Put Together Your Fibromyalgia Treatment Plan

If you have the flu, spend a few days in bed, and you’ll likely feel better. Fibromyalgia is different. Symptoms areeased, never cured, and there is no one "remedy" that works for everyone. For these reasons, fibromyalgia patients should develop a personalized treatment plan to minimize flare-ups and the severity of symptoms.

Identify your symptoms
Widespread, chronic pain is a hallmark of fibromyalgia. It’s diagnosed by the presence of tenderness in 18 specific points of the body, with at least 11 of those 18 spots being abnormally tender, even when mildly touched. Fatigue, sleep, and memory and concentration problems (often called “fibro fog”) also are common symptoms of fibromyalgia. You might also experience restless legs syndrome, irritable bowel syndrome, painful menstruation, depression, dry eyes, anxiety or headaches. Make sure you work with your doctor to treat all of your ailments.

Find the right medications
To date, pregabalin (Lyrica), duloxetine (Cymbalta) and milnacipran (Savella) are the only medications approved by the U.S. Food and Drug Administration (FDA) to treat fibromyalgia pain. Tricyclic antidepressants often have been found to be the most efficacious medications for fibromyalgia, especially since sleep and fatigue problems respond well to some antidepressants. But other painkillers, from over-the-counter ibuprofen to prescription-only narcotics, also are prescribed.

Talk to your doctor about what will give you the greatest relief with the fewest side effects. Because there are so many medications to choose from, you may need to use trial and error to help determine which is best for you. If antidepressants don?t work, you may need to incorporate sleep aids or muscle relaxants into your treatment plan.

Explore alternative treatments
For many people, massage and acupuncture, as well as Pilates, tai chi, chiropractic treatment, and various dietary supplements, can provide relief. You also may find it helpful to work with a physician who incorporates complementary medicine into his or her practice.

Make healthy changes
Stress reduction, a healthy diet and regular exercise can reduce fibromyalgia flare-ups, so lifestyle changes should be a part of your treatment plan. Sleep also is crucial for managing symptoms. Devising a treatment plan will require coordinating with your primary care doctor and/or a rheumatologist, physical therapist, naturopathic physician (if you use one) and other health professionals. Make sure everyone on your health care team is aware of your plan, and consult your doctor before making adjustments.

Reviewed by Steven King, M.D.

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