Meds, exercise can help with fibromyalgia
DEAR DOCTOR: My daughter, who is in her 40s, has fibromyalgia. Is there any cure for this painful condition, or any natural remedies?
DEAR READER:
A chronic pain disorder initially termed “fibrositis syndrome” in the mid19th century, fibromyalgia has been an official diagnosis only since 1990. The condition causes widespread musculoskeletal pain and fatigue, as well as sleep problems and difficulties with concentration and memory.
In the United States, 2 to 3 percent of the population suffers from fibromyalgia, with women affected twice as often as men. Blood tests can’t detect fibromyalgia, so the diagnosis is based on a person’s symptoms, including the tender points identified during a physical examination.
The first step in treating fibromyalgia is to understand the illness and what triggers a flair of symptoms. Anxiety and depression are common with fibromyalgia, and the resulting emotional stress can create a cycle of worsening pain and even lower energy levels.
Practicing good sleep hygiene is vital because poor sleep can worsen fibromyalgia pain and fatigue. Relaxation techniques and therapy can relieve anxiety and depression, while meditation training can ease pain. Reflexology and acupuncture have each shown benefits in small studies at easing a variety of symptoms.
Exercise is a crucial component of therapy. Multiple studies have shown that it decreases pain, increases flexibility and boosts energy. The key is to start slowly with low-impact exercise, such as walking, biking, swimming or water aerobics.
Although they don’t cure the illness, various drugs and supplements can improve specific symptoms relating to sleep, fatigue, depression or pain. These include the antidepressants amitriptyline, duloxetine and milnacipran; the muscle relaxant cyclobenzaprine; anticonvulsants gabapentin and pregabalin; the synthetic cannabinoid Nabilone; and vitamin D supplements.
Because fibromyalgia is a chronic condition, opiates are not recommended due to the likelihood of tolerance or addiction.
The best hope is that people can find help controlling, if not curing, their specific symptoms.
Robert Ashley, M.D., is an internist and assistant professor of medicine at the UCLA.
Send your questions to askthedoctors@mednet. ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA 90095.