Finding Pain Relief from Fibromyalgia

August 5, 2015

While it has no cure, fibromyalgia is a common and chronic disorder characterized by widespread muscle pain and fatigue that can interfere with a person’s ability to carry on with daily activities.  Making matters worse, there are some people who believe that fibromyalgia is a made-up illness.  Sorting fact from fiction and, we sought out the best fibromyalgia treatment options from doctors.

Dr. Ozatkay at work.

Dr. Ozaktay at work.

“Fibromyalgia is a real disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues, appears to result from neuro-chemical imbalances including activation of inflammatory pathways in the brain which results in abnormalities in pain processing,” said Dr. A. Cuneyt Ozaktay, a senior pain care specialist with Anesthesia Pain Care Consultants (APCC), based in Tamarac, Florida.

“Functional MRI scans have shown reproducible blow flow changes in the brains of fibromyalgia patients that are identical to those suffering from chronic pain,” says Dr. Nathan Wei, a board-certified rheumatologist with more than 30 years of practice and clinical research experience who founded the Arthritis Treatment Center in Frederick, Maryland.

“People suffering from fibromyalgia have real pain and a lot of misdiagnosis,” says Dr. Carolyn Dean, Medical Advisory Board Member, Nutritional Magnesium Association and author of “The Complete Natural Medicine Guide to a Women’s Health.”

51JSZ72BWSL__SY344_BO1,204,203,200_“Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress,” says Dr. Ozaktay. “”In other cases, symptoms gradually accumulate over time with no single triggering event. Women are much more likely to develop fibromyalgia than are men. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression. Tenderness or pain in 11 of the 18 ‘tender points’ on patients’ body is another major sign for fibromyalgia.”

Symptoms of fibromyalgia include:

  • Widespread pain. The pain associated with fibromyalgia often is described as a constant dull ache that has lasted for at least three months. To be considered widespread, the pain must occur on both sides of your body and above and below your waist.
  • Fatigue. People with fibromyalgia often awaken tired, even though they report sleeping for long periods of time. Sleep is often disrupted by pain, and many patients with fibromyalgia have other sleep disorders, such as restless legs syndrome and sleep apnea.
  • Cognitive difficulties. A symptom commonly referred to as “fibro fog” impairs the ability to focus, pay attention and concentrate on mental tasks.
  • Other problems. Many people who have fibromyalgia also may experience depression, headaches, and pain or cramping in the lower abdomen.

“Treatment for fibromyalgia includes both medication and self-care,” says Dr. Ozaktay. “The emphasis is on minimizing symptoms and improving general health. No one treatment works for all symptoms. While there is no cure for fibromyalgia, a variety of medications can help control symptoms. Exercise, relaxation and stress-reduction measures also may help.”

Dr. Wei believes that fibromyalgia treatment consists of three major components which include non-impact aerobic exercise, e.g., swimming, cycling, an elliptical trainer; cognitive behavioral therapy: training the brain to cope with the myriad problems associated with this condition. Examples include guided imagery, the use of a planning instrument, self-hypnosis, etc. and medication and medication.  The medication consists of different chemical classes designed to stimulate neural pathways in the brain.  Among the different targets are nor-epinephrine, serotonin, GABA, and dopamine.”

“Very gentle exercises are best to reduce fibromyalgia symptoms,” says Dr. Dean. “Anything aerobic or stressful will make the pain worse.”

“Medications can help reduce the pain of fibromyalgia and improve sleep,” says Dr. Ozaktay. Common choices include:

  • Pain relievers. Over-the-counter pain relievers such as acetaminophen, ibuprofen, or naproxen sodium may be helpful.  Prescription pain reliever such as tramadol (Ultram, Conzip) can be also used. Opioids are not advised, because they can lead to dependence and may even worsen the pain over time.
  • Antidepressants. Duloxetine (Cymbalta) and milnacipran (Savella) may help ease the pain and fatigue associated with fibromyalgia.
  • Anti-seizure drugs. Medications designed to treat epilepsy are often useful in reducing certain types of pain. Gabapentin (Neurontin, Gralise) is sometimes helpful in reducing fibromyalgia symptoms, while Pregabalin (Lyrica) was the first drug approved by the Food and Drug Administration to treat fibromyalgia.

Dr. Dean believes that “magnesium is an important anti-inflammatory” and recommends that “people use magnesium in baths or drink magnesium citrate in water.”

Is there a dietary connection between foods and fibromyalgia flare-ups?  “Sugar, glutin and dairy can make the pain worse,” says Dr. Dean.  “Antifungal foods can make the pain better.  Many people with fibromyalgia have yeast overgrowth which produces toxins and inflammations.  Antifungal herbs, probiotics and foods are important.”

“Although research hasn’t shown that there are specific foods that all fibromyalgia patients should avoid or add to their diets,” says Dr. Ozaktay.  “But it may still be worthwhile to take a closer look at how foods impact the way you feel. Maintaining a healthy, balanced diet with proper nutrition will give patient more energy and generally people feel better.”

“They might be sensitive to MSG, certain preservatives, eggs, gluten, dairy, or other common allergens,” adds Dr. Ozaktay.  “In fact, in a survey published in the journal Clinical Rheumatology, 42% of fibromyalgia patients said their symptoms worsened after eating certain foods. A good way to start identifying the foods that may aggravate your symptoms, it may be good idea keeping a daily food journal, for instance, that they have more fatigue when a particular food eaten, or try an elimination challenge diet, i.e., eliminating dairy products or foods containing gluten.”

Can restful sleep reduce the pain of fibromyalgia?  “Sleeping well may help ease the pain and fatigue of fibromyalgia,” says Dr. Ozaktay.  “Improving your sleep may improve your symptoms. Go to bed the same time each night, give yourself the time to get 7 to 8 hours of sleep nightly and turn off electronic devices which can disrupt sleep.”

Should fibromyalgia patients consider alternative treatment approaches?  “Many people with fibromyalgia find it beneficial to consider adding one or more of the following alternative treatment approaches to manage their condition: physical therapy, chiropractic therapy, nutritional counseling, cognitive behavioral therapy, massage, yoga, or hydrotherapy (using water, ice, and steam),” says Dr. Ozaktay. “Adding any of these approaches may help you manage your fibromyalgia.”

Resources to learn more about fibromyalgia treatment include the National Fibromyalgia Association, Arthritis Foundation and forums and support groups.

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