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How to Treat Fibromyalgia, New and Old Ideas

How to treat fibromyalgia

Anyone who has fibromyalgia may be happy to know that the condition has been recognized as a true health syndrome, but that leaves a question about fibromyalgia treatment. Here are some new and old ideas on how to treat fibromyalgia, including natural approaches.

Why fibromyalgia is a challenge to treat

One reason why fibromyalgia is a challenge to treat is that no one has pinpointed the cause of the syndrome. In a new study published in the Canadian Medical Association Journal, the investigators suggest several possibilities, including a genetic predisposition, an abnormal stress response system, and other triggering situations.

However, as Dr. Mary-Ann Fitzcharles, one of the study’s authors, noted, “In the absence of physical findings or abnormal results from laboratory tests, clinicians must rely on the time-honoured art of medicine to diagnose fibromyalgia.” Some of the common symptoms of fibromyalgia may include widespread pain, areas of tenderness throughout the body, severe fatigue, sleep problems, depression, and anxiety.

One major disadvantage of fibromyalgia is that it cannot be diagnosed using any of the current laboratory tests available. However, that does not mean physicians should not utilize available diagnostic tools to help them diagnose the syndrome, including:

  • Complete blood count
  • Evaluation of thyroid function
  • C-reactive protein level
  • Determination of creatine kinase level
  • Erythrocyte sedimentation rate test

If you are looking for the test involving tender points, a diagnostic tool clinicians used for more than 20 years, that recommended method was recently dropped by the American College of Rheumatology because it was deemed inadequate. It was replaced with a widespread pain index and a symptom severity scale.

The best treatment approach for fibromyalgia, according to the new article, is:

  • Use of primary care physicians (rather than rheumalogists) to diagnose and manage individuals with fibromyalgia, as recommended by the 2012 Canadian Fibromyalgia Guidelines
  • Use of a combination of nondrug approaches (e.g., cognitive behavioral therapy, exercise, relaxation methods) and drugs that are chosen to meet the unique needs of each patient
  • Focus on improving the patient’s function by reducing the most bothersome symptoms, with pain being the primary complaint

Some nondrug treatments to consider
A number of studies have provided some promising results for the use of nondrug treatment for fibromyalgia. Here are a few of them.

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5-HTP: A supplement called 5-hydroxytryptophan (5-HTP) helps boost low levels of serotonin, a brain chemical involved with pain and mood. 5-HTP has been shown to improve symptoms of insomnia, depression, anxiety, and pain in some individuals.

Acupuncture: Several studies have shown acupuncture to be effective for some patients with fibromyalgia. For example, a 2012 randomized clinical trial compared acupuncture with fluoxetine (Prozac) in 30 patients with fibromyalgia.

After four weeks, fibromyalgia symptoms were significantly better in the acupuncture group than in the group who took fluoxetine. At a one-year follow-up, patients in the acupuncture group continued to report significantly better symptoms relief, with fatigue and anxiety being the most improved.

Yoga: Several studies have indicated that the practice of yoga can help relieve fibromyalgia symptoms. A study conducted at the Oregon Health & Science University found that women who participated in an eight-week program of yoga reported a significant improvement in pain, fatigue, depression, stiffness, sleep problems, poor memory, balance, and anxiety when compared with women who were treated conventionally.

Vibration therapy. A relatively new type of treatment called vibration therapy has been used successfully to treat chronic pain conditions such as fibromyalgia. A University of Florida study, for example, found that patients experienced a 40 percent reduction in pain after use of vibration therapy.

Qigong. The ancient practice of qigong involves postures, breathing, and meditation, and individuals with fibromyalgia have been shown to benefit from including it as part of their treatment program. In a study from Dalhousie University, researchers found that patients who participated in a one-hour session once a week for 8 weeks followed by daily practice at home for six months experienced improvements in pain, sleep, anxiety, and overall function.

While 5 to 10 million Americans (the figures vary depending on the source) suffer daily with the pain and other symptoms of fibromyalgia, the condition continues to baffle clinicians and researchers. Anyone with fibromyalgia needs to explore the variety of treatment options and keep their eye on new developments as they are reported.

Fitzcharles M-A et al. Fibromyalgia: evolving concepts over the past 2 decades. Canadian Medical Association Journal 2013. DOI:10.1503/cmaj.121414
Hadianfard MJ, Hosseinzadeh Parizi M. A randomized clinical trial of fibromyalgia treatment with acupuncture compared with fluoxetine. Iranian Red Crescent Medical Journal 2012 Oct; 14(10): 631-40
Juhl JH. Fibromyalgia and the serotonin pathway. Alternative Medicine Review 1998 Oct; 3(5): 367-75

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