Understanding Fibromyalgia - Treatment

How Do I Know If I Have It?

Before fibromyalgia treatment can begin a doctor must diagnose the condition.

Some experts think that fibromyalgia is underdiagnosed.  It can be difficult to diagnose because many of its symptoms are the same as those of other conditions, such as chronic fatigue syndrome, underactive thyroid, Lyme disease, lupus, and multiple chemical sensitivity.  Fibromyalgia is usually diagnosed after other possible causes have been ruled out.

To diagnose fibromyalgia, your doctor will take a thorough history and do physical and neurological exams.  He or she may order laboratory tests to rule out other conditions.  They will also determine whether you have any tender points, the key distinguishing symptom of fibromyalgia.  Some doctors use the American College of Rheumatology guidelines that require a minimum of 11 out of 18 tender points for a fibromyalgia diagnosis.  Others believe that fewer than 11 tender points may indicate fibromyalgia, particularly if you also have severe fatigue and widespread pain that has lasted more than three months.

Because of the difficulty in diagnosing fibromyalgia, it is best to see a doctor who is knowledgeable about the condition, such as a rheumatologist.  Diagnosis is important because the earlier fibromyalgia is detected, the sooner you can make lifestyle changes to reduce the symptoms.

What Are the Treatments?

There is no cure for fibromyalgia, and people with the condition usually have it for life.  However, it is not likely to get worse as you age and it does not damage your muscles, tendons, or ligaments.  Many people are able to reduce their symptoms with a combination of exercise, medication, physical therapy and relaxation.

Lifestyle Choices

A vital part of treating fibromyalgia is frequent, low-impact aerobic exercise.  Examples include walking, biking, water aerobics, and swimming.  Exercise tends to reduce pain and tenderness and to improve muscle fitness and sleep.  Stretching is also important and may help reduce stiffness and pain.

At first, pain and fatigue may make it difficult for you to exercise.  Keep in mind that persisting with an exercise routine may reduce your symptoms, while becoming unfit may make symptoms worse.  If you have not exercised recently, be sure to talk with your doctor before you begin an exercise program, and start slowly.  Your doctor or a physical therapist can help you work up to 20 to 30 minutes of exercise on most days of the week.

Better-quality sleep may also help reduce fibromyalgia symptoms.  Low-dose tricyclic antidepressants help relieve sleep problems and pain in many people with fibromyalgia.  Also, try to go to bed and wake up at the same time every day; some people notice that their symptoms get worse when they stay up just an hour or two later than usual.

Avoid alcohol and caffeine.  These disrupt deep, restorative sleep and may aggravate your symptoms.

Relaxation techniques can help relieve muscle tension and reduce stress.  Evaluating the causes of stress and learning new ways to cope may also lessen symptoms.

Medication

Nonsteroidal anti-inflammatory drugs (such as ibuprofen, naproxen, ketoprofen, and aspirin) or other pain medication (such as Ultram) may help relieve muscle pain.  For a particularly tender area, your health care provider may inject a local anesthetic to provide relief that typically lasts about two to three month

At-Home Remedies

Applying heat or cold packs to painful areas may relieve symptoms temporarily. Staying warm and improving your posture may also help. Reducing stress may reduce symptoms and may even eliminate them in mild cases. Pace yourself with work, household chores, and social activities -- don't take on too much.

Take a proactive role in learning about fibromyalgia to help control it, and be vigilant about following your treatment plan.  Emotional support is very important, too.  Living with fibromyalgia may be difficult if your family, friends, or employer do not understand the condition.  Seek out supportive family, friends, clergy, support groups or a mental health counselor.