How Is Fibromyalgia Treated?

People with fibromyalgia receive individual treatment based on several factors, including their overall health, medical history, number of tender points, severity of pain, and presence of other symptoms. Treatment for fibromyalgia includes:

• Medications that decrease pain and improve sleep (see below)
• Lifestyle changes, including stress reduction
• Exercise to improve heart and lung health, flexibility, and strength
• Relaxation techniques to relieve muscle tension.

What Medications Are Used to Treat Fibromyalgia?

The FDA has approved Lyrica as the first drug treatment for fibromyalgia. It reduces pain and improves daily functions for some patients. The drug's most common side effects include mild to moderate dizziness and sleepiness. Lyrica can also cause blurry vision and trouble concentrating. The FDA advises patients to talk to their doctor about whether the use of Lyrica may impair their ability to drive.

Medications that increase restful sleep may help. These include low doses of antidepressant medication such as amitriptyline taken before bedtime. Other kinds of sleeping pills are not very helpful for people who have fibromyalgia.

Nonsteroidal anti-inflammatory drugs (NSAIDs) -- including ibuprofen and naproxen -- may help decrease pain, but should be used long-term only under the care of a doctor. These drugs have many side effects, such as stomach upset and bleeding and swelling from fluid retention. They also may interact unfavorably with other drugs, such as medications for high blood pressure. Tylenol (acetaminophen) may be helpful, and it is easier on the stomach and less likely to cause drug interactions than NSAIDs. However, acetaminophen should only be taken as recommended. Too much acetaminophen can lead to liver problems.

Muscle relaxants, such as Flexeril, may provide some relief of muscle pain, especially when taken at bedtime.

Steroids (such as prednisone) used to treat inflammation associated with other rheumatic conditions have been tested in people with fibromyalgia and did not appear to improve symptoms. However, a steroid injection directly into a muscle spasm (trigger point) may sometimes be used when other treatments have failed.

Newer antidepressants -- including Effexor and Cymbalta -- may reduce pain and improve functioning.

Participating in aerobic exercise for 30 minutes at least four times each week is an important step to improve fibromyalgia symptoms. Exercise increases heart and lung function and stretches tight, sore muscles. Research has shown that exercise improves the pain associated with fibromyalgia possibly via production of natural endorphins. Brisk walking, biking, swimming, and water aerobics are good activities to choose when starting your exercise program. Your doctor can help you choose an exercise program that is right for you.

What Are Some Techniques I Can Use to Reduce Stress and Relax?

Evaluating the causes of stress and learning new ways to handle stress should help improve fibromyalgia. Relaxation exercises can help you cope with stress. Although fibromyalgia is not caused by stress, stress can make symptoms much worse. Occasionally, if the situations that caused the initial stress are resolved, the condition may spontaneously improve and medications may not be necessary.

What Is the Long-Term Outlook for People With Fibromyalgia?

Many people with fibromyalgia will continue to have symptoms despite treatment, especially when life is stressful. However, medications that can alter the balance of pain-producing chemicals, such as anti-depressant drugs, should improve symptoms.

When other forms of treatment, such as acetaminophen (Tylenol) and aerobic exercise, are combined to treat fibromyalgia, even more improvement can be expected.

Those who are able to continue working and fulfill their social obligations, despite their pain, end up doing best.

Learn about anti-inflammatory medications.
Make exercise a part of your life with these tips.
View the full table of contents for the Arthritis Guide.

WebMD Medical Reference provided in collaboration with the Cleveland Clinic