Fibromyalgia is not a curable condition but treatment can help to alleviate and allow patients to manage some of the symptoms leading to increased level of function and improved quality of life. In fact sufferers are often encouraged to carry on working and undertake regular exercise, as hard as this may be. Self-management has a large role to play in fibromyalgia treatment and “pacing” is often key whereby the sufferer learns to work within their limitations to avoid a flare up of symptoms.
Because fibromyalgia is usually associated with a range of symptoms no one treatment will work for all of them. It is often the case that a multi-disciplinary treatment approach will be adopted involving perhaps a rheumatologist (who specialises in conditions affecting the muscles and joints), a neurologist (specialising in conditions relating to the central nervous system) and a clinical psychologist (who will specialise in psychological treatment and therapy). Treatment will often involve the prescribing of medication and changes to one’s lifestyle. Medication for fibromyalgia includes painkillers ranging from paracetamol to codeine or Tramadol and anti-depressants.
Physiotherapy often has a role to play in the treatment of the condition and can help with maintenance and improvement of function and mobility. Stretching and gentle exercises are often employed in order to help achieve this.
Psychological therapies can include treatments such as Cognitive Behavioural Therapy which is a talking therapy that can help manage problems by changing the way the patient thinks and behaves and how pain is managed.
The use of anti-depressant medication in treating the symptoms of fibromyalgia is now well established. It is believed that low levels of certain chemicals that transmit messages to and from the brain, known as neurotransmitters, could well be a factor in the development of fibromyalgia. By increasing the levels of these chemicals it is believed that this can have the effect of reducing the level of widespread pain associated with the condition.
The type of anti-depressant used in the treatment of the condition varies according to the severity of symptoms and includes:-
- Serotonin-noradrenaline reuptake inhibitors (SNRIs) such as venlafaxine or duloxetine,
- Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, and
- Tricyclic anti-depressants such as amitriptyline which can also improve sleep.