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TREATMENT OPTIONS:
The most common goals of any fibromyalgia treatment program are to: break the pain cycle,
restore sleep patterns, and increase functional activity levels. There is no single medication
or treatment that will relieve all the symptoms. Generally, a combination of methods specific
to each individual's needs is tried. The main options presently available are: education,
exercise, nutrition, and medications. Because of the chronic aspect of the symptoms, many
individuals get frustrated when conventional treatment methods fail them and resort to trying
one or more complementary/alternative treatments to relieve their symptoms and improve their
quality of life. These include chiropractic manipulation, therapeutic massage therapy,
acupuncture, herbal remedies, and various meditative/relaxation techniques. There is evidence
that some treatment alternatives may be helpful in some cases.
I will outline some of the treatment methods that are suggested for individuals with
fibromyalgia. Please remember that I am not a professional and am only relaying
information I have found in my research. I have attempted to use only sources that
appear to be reliable. I will provide links to many of these sources, so you may
confirm the information yourself and decide whether a specific option may be one
you wish to try. I strongly suggest that you discuss any such options with your
medical practitioner before using it, as many have side effects that may need
consideration.
Life-style changes can only occur after a you are educated/counselled about
fibromyalgia and its implications. You will then be able to make changes in sleep,
nutrition, exercise, and medications that may be helpful in conserving energy and
minimizing pain. Reducing stress and improving coping skills may also reduce painful
symptoms. It is important to understand that some activities may no longer be possible
as long as symptoms persist and that some other activities may need to be altered and
performed more slowly. Pacing oneself is a very important aspect of maximizing quality of
life with fibromyalgia. Plan ahead and take your time, or you may pay the price of decreased
energy levels and increased discomfort levels for several days after a long or arduous
activity. You also may find that joining a support group is beneficial to your emotional
well-being. Talking with others who share your symptoms and concerns can be very cathartic.
A treatment for fibromyalgia that I can not classify in any of the other groups, but
feel is important to mention, is heat treatment. It seems so simple, but for me it is
often the most effective treatment I can use, especially for muscle spasm type pain.
The methods of heat transmission are varied, including showers, baths, hottubs,
whirlpool spas, heating pads, hot water bottles. There is even the added bonus that if
you find heat an effective treatment for you and your medical practitioner will support
you in this assessment, you can take a tax deduction on the purchase/installation of a
spa/hottub at your home.
Exercise includes physical therapy and a moderate exercise routine that may
include stretching, toning, and light impact exercises such as walking, bicycling,
and swimming. Your physician and a physical therapist can help you develop a program
that is specific to your particular needs. It is suggested that moderate exercise may
be one of the most beneficial treatments in relieving fibromyalgia discomfort. But it
should be noted that too much exercise may increase pain levels.
The benefits of nutritional changes for a person with fibromyalgia are harder to
define. Many suggestions have been made, depending upon what you read, and just as many have
been said to have no effect (or even a negative effect) on the symptoms. Vitamin/mineral
supplements of various types have also been suggested with varying levels of proof about
their efficacy. The combination that seems to be most likely to be helpful is a combination
of Vitamin B complex/Vitamin C. Together these vitamins boost energy levels in the body
(I take this combination on a regular basis). Some medical authorities also recommend
calcium/magnesium supplements. The calcium is needed to balance the magnesium, which is
needed by the body for proper muscle functioning and relief of muscle pain/spasms. If you
do consider taking any calcium supplements, be sure that your calcium levels are not already
elevated due to your sarcoidosis. Hypercalcemia is fairly common with sarcoid and can result
in serious medical problems if not properly treated. Another combination involving magnesium
that has been both suggested and refuted in resources I have reviewed is magnesium/malic acid.
In general, the sources that refute the need for additional magnesium state that individuals
with fibromyalgia do not usually have a magnesium deficiency, nor do they benefit from a
magnesium supplement. It is also recommended that intake of caffeine, alcohol, and nicotine
be restricted or completely avoided, since these substances tend to interfere with sleep and
energy patterns.
Medications are many and often uncertain in their effectiveness to control
pain and ease other symptoms of fibromyalgia. The most common medications are the tricyclic
anti-depressants. For fibromyalgia relief they are administered in low doses and can
alleviate minor depression as well as fibro pain, and assist in more restful sleep patterns
(these medications did not help me). The most common of these anti-depressants is Elavil
(amitriptyline). Two other drugs that seem to be frequently prescribed to individuals with
fibromyalgia for pain alleviation are Ultram (tramadol), which is an analgesic like Tylenol
or Darvon, and Effexor (venlafaxine), which is an SSRI like Prozac, Zoloft, and Xanax. I
have not read the same positive results regarding these two medications that I have with
Elavil. Some sources recommend the use of non-steroidal anti-inflammatory drugs such as
ibuprofen or aspirin, while others state that they are not very beneficial. Muscle relaxants
such as Baclofen, Flexeril, and Soma may be prescribed to relieve muscle spasms/cramps.
Ambien is the most often used sleep medication for fibromyalgia because it helps individuals to
stabilize their sleep patterns and does not cause a "hangover" the next morning (the common
"fibro-fog" and lack of energy in the mornings can be debilitating enough).
Alternative treatments for fibromyalgia symptoms have been tried by many who
find no relief from conventional methods. The most positive alternative treatments I
have researched are acupuncture and biofeedback. There appear to be some very positive
evidence that these methods of pain control can be reasonably effective in some individuals.
Other treatments such as massage therapy, aroma therapy, relaxation techniques (such as
meditation), biofeedback, yoga, tai chi and chiropractic manipulation may provide some
temporary relief for some individuals, but their benefits for fibromyalgia patients are
not well documented.
I have read much about herbal remedies of various types. Although many individuals
maintain that certain herbals have benefitted them, there is very little scientifically
acceptable proof that these "natural medications" really do help. The most important thing
I learned during my research of herbal remedies is that a person must be just as careful in
taking them as he/she would be in taking any conventional medication. They all may have some
side effects and/or may be detrimental to certain individuals with specific conditions. For
instance, echinacea and other herbals that help to enhance the immune system could be
detrimental to individuals with autoimmune diseases because in these individuals the immune
system is already overactive (fibromyalgia is presently listed among the more than 100 known
autoimmune diseases). Another herbal, ginkgo biloba, may help improve circulation and brain
function, but it is also a blood thinner. The only herbal that I have found that has been
researched enough to provide reliable proof of some level of efficacy with relatively few/minor
side effects is St. John's Wort. It helps some individuals with mild depression.
I would strongly suggest that anyone considering the use of herbals should consult with an
herbal expert before beginning any such regimen. Medical doctors are not usually very
knowledgeable about herbal remedies and will likely discourage what they don't understand,
so find someone whose area of expertise is herbal remedies. Be sure to ask about ALL
possible effects of the remedy you want to try, both positive and negative.
In cases of severe fibromyalgia pain that is not well controlled by conventional or
alternative therapies, your medical practitioner may recommend and refer you to a
pain clinic. Pain clinics will provide you with very specific instruction about
coping techniques to deal with the pain.
Personal Note: From my research and personal experience, some of the therapies/treatments that seem to indicate the most positive results are: stress-reduction, heat, moderate exercise program, a Vitamin B Complex/Vitamin C supplement, and acupuncture.
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