Pain management health centre

What is fibromyalgia?

What tests are used to diagnose fibromyalgia? continued...

Your doctor will also use a diagnosis of inclusion. That means your doctor will make sure your symptoms satisfy the diagnostic criteria for fibromyalgia syndrome. These criteria include widespread pain that persists for at least three months. Widespread pain refers to localised points of pain that occurs in both the right and left sides of the body, both above and below the waist, and in the chest, neck and mid or lower back. Pressure on these points causes a level of pain out of proportion to the pressure applied. Finding a certain number of these points (usually 11 out of 18 specific sites) can help the doctor with the diagnosis.

The doctor will evaluate the severity of related symptoms such as fatigue, sleep disturbances and mood disorders. This will help measure the impact FMS has on your physical and emotional functions, as well as on your overall health-related quality of life.

What is the standard treatment for fibromyalgia?

There is no cure for fibromyalgia, and there is no single treatment that will address all of the fibromyalgia symptoms. Instead a wide array of traditional and complementary treatments has been shown to be effective in treating this syndrome. A treatment programme may include a combination of medication, exercise, (both strengthening and aerobic conditioning) and behavioural techniques.

What medication is used to treat fibromyalgia?

Medication does not deal with the underlying cause or causes of fibromyalgia, but does help to relieve the symptoms.

Specific recommendations on treatments may include:

• Tramadol, an opioid analgesic is recommended for the management of pain. Although other treatment options may include simple analgesics (such as paracetamol) and other weak opioids, nonsteroidal anti-inflammatory drugs ( NSAIDS) have not been found to be effective. Corticosteroids and strong opioids are not recommended.
• Antidepressants are recommended for the treatment of FMS because they decrease pain and often improve function. Appropriate options may include tricyclic antidepressants such as amitriptyline, as well as newer drugs such as fluoxetine, duloxetine and paroxetine.
• Pramipexole, a treatment for Parkinson’s disease and restless legs syndrome, has been found to reduce pain in FMS.
• Pregabalin is an anti-epileptic drug that has also been found to help with pain in FMS patients.

Are there complementary treatments for fibromyalgia?

Complementary therapies, although they are not well-tested, can help manage the symptoms of fibromyalgia. For instance therapeutic massage manipulates the muscles and soft tissues of the body and helps ease deep muscle pain. It also helps relieve pain of tender points, muscle spasms and tense muscles. Similarly myofascial release therapy, which works on a broader range of muscles, can gently stretch, soften, lengthen and realign the connective tissue to ease discomfort.

Cognitive behavioural therapy (CBT), relaxation techniques and physiotherapy may help some patients.

Moderately intense aerobic exercise at least two or three times a week can help FMS symptoms, and although the scientific evidence may not be strong, the benefits of exercise for general health and feelings of well-being suggest its use should be encouraged. Hydrotherapy in a heated pool may also be beneficial.

Techniques such as hypnosis, acupuncture and chiropractic manipulation may help pain in individual cases, but further evaluation of these methods is required.

Along with complementary therapies, it is important to allow time each day to rest and relax. Relaxation therapies such as deep muscle relaxation or deep breathing exercises can help reduce the added stress that can trigger fibromyalgia symptoms. Having a regular bedtime is also important. Sleep is essential to allow the body repair itself.