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Although large-scale studies are still needed to confirm their effectiveness, the newest FDA-approved treatments for fibromyalgia include Quell and milnacipran
Although large-scale studies are still needed to confirm their effectiveness, the newest FDA-approved treatments for fibromyalgia include Quell and milnacipran.
- Quell is an over-the-counter transcutaneous electrical nerve stimulator intended to be used for pain relief.
- Milnacipran is a serotonin and norepinephrine reuptake inhibitor (SNRI) that has shown promising results in pain relief and improved physical function in people with fibromyalgia. However, the exact mechanism of action of milnacipran in treating fibromyalgia is unclear. Although it is an antidepressant, it is not used to treat depression due to its side effects, which include:
Fibromyalgia treatment is not definitive and results vary from person to person. Since there is no single drug that works for everyone, you may need to try a few different treatments before finding one that works best for you.
What are current treatments for fibromyalgia?
Pregabalin
Pregabalin is an anticonvulsant that is used to treat epilepsy, anxiety, and neuropathic pain and may be helpful in treating fibromyalgia. Pregabalin reduces fibromyalgia symptoms by lowering pain by up to 25% and improves sleep and tiredness. It is unclear how pregabalin acts to alleviate fibromyalgia symptoms, but some believe it attaches to a protein in the nerve cells that is responsible for increased pain sensitivity.
Long-term pregabalin use can cause various side effects such as:
- Dizziness
- Drowsiness
- Dry mouth
- Constipation
- Increased hunger
- Weight gain
- Edema
- Swelling of the hands and feet
- Excessive happiness
- Difficulty concentrating
- Balance disorder
- Blurred vision
Duloxetine
Duloxetine is a selective SNRI that stabilizes mood, reduces pain, and improves sleep. It is a type of antidepressant and is usually used to treat chronic pain. The exact role of duloxetine in treating fibromyalgia is unclear. It is believed that symptoms of fibromyalgia, especially pain, may be suppressed with increased activity of serotonin and norepinephrine in the brain.
Side effects of duloxetine include:
- Nausea and vomiting
- Constipation
- Dry mouth
- Increased sweating
- Decreased appetite
- Drowsiness
- Agitation
Transcranial magnetic stimulation (TMS)
So far, TMS therapy has only been approved by the FDA for the treatment of major depression. However, multiple studies have shown that it can be very effective for fibromyalgia as well.
Pain associated with fibromyalgia is caused by muscles locally and by the brain’s perception of pain signals. TMS uses magnetic pulses to directly stimulate the brain cells and alter their perception of pain. Although similar to fibromyalgia drugs in effectiveness, TMS does not carry any negative side effects.
QUESTION
What characterizes fibromyalgia?
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What other therapies can help relieve fibromyalgia symptoms?
- Cognitive behavioral therapy (CBT): CBT is often used to treat fibromyalgia by helping patients learn how to cope with their condition and manage pain.
- Stress management: Stress reduction through deep breathing exercises or meditation may improve fibromyalgia symptoms.
- Exercise: Although exercise may initially aggravate pain, doing it gradually and regularly can reduce symptoms. Low-impact exercises such as stretching, walking, swimming, and water aerobics are all appropriate exercises.
- Acupuncture: Acupuncture involves inserting very small needles into the skin at various depths, which is believed to cause changes in blood flow and neurotransmitter levels in the brain and spinal cord.
- Tai chi and yoga: Tai chi and yoga both involve meditation, slow movements, deep breathing, and relaxation, all of which can be effective in treating fibromyalgia symptoms.
- Dietary modifications: Eating healthy and nutritious foods, quitting tobacco and alcohol, and limiting caffeine intake can improve energy levels and promote overall health.
What causes fibromyalgia?
Although the cause of fibromyalgia is unknown, it is speculated that it may be caused by a nerve cell misfiring in the central nervous system, which causes abnormalities in processing pain sensations. Factors that may contribute to the development of the condition include:
- Genetics
- Physical and emotional stress
- Childbirth
- Injury
- Infection
- Surgery
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What are the symptoms of fibromyalgia?
Fibromyalgia presents with similar symptoms as arthritis, such as pain and fatigue, but it does not cause permanent joint damage or deformity.
The most common symptom of fibromyalgia is widespread pain, which can occur in one or more areas of the body. Pain may migrate over the body and change in intensity on a daily or even hourly basis.
Other symptoms of fibromyalgia include:
- Excessive fatigue
- Increased sensitivity to pain
- Muscle stiffness
- Sleeping difficulty
- Irritability
- Headache
- Gastrointestinal problems such as:
- Constipation
- Diarrhea
- Irritable bowel syndrome
- Stomach pain
- Bloating
- Bladder dysfunction
- Increased sensitivity to light, sounds, and smell
- Heightened sensitivity to touch and pressure
- Disturbances in memory and concentration
- Problems with cognition (mental processes) known as “fibro-fog”
- Mood disorder
- Depression
What are the risk factors for fibromyalgia?
Risk factors for fibromyalgia include:
- Age: Fibromyalgia is mostly seen among people ages 20-50, although children and teens may also develop the condition.
- Sex: About 80%-90% of people with fibromyalgia are women.
- Family history: Fibromyalgia may run in the family. If your immediate relative has fibromyalgia, you are at higher risk.
- Rheumatic diseases: If you have a history of other rheumatic diseases such as ankylosing spondylitis, rheumatoid arthritis or lupus, the risk of fibromyalgia increases.
- Stressful events: Fibromyalgia is sometimes linked to stressful or traumatic incidents, such as a car accident or family member's death.
How is fibromyalgia diagnosed?
Fibromyalgia cannot be diagnosed through physical exams, blood tests, urine tests, or imaging tests, although the data can be used to rule out other illnesses.
A diagnosis can be confirmed based on a medical history of three months of widespread pain with causative underlying diseases and one or more other chronic symptoms such as:
- Chronic sleep problems
- Exhaustion
- Cognitive or memory challenges
Although fibromyalgia is not a life-threatening disease, it can cause severe disability and reduced function. Timely medical attention and appropriate treatment can help reduce symptoms and improve quality of life.
