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Is there anything new in the treatment of fibromyalgia? My case is pretty well under control but I like to be ready if I should have a flare-up.
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There's new understanding of the underlying pathophysiologic mechanisms for fibromyalgia. And that new knowledge is slowly bringing forth new medications and ideas for managing the painful symptoms of this condition.
Today's modern approach to is multimodal, meaning many different treatment options are pursued at the same time. Combining medications with exercise, behavioral counseling, and alternative medicine have made it possible to live a more normal life for those who suffer with this condition.
At one time, there was a strong suspicion that the symptoms of fibromyalgia were psychosomatic -- the result of stress and "all in the head" of affected individuals. But scientists have come a long way since then in unraveling the mystery behind this complex condition.
Right now, the main theory is that FMS occurs when something goes hay wire in the nervous system. That something may be what's called central sensitization syndrome. It means the nervous system is ramped up to react too soon, too often, and for too long.
With a dysregulation of the central nervous system, there appears to be some kind of mistake within the nervous system in how it recognizes and transmits pain messages. Somehow, the nervous system seems to think even the simplest touch is a noxious (painful) stimulus. It's like a ten-alarm fire signal is sent to the brain when a breeze blows by the barn.
Nervous system dysregulation of this type is likely caused by biochemical abnormalities, altered brain blood flow, and problems with the pain processing mechanisms. Sufferers have lower pain thresholds and lower levels of serotonin, a brain chemical involved in pain, sleep, and mood.
Many people with fibromyalgia also have anxiety disorders, depression, panic disorders, and phobias that are chemically induced and/or the result of abnormal central (nervous system) processing. It's these chemical changes that have prompted drug companies to look for a way to treat the problem with pharmaceuticals (medications).
Two of the drugs now approved in the U.S. for fibromyalgia are antidepressants (duloxetine and milnacipran). Studies have shown that these medications don't work because they improve the person's mood (reduce depression). The chemical pathway of the drug seems to impact pain signals directly.
Neither one of these drugs works to improve sleep. They do improve energy levels, physical functioning, and cognitive function -- probably because they reduce pain, a symptom that can level a person in all these areas.
Medications are only used in conjunction with other treatment such as exercise, meditation, hypnosis, acupuncture, nutritional counseling, biofeedback, massage, and behavioral counseling. A new treatment approach involving electromagnetic wave therapy is being tested for pain control by modifying brain activity in a noninvasive way without drugs or surgery.
Should you have a flare-up of symptoms that don't go away using your management plan, seek your primary care physician's counsel on what else is available that would best suit your situation. Having some information like this about what's new will help you explore together options best for you.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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