What causes fibromyalgia?
Fibromyalgia often develops after some sort of trauma that seems to act as a trigger, such as a fall or car accident, a viral infection, childbirth, an operation or an emotional event. Sometimes the condition begins without any obvious trigger. The actual cause of fibromyalgia has not yet been identified. In recent years, however, research has produced some insights into this puzzling condition. For instance, it is now known that most people with fibromyalgia are deprived of deep, restorative sleep. Current studies may discover how to improve the quality of sleep and some of the prescribed medicines are specifically aimed at addressing this issue.
Research has also identified a deficiency in serotonin within the central nervous system coupled with a threefold increase in the neurotransmiter substance P, that is found in spinal fluid and transmits pain signals.
The effect is disordered sensory processing. The brain registers pain when others might experience a slight ache or stiffness. It is hoped that more research will discover the cause and result in more effective treatments.
What medication is used to treat fibromyalgia?
Medication does not deal with the underlying cause or causes of fibromyalgia, however it does help to relieve the symptoms. Specific recommendations on treatments may include:
- Tramadol is an opioid analgesic recommended for the management of pain. Although other treatment options may include simple analgesics (such as paracetamol) and other weak opioids, nonsteroidal anti-inflammatory drugs (NSAIDS) have not been found to be effective. Corticosteroids and strong opioids are not recommended
- Antidepressants are recommended because they decrease pain and often improve function. Appropriate options may include tricyclic antidepressants such as amitriptyline, as well as newer drugs such as fluoxetine, duloxetine and paroxetine
- Pramipexole, a treatment for Parkinson's disease and restless legs syndrome, has been found to reduce pain in FMS
- Pregabalin is an anti-epileptic drug that has also been found to help relieve pain symptoms
Are there complementary treatments for fibromyalgia?
Complementary therapies, although these are not well-tested, can help manage the symptoms of fibromyalgia. For instance, therapeutic massage manipulates the muscles and soft tissues of the body and helps to ease deep muscle pain. It also helps relieve pain of tender points, muscle spasms and tense muscles. Similarly, myofascial release therapy, which works on a broader range of muscles, can gently stretch, soften, lengthen and realign the connective tissue to ease discomfort.
Cognitive behavioural therapy (CBT), relaxation techniques and physiotherapy may help some patients. Moderately intense aerobic exercise at least two or three times a week can help with symptoms, and although the scientific evidence may not be strong, the benefits of exercise for general health and feelings of wellbeing suggest its use should be encouraged. Hydrotherapy in a heated pool may also be beneficial.
Techniques such as hypnosis, acupuncture and chiropractic manipulation may help relieve pain in individual cases, but further evaluation of these methods is required.
Along with complementary therapies, it is important to allow time each day to rest and relax. Relaxation therapies such as deep muscle relaxation or deep breathing exercises can help reduce the added stress that can trigger fibromyalgia symptoms. Having a regular bedtime is also important.