Fibromyalgia is a disorder that affects how the body processes pain signals. It frequently results in fatigue and widespread pain in the muscles and joints of the body. Patients could experience cognitive issues, including impairments in attention span and concentration, and some might also have anxiety, depression, tension headaches, or irritable bowel syndrome. For reasons that are not fully understood, women have a higher risk of fibromyalgia compared to men. Physicians diagnose fibromyalgia by ruling out other conditions that could cause the patient's symptoms. In the past, doctors would perform a physical examination to check for tenderness at eighteen sites across the body, though modern guidelines suggest this exam is no longer necessary. Currently, if a patient has experienced widespread pain for at least three months and no other medical condition accounts for their symptoms, a diagnosis of fibromyalgia can be made.
Some of the most widely used treatment options for fibromyalgia are discussed below.
Originally developed to treat epilepsy, anti-seizure medication is also effective in reducing the type of pain that frequently occurs with fibromyalgia. Gabapentin is one of the anti-seizure medications most often prescribed for patients with this condition. Patients taking this medicine may experience potential side effects such as dizziness, sleepiness, or memory loss, and water retention and walking difficulties have been reported. In addition to gabapentin, an anti-seizure medication known as pregabalin, the first drug specifically approved for fibromyalgia treatment in the United States, is particularly beneficial for many patients. This drug can be taken orally, and it may also be injected. If patients are prescribed the injectable form of this medicine, they take it at home as a self-administered injection. Common side effects of pregabalin include tremors, blurry vision, dry mouth, weight gain, and loss of balance and coordination. Patients could develop constipation, breast swelling, or memory issues, and some individuals have experienced weight gain.
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Antidepressants may help in reducing the pain and fatigue associated with fibromyalgia. The antidepressants duloxetine and milnacipran are routinely used for this purpose, and they might be prescribed together with amitriptyline or cyclobenzaprine (a muscle relaxant) to help patients sleep more easily. Patients taking antidepressants should be monitored regularly, especially during the first three months of treatment. Doctors should ask about the patient's mood, and patients should inform their healthcare provider immediately if they develop any suicidal thoughts, panic attacks, or worrying changes in behavior.
Potential side effects of duloxetine include sweating, nausea, loss of appetite, diarrhea, constipation, and dry mouth. Some patients could develop headaches, muscle aches, heartburn, or increased urination. Individuals taking milnacipran may experience hot flashes, swelling in the hands and feet, insomnia, and changes in weight. Bloating, upset stomach, and nausea have been reported as well. Patients taking antidepressants should make sure they are informed about all potential side effects of their particular medication, and they may wish to keep a diary of any symptoms or unusual side effects that they experience. If a particular antidepressant causes troublesome side effects or does not seem to sufficiently reduce fibromyalgia pain, the patient's physician may be able to prescribe another antidepressant better suited to the patient's needs.
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Physical therapy may help fibromyalgia patients move with less pain and have a higher quality of life. Many patients with fibromyalgia may wish to have physical therapy on a long-term basis, and working with a therapist who specializes in this condition might be particularly helpful. When the patient visits a physical therapist for the first time, the therapist will begin by conducting a thorough health history and clinical assessment. Based on the patient's areas of pain and any associated issues, the therapist will guide the patient in exercises that can strengthen muscles and joints and improve flexibility and stamina. Therapy can help patients use their muscles more efficiently and improve their posture, and these changes often minimize fatigue and pain. Some of the stretches the physical therapist uses may be done with elastic bands or with the patient's own body weight. Many therapists find therapy sessions conducted in a swimming pool are especially helpful for fibromyalgia patients. While participating in physical therapy, patients should always let their therapist know about any new or worsening symptoms, and they should inform the therapist immediately if any stretches or other exercises result in soreness or pain.
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Occupational therapy helps patients with fibromyalgia learn new ways of completing daily tasks that could minimize the strain placed on the body. For example, occupational therapists might suggest purchasing a new office chair at a different height or one with added padding to protect against back pain and strain on the lower body. The patient could also be advised to consider adjusting their desk or computer in a way that might reduce neck strain or pain in the arms from typing and other workplace tasks. Therapists can help patients with modified methods of dressing, cooking, and doing household chores. These methods aim to reduce pain and make it easier for patients to be as comfortable and independent as possible. Sometimes, patients may be provided with aids that make common tasks less painful. For example, instead of having to stand on a stool to reach a high shelf, the patient might be provided with a handheld grasping device that can get these items while the patient stands in a comfortable position on the floor.
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Engaging in Regular Low-Impact Exercise
Studies have shown engaging in regular low-impact exercise can help reduce the pain patients with fibromyalgia may feel. Exercise helps in improving range of motion, flexibility, stamina, and muscle strength, and it also releases natural endorphins that could reduce the depression and anxiety that sometimes occur with this condition. In addition to swimming and water therapy exercises, doctors recommend low-impact exercises such as tai chi, Pilates, walking, and gentle forms of yoga for patients with fibromyalgia. Ballroom dancing, low-intensity cycling, and hiking can be beneficial, too. Before beginning any exercise program, patients with fibromyalgia should always consult their doctor to make sure they are healthy enough for exercise.