Fibromyalgia: Treatments

Treatments for fibromyalgia require a multidisciplinary approach, with the involvement of multiple doctors, and they are not limited to treatment for pain alone.

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There is no cure (treatment for the root cause), but there are a number of non-specific treatments for fibromyalgia symptoms, with a global approach looking at the patient as a whole: pain specialists, muscle and physiology specialists and specialists in stress management.

The classes of therapy most commonly prescribed are:
- Painkillers (over 60% of prescriptions): paracetamol (class I painkiller) and similar “usually have no effect on pain”, and so tramadol (class II) or even morphine are often prescribed;
- Antidepressants (over 40% of prescriptions by general practitioners, 30% of rheumatologists): they are prescribed for their effects on pain and sleep, as well as their role in treating depression;
- Anti-anxiety and hypnotic medications (prescribed in almost 30% of cases of fibromyalgia): they will help with muscular tension and insomnia. The HAS (French High Authority of Health) draws attention to the risk of dependence associated with the long-term use of these products;
- Antiepileptics (between 18% and 25% of prescriptions): they are also used for their analgesic properties.

Fibromyalgia: Non-Pharmaceutical Treatment Methods

In parallel, there are also a number of approaches to treating fibromyalgia that do not involve the use of drugs. People who suffer from the condition are those who tend to withdraw into themselves. They are isolated by their disease and pain. As a result, the non-pharmaceutical treatments suggested are primarily psychotherapy (also comprising supportive psychotherapy, cognitive therapy, cognitive behavioural therapy...) or measures for the patient’s mental state. Even though fibromyalgia is not synonymous with depression, the consequences of the disease can trigger reactive depression, which requires treatment.

Therapy for the muscles is also important in the treatment of fibromyalgia: techniques frequently employed include physical therapy, rehabilitation, biofeedback and massages.

Sleep disturbances must not be ignored. Fibromyalgia patients do not go through all the stages of the sleep cycle, and doctors may prescribe conventional medications, sleeping pills or antidepressants.

Hypnosis, acupuncture and other relaxation techniques are sometimes used to reduce muscle tension and to “manage” the pain.

Specific, grouped and multidisciplinary approaches are also implemented. Care for fibromyalgia also involves treatment for pain, but also endurance training, counselling, gentle physical activity with follow-up of the progression of the symptoms, all provided in consultation with the treating doctor.

In terms of medical innovation, the avenues currently being pursued concern the connection between fibromyalgia and chronic fatigue syndrome (CFS/ME), which are related conditions. Specialists are currently focusing their fibromyalgia research on the connections between chronic infections and intestinal bacteria. Gluten-free or lactose-free diets, food supplements or probiotics are current subjects of research.

Source: NHS

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