Fibromyalgia Syndrome or FMS is a disabling condition that results from symptoms that affect several different body systems. These symptoms can vary from patient to patient and can also vary in the patient from year to year. While doctors haven’t been able to identify specific causes for the disorder or discover a cure they have developed a variety of treatment options that can be individualized to different patient situations.
Treatment protocols for FMS have multiple factors because the disease has multiple factors. The symptoms range from widespread pain and muscle and joint stiffness to headache, nausea and severe menstrual cramps. The treatment options include medications and self care options such as mild to moderate exercise, restorative sleep and good nutrition.
The goals of treatment are to minimize the symptoms the patient is experiencing and improve their overall general health. Because FMS often affects physical, mental and emotional aspects of the individual’s health it’s important to address these areas to increase the person’s overall function allowing them to maintain productive employment.
Medications are used to help decrease the pain experienced with FMS and improve the sleep patterns of the individual. Researchers theorize that while the sleep patterns may in fact be a part of the trigger for FMS they also think it may have something to do with decreasing the perceived pain and symptoms of the disease.
Analgesics such as Tylenol, may help to decrease pain and stiffness caused by FMS. But, like in other muscular or joint problems, the effectiveness varies from individual to individual. Ultram is another analgesic that has been used as a pain reliever but long-term studies have revealed that this drug has addictive properties similar to opiates.
Individuals may also consider non-steroidal anti-inflammatory medications (NSAIDs) such as ibuprofen, aspirin or naproxen. These NSAIDs can be combined with other pain medications but thus far haven’t been proven to be effective in management of pain when they are taken alone.
It isn’t surprising that those who suffer from the symptoms of FMS will also have a higher risk of suffering from depression. And while anti-depressant medication can be successfully used to help treat their depressed mood one of the beneficial side effects of antidepressant medications has been to help promote effective sleep patterns and decrease pain perception.
The decreased pain perception seems to be related to the newer class of anti-depressant medications known as serotonin reuptake inhibitors (SSRIs) which regulate chemicals in the brain that may be used to transmit pain signals.
Some patients have found that using muscle relaxants, especially at bedtime, will help to treat muscle pain and spasms during the night. It’s important to take this type of medication only at night since it will inhibit the ability to perform normal daily activities and increase drowsiness during the day. Patients with FMS should be incorporating a mild to moderate exercise program in their day to decrease their pain perception as well. If taking muscle relaxants during the day the individual will be unable to complete their exercise program. It’s important to note that the beneficial effects of using muscle relaxants are relatively short-term.
Another class of drug that has been found to have beneficial effects in the treatment of pain with FMS is anti-seizure medications, namely Pregabalin. Studies have shown that pregabalin was found to reduce signs and symptoms of FMS. The results of these studies have been varied. In one study about half of the participants who were taking the highest dose possible reported a 30% improvement in symptoms. However, side effects of this medication are significant and may be more uncomfortable than the disease itself.
Individuals with FMS usually suffer from sleep disorders. There has been some short-term benefits to using sleeping pills to give patients restorative sleep but doctors will recommend against long-term use. These medications only work for a short time before the body becomes used to the medication and becomes resistant to the effects.
Although, based on the types of symptoms suffered by patients with FMS, one would think that they were inflammatory in nature researchers and doctors have found no benefits from the use of corticosteroids to help treat the painful symptoms of the syndrome.
Other aspects of a treatment program should include counseling or cognitive behavior therapy to help improve the belief the individual has in themselves for dealing with stressful situations. This is because stress will increase the perception of pain and will aggravate the symptoms of FMS.
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