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.
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.
I was diagnosed with Fribromyalgia over 20 years ago before they knew much about it so I did my own research and tried different treatments, experimented based on studies, and was able to put it into remission for 10 years. Traumatic stress caused it to flare up again over a period of a year and now for the last decade I have been struggling to get back to that place of recovery. I have participated in pain clinics, received weekly neuromuscular saline injections, and attended the Complex Chronic Disease Clinic at a hospital for a year. What works for me: sleep/relaxation medications like chlorbenzeprine, and topic prescription strength pain cream. I walk every other day 10,000-20,000 steps, cycle when weather is nice. Does exercise hurt, yup its not too comfortable, I accept that when I get home I may need to rest body for awhile. The pain is constant with occasional super flares so I pace myself, recognizing that more intense periods of work, exercise or stress need to be counterbalanced by meditation, relaxation, doing nothing. I get help for household stuff and even avoid cooking if rest is more important. I work toward increasing exercise at increments that feel right for me. Finally I work hard to lose as much weight as I healthily as lower weight decreases the pressure on joints, muscles, etc = help with pain and fatigue. I work in jobs where occasional naps at home are possible. Right now I work remotely so easier.
I have been suffering with fibromyagia for years and have been through the recommended medication lists twice and nothing really works. I average about 4 hours of sleep daily. Costochondritis is awful. It is a condition that affects the chest wall and rib cage. It's inflammation in those areas and very very painful. It's so hard to breathe because taking a deep breath hurts. They say exercise is key, but too much hurts and too little hurts finding a middle ground is nearly impossible. Fibro fog is horrid because you forget almost everything. The constant bouts of diarrhea and constipation… Back pain, hip pain, shoulder pain, it's a living hell.
There is a natural plant based supplement called CBD oil, that is becoming widely available, comes in capsule form, that is doing wonders for the wide array of fibromyalgia symptoms such as joint and body pain, sleep issues, and many others. Besides working, the other great part is lack of side effects and is not addicting.
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