Treating fibromyalgia

Treatment for fibromyalgia tries to ease some of your symptoms and improve quality of life, but there's currently no cure.

Your GP will play an important role in your treatment and care.They canhelp you decide what's best for you,depending on what you prefer and the availabletreatments.

In some cases, several different healthcare professionals may also be involved in your care, such as:

• a rheumatologist a specialist in conditions that affect muscles and joints
• a neurologist a specialist in conditions of the central nervous system
• a psychologist a specialist in mental healthand psychological treatments

Fibromyalgia has numerous symptoms, meaning that no single treatment will work for all of them. Treatments that work for some people won't necessarily work for others.

You may need to try a variety of treatments to find a combination that suits you. This will normally be a combination of medication and lifestyle changes.

Information and support

You may find it helpful to research fibromyalgia to improve your understanding of the condition. Many people also find support groups helpful. Just talking to someone who knows what you're going though can make you feel better.

You can visit UK Fibromyalgia's support group section for a list of fibromyalgia support groups across the country.

Fibromyalgia Action UK is a charity that offers information and support to anyone who has fibromyalgia. It hasa telephone service (0844 887 2444) you can call with any questions about the condition. It also has a network of local support groups you may find helpful.

There's also an online community where you can find out about news, events and ongoing research.

Medication

You may need to take several different types of medicines for fibromyalgia, including painkillers and antidepressants. These are described below.

Painkillers

Simple painkillers that areavailable over the counter from a pharmacy, such as paracetamol , can sometimes help relievethe pain associated with fibromyalgia. However, these aren't suitable for everyone, so make sure youread the manufacturers instructions that come with the medication before using them.

If over-the-counter painkillers aren't effective, your GP (or another healthcare professional treating you) may prescribe a stronger painkiller, such ascodeine or tramadol.

However, thesepainkillers canbe addictive and their effect tends to weaken over time. This means that your dose may need to be gradually increased and you could experiencewithdrawal symptoms if you stop taking them. Other side effects include Traveller's diarrhoea and fatigue (extreme tiredness).

Antidepressants

Antidepressant medication can also help to relieve pain for some people withfibromyalgia. They boost the levels of certain chemicals that carry messages to and from the brain, known as neurotransmitters.

Low levels ofneurotransmitters may be a factor in fibromyalgia, and it's believed that increasing their levels may ease the widespread pain associated with the condition.

There aredifferent types of antidepressants. The choice of medicine largely depends onthe severity of your symptoms and any side effects the medicine may cause.

Antidepressants used to treat fibromyalgia include:

• tricyclic antidepressants such as amitriptyline
• serotonin-noradrenaline reuptake inhibitors (SNRIs) such as duloxetine andvenlafaxine
• selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine and paroxetine

A medication calledpramipexole, which isn't an antidepressant, but alsoaffects the levels of neurotransmitters,is sometimes used as well.

Antidepressants can cause a number of side effects, including:

• feeling sick
• dry mouth
• drowsiness
• feeling agitated, shaky or anxious
• dizziness
• weight gain
• constipation

For information on the side effects of your particular medication, check the patient information leaflet that comes with it.

Medication to help you sleep

As fibromyalgia can affect your sleeping patterns, you may want medicine to help you sleep. If you're sleeping better, you may find that other symptoms aren't as severe.

Speak to your GP if you think you could benefit froma medicine like this. They may recommend an over-the-counter remedy, or prescribe a short course of a stronger medication. Some antidepressants may also improve your sleep quality.

Read moreabout treating insomnia for information on good sleeping techniques and medicines to help you sleep.

Muscle relaxants

If you have muscle stiffness or spasms (when the muscles contract painfully) as a result of fibromyalgia, your GP may prescribe a short course of a muscle relaxant, such as diazepam.

These medicines may also help you sleep better because they can have a sedative (sleep-inducing) effect.

Anticonvulsants

You may also be prescribed an anticonvulsant (anti-seizure) medicine, as these can be effective for those with fibromyalgia.

The most commonly usedanticonvulsants for fibromyalgiaare pregabalinand gabapentin. These are normally used to treat epilepsy , but research has shown they can improve the pain associated with fibromyalgia in some people.

Some common side effects of pregablin and gabapentin include:

• dizziness
• drowsiness
• swelling of your hands and feet ( oedema )
• weight gain

Antipsychotics

Antipsychotic medicines, also called neuroleptics, are sometimes used to help relieve long-term pain. Studies have shown that these medications may help conditions such as fibromyalgia, but further research is needed to confirm this.

Possible side effects include:

• drowsiness
• tremors (shaking)
• restlessness

Other treatment options

As well as medication, there are other treatment optionsthat can be used to help cope with the pain of fibromyalgia, such as:

• swimming, sitting or exercising in a heated pool or warm water (known as hydrotherapy or balneotherapy)
• an individually tailored exercise programme
• cognitive behavioural therapy (CBT) a talking therapy that aims to change the way you think about things, so you can tackle problems more positively
• psychotherapy a talking therapy that helps you understandand deal with your thoughts and feelings
• relaxation techniques
• psychological supportany kind of counselling or support group that helps you deal with issues caused by fibromyalgia

See self-help for fibromyalgia for more information about exercise and relaxation techniques.

Alternative therapies

Some people with fibromyalgia try complementary or alternative treatments, such as:

• acupuncture
• massage
• manipulation
• aromatherapy

There's little scientific evidence that such treatments help in the long term. However, some people find that certain treatments help them to relax and feel less stressed, allowing them to cope with their condition better.

Research into some complementary medicines, such as plant extracts, has found they're not effective in treating fibromyalgia. If you decide to use any complementary or herbal remedies, check with your GP first. Some remedies can react unpredictably with other medication, or make it less effective.

Treating other conditions

If you've been diagnosed with fibromyalgia and another condition, such as depression or irritable bowel syndrome (IBS) , you may need to have separate treatment for these. For example, additional counselling or medication may be recommended.

treating IBS