Fibromyalgia (FM) is a chronic pain syndrome. Though the exact cause(s) of the condition remains unknown, research has identified several factors that seem to contribute to its development. For instance, emotional and physical trauma, chronic stress, previous infections, genetics, and abnormal responses by the brain in managing pain have all been identified as possible causes. Symptoms of the condition manifest as widespread pain and tenderness in muscles and other soft tissues. Pain can occur at any time in areas known as trigger points in all four quadrants of the body such as the neck, shoulders, chest, hips, elbows, knees, and shins. Other symptoms seen in most sufferers are fatigue, sleep disturbance, anxiety, and depression. It affects men, women, and children but is more likely to affect women between the ages of 30 and 70 with a prevalence rate of 2.4 and 6.8%, compared to 0.2 and 6.6% in the general US population. An estimated 5 million people in the US are currently living with the condition. Fibromyalgia not only affects the physical and mental states of those living with it, it costs an estimated $25 billion per year in treatment.

TREATMENTS AVAILABLE FOR FIBROMYALGIA

Treatments for fibromyalgia are aimed at improving the quality of life by managing pain, depression, and sleep disturbance as well as helping patients improve their physical capacity to keep disruption of daily activities to a minimum. To accomplish these goals, patients are often treated with a combination of medication and self-management care. This two-pronged approach has proven more effective than any single intervention.

PHARMACOLOGICAL TREATMENTS
There are several medicines that are used to treat the symptoms of fibromyalgia, but only three have been FDA-approved.

1. Pregabalin(Lyrica), is an anti-seizure medication that was approved by the FDA in 2007 to treat damaged nerve pain. A small number of fibromyalgia patients who took 300-600 mg of Pregabalin experienced a significant decline in the level of pain from 12-26 weeks.
2. Gabapentin is another anti-seizure medicine used to manage pain. Although not FDA-approved, it was tested on 150 people with fibromyalgia at a dosage between 1200 to 2400 mg/day for 12 weeks. Five out of ten experienced a major reduction in pain compared to the placebo.
3. Duloxetine (Cymbalta) is often prescribed to treat depression and is FDA approved.
4. Avella (Milnacipran HCI) is FDA-approved and given to help treat abnormal brain responses to pain.
5. Amitriptyline, Ambien, Xanax (Alprazolam), or Lunestain in small doses may be prescribed to help patients sleep.

Some over-the-counter (OTC) pain relievers such as ibuprofen, aspirin, or other NSAIDs may also be helpful.
NON-PHARMACOLOGICAL TREATMENTS

As is often the case, many prescribed medications are expensive, can carry serious side effects that can outweigh their benefits, or they may lose their effectiveness over a period of time. As a result, finding alternative, beneficial treatments to medication for fibromyalgia patients is often needed. The following alternative treatments have been recommended based on evidence from scientific research.

1. Acupuncture

Acupuncture is an ancient traditional Chinese medicine technique, widely used as an alternative treatment for pain and several other conditions. The technique has been shown to promote the natural healing of the body, improve blood flow, and encourage proper body function. During the process, sterile, fine needles are inserted into the skin at precise areas of the body known as acupoints. The treatment can last up to 30 minutes. Several randomized controlled studies have shown acupuncture to be an effective alternative treatment for pain in fibromyalgia patients, with benefits lasting about a year.

2. Cognitive Behavioral Therapy (CBT)

CBT is a form of psychotherapy aimed at helping fibromyalgia patients change the way they think about certain things like themselves or their pain, which can lead to a change in their behaviors as far as seeking treatment for the condition. Studies have shown CBT to be effective for depression, emotional trauma, anxiety, neuropathic pain, and sleep disturbance. Patients usually meet with a therapist alone or in a group and are properly educated about the condition, taught certain skills that will help manage pain, and encouraged to apply those skills in real life.

3. Exercise

Traditionally, people with chronic pain including fibromyalgia sufferers have often been told to avoid physical activity like exercise and instead remain at rest. However, as more research becomes available about fibromyalgia and the benefits of exercise in general, those recommendations are no longer being strictly adhered to. It is now known that exercise has important benefits for people suffering from chronic pain as it can improve their mental outlook and physical health. Several studies evaluating various types of exercise including aerobic offer evidence to support physical activity as an alternative treatment for pain and depression in fibromyalgia patients. Other forms of physical activity to consider are Tai chi, yoga, and massage therapy.

4. Diet, Herbs, and Nutrition Supplements

Although there is limited evidence to support the use of dietary changes, herbs, and nutrition supplements in the treatment of fibromyalgia, any person with or without fibromyalgia can still benefit to some extent from eating a predominantly plant-based diet. In fact, one study shows that eating a primarily vegetarian diet could have some important benefits for those suffering from fibromyalgia, probably because of the high antioxidant content of most vegetables and fruits. In addition, a vegetarian diet could help people with the condition control their weight and prevent obesity which is linked to depression.

NUTRITION SUPPLEMENTS THAT MAY HELP FM PATIENTS

1. Chromium Picolinate. This supplement may help those taking Amitriptyline, which can cause weight gain and carbohydrate cravings in some individuals. It stabilizes blood sugar levels, decreases cravings, and increases energy levels.

2. Vitamin D. Studies have shown that FM patients often have low levels of this vitamin. A study was conducted in 2013 to test the effect of vitamin D supplementation on symptoms in FM patients. The study was conducted for 20 weeks and aims for 32 and 48mg/mL of vitamin D levels in serum. At the end of the period, there was a significant decrease in pain in those treated with vitamin D.
3. Omega-3 fatty acid. Found mainly in fish like salmon, mackerel, tuna, cod, and krill, and in seeds like flax and chia. Many studies over several decades have shown a link between low levels of omega-3 fatty acids and mood disorders like depression. Supplementation with omega-3 may improve symptoms of depression in FM sufferers.

4. Coenzyme Q10 (CoQ10) is an antioxidant involved in cellular respiration and energy production. Several studies show that people with FM had low levels of CoQ10 and that administration of CoQ10 supplementation improved clinical symptoms in FM sufferers.

5. Calcium and Magnesium.

Magnesium plays a very important role in maintaining the electrical charge of cells. It helps control the flow of potassium in our bodies. Both of these are needed by the body for nerve transmission and muscle contraction. Taken together, they may relax FM patients and help them sleep better.

6. Vitamin B complex may help FM patients cope with fatigue and stress.

SUMMARY

FM is not a life-threatening or progressive condition, but the intensity of pain and other symptoms vary widely and can be serious enough to disrupt day-to-day affairs. For many patients, this unpredictability in the severity of symptoms or pain levels makes it especially difficult to deal with and causes confusion and fear among sufferers. Fortunately, there are many alternative and pharmacological treatments now available to manage pain, sleep disturbances, and depression, and help FM patients live normal, healthy life. As further research sheds more light on the causes of the condition, better treatments will become available in the future; in the meantime, it is always helpful to talk with your healthcare provider about the combination of treatments that’s right for you. FM doesn’t have to be a debilitating condition for you if you’re willing to take on an active role in your recovery.

This Article is Written By Lisa Gibson:

Lisa Gibson is a writer and published author. She received her bachelor of science degree in 1999 from Sam Houston State University in Huntsville, Texas. Upon graduation, she worked as a research assistant at the University of Texas Southwestern Medical Center in Dallas in the area of atherosclerosis, after that she was a teacher. Lisa currently resides in the Caribbean and manages a health and nutrition website.