Fibromyalgia Treatment Protocols and Goals

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Understanding fibromyalgia treatment methods and goals is very important. The "Managing MY Fibromyalgia" web site focuses on improving function and improving one's quality of life. Fibro treatment via Physical Medicine and Rehabilitation strive to empower the person with fibromyalgia, abilities to improve the quality of life, even if the condition is ever present.

It is easy to think of people with FM as a homogeneous group of people. That is, we all have the same condition. We may all have the same thing, but we certainly do not behave in the same manner, nor do we all respond the same to fibromyalgia treatment. What works for one person may not work at all for another person. There is no one formula for fibromyalgia treatment because each of us with fibromyalgia is a unique individual.

Which ever fibromyalgia treatment we receive should have several goals in mind. They are: 1. The decreasing of pain and fatigue as much as possible. 2. Improving Function. 3. Having the person who has FM learn and begin a successful program to be able to self-manage fibromyalgia.

I think the best short and sweet summary of fibromyalgia treatment I have read were written by Dr. Mark A.Pellegrino. His list is basically as follows:

Education This is half the battle. People with fibromyalgia must understand that this condition is not life threatening, deforming or paralyzing, and it is a valid medical condition. The more one learns about fibromyalgia, the more it is understood and the less frightening it becomes. I think I discussed something similar to this on a different web page when we discussed the use of fibromyalgia message board and fibromyalgia chat.

Medicines There is no magic medicine available to eliminate all the symptoms of FM but many medicines can be helpful in controlling various fibromyalgia symptoms. Sleep modifiers (i.e. Ambien, Restoril), antidepressants medicines (i.e, tricyclics and serotonin re-uptake inhibitors), pain medicines and various other prescribed medicines can be helpful. Often different medicines need to be tried together to find the best combination, and even when a good combination is found, the medicines can stop working after a while. Rotating different medicines over time can help maintain the best relief of symptoms.

Nutritional Supplements A variety of nutritional supplements can be used to help the fibromyalgia symptoms. Magnesium with malic acid, 5-HTP, Colostrum and others can be a beneficial fibromyalgia treatment. Many people who are too sensitive to prescribed medicines can better tolerate nutritional supplements. Some people will have better results from nutritional supplements than others.

Pain Management Apart from medicinal therapy, one may use a variety of programs that may include moist heat, bio-electric therapy, trigger point injections, ultrasound and others with the goal of decreasing pain to a lower level. Once the pain has decreased, one can try to progress to an exercise program.

Exercise It is important to increase the flexibility and tone of the muscles, this can be done by instructing a person on a combination of postural stretches, light aerobic conditioning and strengthening and toning exercises. Mild exercise should be increased gradually so as not to aggravate the body's reaction.

Manual Therapy This includes therapeutic massage, myofascial release, soft tissue mobilization and adjustments. Massage for fibromyalgia is becoming more common.

Relaxation Deep breathing exercises, guided imagery, biofeedback, yoga, tai chi, and prayer are a few examples of relaxation techniques. Sometimes one of the best treatments to prescribe is relaxation!

Home Program Each individual needs to find whatever works best and follow through with a home program on a regular basis.

A combination treatment approach that is individualized for each person with fibromyalgia is usually best.

Many doctors and specialists who want to help should be open-minded and try to use the best of all fibromyalgia treatment options available to enable each individual to achieve the best quality of life with the least amount of pain. The doctor’s job, whatever his qualifications are, is to try to point you in the right direction. You, though, must have two important qualifications: you must have fibromyalgia and you must want to do better!

Disclaimer:

The "Managing-My-Fibromyalgia" web site is provided for informational and educational purposes only, and no endorsement of any treatment program is intended or implied. Please consult with your own physician regarding the application of any opinions or recommendations with respect to your symptoms or medical condition.

The Latest News Headlines About Fibromyalgia Treatment

New medications may help to ease the pain of fibromyalgia.

Conventional analgesics, such as Tylenol, Motrin or even morphine, provide little relief to sufferers of fibromyalgia, a mysterious and debilitating pain disorder for which there is no effective treatment.

But a new drug may be able to thwart the nerve signals that scientists now believe trigger the pain.

"This is a real breakthrough not only because it works, but it proves fibromyalgia can be treated," says Dr. Leslie Crofford, a rheumatologist at the University of Michigan in Ann Arbor who has studied the new drug, pregabalin.

Other drugs for fibromyalgia....

Tricyclics, an older class of antidepressants that includes Elavil, Tofranil and Sinequan, are the most common form of drug therapy for fibromyalgia.

They can relax the muscles, and promote the secretion of endorphins, hormones that help fight pain and boost mood.

"But only about a third of people who take tricyclics have a significant response," says Dr. Daniel J. Wallace, a rheumatologist in the University of California, Los Angeles School of Medicine.

These drugs also have unpleasant side effects, such as grogginess, dry mouth, weight gain and blurred vision.

However, another fibromyalgia medication that's currently being tested relieves pain and elevates mood in the same way as the tricyclics but without their side effects.

Milnacipran, which isn't as far along in its development as pregabalin, enhances levels of two key brain chemicals, norepinephrine and serotonin, that play a role in pain transmission.

The syndrome, which affects an estimated 5.6 million Americans, the majority of whom are women, is characterized by pervasive muscle aches and pain so intense that many people are unable to work or perform the simplest of tasks.

"Patients got a bad rap because doctors felt they didn't want to get better," says Crofford, "and that there was nothing that could make them get better."

The underlying cause of this condition is still unknown.

But newer, more precise imaging tools can now map out the nerve pathways in the brain that are responsible for pain.

This has given scientists some insights into why fibromyalgia sufferers are so exquisitely sensitive.

"The slightest sensory stimulation --- even being touched when putting on clothes --- can be highly painful in people with fibromyalgia," says Laurence Bradley, a fibromyalgia expert at the University of Alabama at Birmingham.

"We suspect there are abnormalities in both the pain-transmission and pain-inhibition system."

Pregabalin reduces the release of specific brain chemicals, such as glutamate and noradrenaline, that may cause pain, says Terry Griesing, a neurology researcher with Pfizer in New York, the company that makes pregabalin.

"This is our best understanding of what is happening," she says.

Early studies of the drug demonstrated that it was effective in controlling pain due to nerve damage, such as that suffered by people with shingles and diabetics with hand and foot pain.

Because scientists suspect that fibromyalgia is caused by a similar mechanism, Griesing says, "the decision was made to test it for fibromyalgia."

In a recent eight-week study of pregabalin in 529 fibromyalgia patients, 29 percent of the pregabalin-treated volunteers reported at least a 50 percent reduction in pain, and their sleep quality and fatigue levels were significantly improved.

Patients who took the highest doses of the drug had the best responses, Crofford says.

Pregabalin has already completed pivotal tests as a treatment for generalized anxiety disorder, nerve pain and epilepsy.

Pfizer hopes to file for approval from the Food and Drug Administration for these uses within 12 months, according to a spokesman.

The drug could be on the market as early as 2004.

Once it's approved, doctors can prescribe it for other conditions, such as fibromyalgia.

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