Trouble sleeping? Symptoms seen with fibromyalgia and 4 treatment approaches

Fibromyalgia causes people to struggle daily – putting their body in constant pain, fatigue and foggy thinking. Although there is no cure, there are things you and your doctor can do to help with a fibromyalgia diagnosis.

“There is no test that diagnoses fibromyalgia. Since we don’t understand why it occurs, there’s some controversy about its existence because not all doctors believe in it,” said Dr. Thomas Sandager, a Marshfield Clinic Health System family medicine doctor. “Since we don’t know exactly what causes it, treatments have been developed based on what seems to help rather than a deep understanding of why it occurs.”

Symptoms seen more frequently in someone with fibromyalgia include:

• Migraines or headaches
• Sleep disturbances, like sleep apnea
• Irritable bowel syndrome
• Brain fog

If you have aching that causes you to hurt all over for more than three months along with any of these secondary symptoms, you could have fibromyalgia.

“Just being able to call it something is important because without a diagnosis of fibromyalgia these patients wouldn’t have a diagnosis. I think it is more frustrating to not even have a plan,” Sandager said.

Initial blood tests are often completed to make sure a systemic disease is not the problem. Your doctor may work with a rheumatologist to rule out other causes such as rheumatoid arthritis, lupus or a vitamin deficiency. A sleep doctor and psychologist are sometimes consulted during your treatment plan.

Prescriptions you are taking can provide symptoms that appear to be fibromyalgia, such as taking statins for high cholesterol.

Setting goals

Dr. Melissa Matzumura, a Marshfield Clinic Health System rheumatologist, recommends setting attainable goals before treatment begins because being pain free is often not possible with fibromyalgia.

Education is key with fibromyalgia treatment. Different treatment options, including medication and adjuvant therapies like physical therapy, have to be discussed,” said Matzumura. “Treating different factors associated with the pain, and not only the pain, can make a big difference. Most importantly, discussing the goals of treatment is important because sometimes being pain free is not a realistic option.”

Lifestyle treatment options

Fibromyalgia is a difficult condition to treat because many factors cause it. Both Sandager and Matzumura said making healthy lifestyle changes are an important first step.

“It is not all about medication, but about exercises, healthy habits and having close follow-up with your primary care,” said Matzumura.

Low impact exercises such as walking or biking help build a natural tolerance to pain, including from fibromyalgia. Sandager warns not to overdo it because exercising can make things worse for the first few weeks.

Taking a look at your sleep also can reduce the pain.

“Sleep is restorative to our muscles when we are tired. We feel better after a good night’s rest. People with fibromyalgia often report they feel better after a good night’s sleep,” said Sandager.

Treating sleep apnea and symptoms such as migraines can provide additional relief.

Medication treatment options

Along with lifestyle changes, doctors can prescribe many medications that provide small amounts of relief. The commonly prescribed medications are:

• Amitriptyline (Elavil®) or doxepin (Sinequan®)
• Gabapentin (Neurontin®)
• Pregabalin (Lyrica®)

Additionally, Ibuprofen (Advil®) or naproxen (Aleve®) can sometimes be helpful.

While fibromyalgia puts a body in constant pain, doctors discourage using narcotics because it is not effective.

Some treatment options may help, but it is often a combination of these options that provide the most relief.

For more information about fibromyalgia, talk to your primary care provider.