Physical Medicine & Rehabilitation
Over-the-counter pain medications don’t seem to work well for my fibromyalgia symptoms. Are any other treatments available?
Fibromyalgia can be a frustrating condition. Despite the fact that between two and five percent of the population may have this condition, fibromyalgia can be difficult to diagnose and those who are diagnosed may struggle to find effective relief from their pain.
Fibromyalgia can cause significant pain throughout the muscles of the body. This pain will frequently seem to radiate through the muscles from the points where the muscles attach to the bones and joints. The result is generalized pain, almost as though every muscle in your body is affected. Some individuals will feel this as a dull, persistent ache while others will also feel acute pain in specific areas of the body. The level of pain can vary among individuals. Some will have persistent but relatively mild discomfort while others experience debilitating pain that can be severe enough to be disabling.
No laboratory test exists that can diagnose fibromyalgia. Instead, a physician will rely on a patient’s description of symptoms and physical findings that show pain increases when pressure is applied to specific “tender points” on the body.
Little is known about the causes of fibromyalgia. It appears to be a disorder of the body’s immune system and evidence suggest that it may be an inherited condition. Fibromyalgia is much more common in women than in men and also tends to coexist with other disorders including sleep apnea, rheumatoid arthritis, lupus, irritable bowel syndrome and chronic fatigue syndrome. One theory about fibromyalgia is that the brain over-reacts to repeated pain stimulus and over-time this reaction becomes a kind of learned response by the brain. This doesn’t mean that the pain is imagined. Although the cause of the pain may be unclear, the fact that you are experiencing pain is real. The effectiveness of treatment options varies by individual. What works for one person may or may not help the next, so it’s important for you to work with your physician to find the approach that’s best for you. For most individuals, this will require combining different types of treatment to relieve pain.
Among over-the-counter pain medications, analgesics such as acetaminophen are generally more effective than non-steroidal antiinflammatory drugs such as ibuprofen or naproxen sodium. Prescription antidepressants and prescription pain medications may also provide relief for some patients. To date, the U.S. Food and Drug Administration has approved just one prescription medication (Lyrica) for treating fibromyalgia.
In my own practice, osteopathic manipulative treatment (OMT) in conjunction with other forms of care has been effective in providing pain relief for individuals with fibromyalgia. OMT is a technique that osteopathic physicians employ to manually move muscles and joints using techniques that include stretching, gentle pressure and resistance. OMT can ease pain, promote healing and increase mobility. One study published in the Journal of the American Osteopathic Association involving 24 women who were diagnosed with fibromyalgia found that OMT improved outcomes involving “pain threshold, perceived pain, attitude toward treatment, activities of daily living, and personal functional ability.”
Originally published in The University Doctors' MedicaLink - 08/09
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