Here’s what you need to know about new, natural, and tried and true fibromyalgia treatments.
Not getting enough of this mineral—found in green leafy vegetables, meat, and milk—may trigger muscle spasms and cramps. That may be why Turkish researchers found that giving women with fibromyalgia 300 mg daily for eight weeks reduced pain and tenderness. Your doc can test your levels and prescribe a supplement, if necessary.
In a small pilot study, women who attended a 2-hour weekly yoga program and practiced the poses at home for 20 to 40 minutes a day experienced a 31% drop in symptoms, including pain and fatigue. “The breathing techniques induce a relaxation response that may alter pain signals,” says study leader James W. Carson, PhD, of the Comprehensive Pain Center at Oregon Health & Science University.
Biofeedback and breathing
Learning to be aware of and control the body’s responses (like heart rate and breathing) involved in pain perception may help reduce pain. “There’s a rate of slow breathing—different for everyone—that triggers important reflexes,” says researcher Paul Lehrer, PhD, professor of psychiatry at Robert Wood Johnson Medical School.
A Tufts University study gives this gentle mind-body exercise high marks for improving sleep and easing fibromyalgia’s pain and depression. Tai chi’s controlled breathing and movements promote a restful state, which may interrupt the pain cycle.
This therapy may increase the activity of brain receptors that dampen pain signals, say researchers who studied the brain images of women with fibromyalgia who received acupuncture. Pain eased for all of them whether they got real or sham acupuncture, but experts claim that even the sham version may affect the brain and pain.
In a 2010 study from Spain, researchers reported that participants with fibromyalgia who underwent 20 once-a-week 90-minute sessions of a form of massage called myofascial release had noticeably less pain and anxiety. (And more research shows massage is a healthy choice all-around.) Fascia, the connective tissue that surrounds muscles and organs, tightens in people with fibromyalgia, increasing pain, but this form of massage—a slow, gliding pressure—separates tight bands of fascia, making them softer, says Nancy M. Porambo, a certified neuromuscular therapist in Jim Thorpe, PA.
Reducing just a little can lessen your symptoms—and maybe prevent you from getting fibromyalgia in the first place. In a 2010 study, Norwegian researchers reported that overweight or obese women had a 60 to 70% higher risk of developing fibromyalgia than women with normal BMIs. It’s not clear why, but one theory is that elevated levels of inflammatory substances called cytokines, common in both obese people and those with fibromyalgia, can trigger pain and heighten sensitivity to it. Lugging around extra weight may also worsen symptoms. “Being overweight contributes to fatigue and stress on joints, which could increase pain,” explains Dr. Zashin. The good news: A pilot study found that losing just 4.4% of your body weight helps ease symptoms.
It’s hard to exercise when you hurt, but researchers at Johns Hopkins University found that lifestyle physical activity (LPA) really was possible for patients and paid off in a 35% reduction in perceived pain. During the study, fibromyalgia sufferers began with 15 minutes of LPA—such as walking, gardening, vacuuming, or swimming—5 to 7 days a week, increasing their active time by five minutes each day, until most were getting 30 minutes or more of moderate activity daily. LPA can also be a gateway to more strenuous exercise, which Boston researchers found can improve physical functioning, lessen pain, and ease depression and fatigue related to fibromyalgia.
The FDA has approved two serotonin and norepinephrine reuptake inhibitors (SNRIs) to treat fibromyalgia pain—duloxetine (Cymbalta) and milnacipran (Savella). These meds may affect brain chemicals that can tamp down your pain response. Older antidepressants, such as amitriptyline, work similarly and may be prescribed off-label. Milnacipran acts like an antidepressant, and patients with fatigue often see benefits from it, says Jennifer A. Reinhold, PharmD, a Prevention advisor.
Gaining better understanding of your thoughts and actions by talking to a therapist can ease physical as well as emotional symptoms. In a recent study, six weekly sessions of telephone-based cognitive behavioral therapy increased how much pain participants could bear. “Through therapy, they learn to modify their maladaptive thoughts into more beneficial ones, reducing their response to symptoms,” says study author Dennis C. Ang, MD, chief of rheumatology at Wake Forest University.
Exactly how anticonvulsant drugs ease symptoms isn’t clear, but, says Dr. Reinhold, they calm the nervous system generally. Pregabalin (Lyrica), the first FDA-approved drug for fibromyalgia, may block overactive nerve cells that transmit pain signals. Your doc may start you on gabapentin (Neurontin), another, cheaper anticonvulsant. It’s not FDA approved to treat fibromyalgia, but at least one study suggests that it works.
Doctors may try to reserve these potentially addictive painkillers to handle episodes of acute pain until they can work out a less-intensive pain-control plan with their patients, but the drugs can be a useful short-term therapy. Tramadol (Ultram), an analgesic, is FDA approved for moderate to moderately severe chronic pain. It affects pain receptors, changing how strongly the body feels pain, and can help people who need round-the-clock relief. Side effects include dizziness, constipation, and drowsiness.