Fibromyalgia doesn’t have to rule your life. Coordinated care from a team of experts can help you take charge of this chronic pain condition.
“People often think, ‘the more I hurt, the sicker I am.’ But the pain is caused by an increased sensitivity to pain signals, and today there is much we can do to help control that kind of pain,” says rheumatologist Carmen Gota, MD, head of Cleveland Clinic’s Fibromyalgia Clinic.
Shared symptoms vary
The pain associated with fibromyalgia varies widely — on a day-to-day basis and among patients. These symptoms are shared by millions of people with fibromyalgia to varying degree:
- Pain all over, sometimes targeting the neck and shoulders, back, hips, and legs, often at night, in the morning and with prolonged inactivity
- Insomnia and restless sleep
- Stiffness on awakening
In addition, fibromyalgia patients often have other chronic conditions, including:
- Mood disorders such as depression or anxiety
- Medical problems such as irritable bowel syndrome, headache or urinary difficulties
The cause of fibromyalgia is unknown. Often a traumatic stressful event, such as loss of a loved one, can trigger the condition. Women develop fibromyalgia much more often than men.
Addressing the whole person
“Because each patient may experience fibromyalgia differently, we need to look at the whole patient and tailor treatment to the individual,” Dr. Gota says.
Coordinated care by a team is most effective, Dr. Gota says. The team should include a rheumatologist, primary care doctor, behavioral therapist, physical therapist and, if needed, an occupational therapist, Dr. Gota says.
Care may involve:
Medications — Rheumatologists can prescribe medications to lessen pain. Drugs used to treat fibromyalgia include muscle relaxants, antidepressants and gabapentinoids. Antidepressants have been in use for decades, not only for the treatment of depression, but also for conditions such as neuropathic pain and sleep disorders.
“While three drugs are now approved by the U.S. Food and Drug Administration for the treatment of fibromyalgia, rheumatologists use many others in the same category with similar benefits,” Dr. Gota says.
Physical therapy — People with fibromyalgia often are afraid to exercise because they hurt more after they move. But exercise raises the level of endorphins, which improve sleep, memory and mood. Exercise also improves brain function and gives patients control over their own bodies. Physical therapists will tailor an exercise program for each patient.
“Fibromyalgia pain can worsen when people try to do too much. Guidance from a physical therapist can show them how to gradually increase their exercise levels,” Dr. Gota says.
Pain management guide