., Buyl, R., & Nijs, J. (2017). Kinesiophobia and maladaptive coping strategies prevent improvements in pain catastrophizing following pain neuroscience education in fibromyalgia/chronic fatigue syndrome: An explorative study. Physiotherapy theory and practice,33(8), 653–660. https://doi.org/10.1080/09593985.2017.1331481

Stuifbergen, A., Blozis, S., Becker, H., Phillips, L., Timmerman, G., Kullberg, V., . . . Morrison, J. (2010). A randomized controlled trial of a wellness intervention for women with fibromyalgia syndrome. Clinical Rehabilitation, 24(4), 305-318.

Theadom, A., Cropley, M., Smith, H., Feigin, V., Mcpherson, K., & Theadom, A. (2015). Mind and body therapy for fibromyalgia. The Cochrane Database of Systematic Reviews, 2015(4), CD001980–CD001980. https://doi.org/10.1002/14651858.CD001980.pub3

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Disclaimer

Fibromyalgia is not a "one size fits all" diagnosis. What works for some doesn't work for others. The information provided is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. Should you have any health-related questions, please consult your physician or other health care provider promptly.

 

Teresa & Hannah are fellow fibromyalgia warriors. Teresa is a certified dietary manager and wellness coach. Hannah is an occupational therapist. Together, we're a mother-daughter duo on a mission to empower others to fight against fibro.

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