Fibro - Which Treatments Are the Most Effective?

Discussion in 'Fibromyalgia Main Forum' started by JLH, Dec 4, 2005.

  1. JLH

    JLH New Member

    Might be helpful for new members .....

    Short article with info re:

    For fibromyalgia, which treatments are the most effective?

    There is no single most effective modality for the treatment of fibromyalgia syndrome, and no objective comparison of the results from the different studies is available.

    Low-dose tricyclic antidepressants [Elavil](TCAs)improve sleep quality and global well-being and have a moderate beneficial effect on tenderness and stiffness (based on a systematic review of randomized controlled trials [RCTs]).

    Selective serotonin reuptake inhibitors (SSRIs) may moderately improve fibromyalgia-related symptoms.

    The serotonin and norepinephrine reuptake inhibitors (SNRIs) duloxetine (Cymbalta) and milnacipran (Ixel, not currently available in the US) improve pain and other symptoms.

    Tramadol (Ultram) improves pain and other outcomes. Cyclobenzaprine (Flexeril) improves both pain and sleep quality.

    Aerobic exercise improves overall functional capacity and sense of well-being for patients with fibromyalgia.

    Cognitive behavioral therapy improves patients' self-reported symptoms.


    J Fam Pract. 2005 Dec;54(12):1094-5.
    Yousefi P, Coffey J.

    Department of Family and Community Medicine, Baylor College of Medicine,
    Houston, TX USA.

    PMID: 16321351

  2. JLH

    JLH New Member

    Patti, lots of stuff on this list has not helped me either.

    For example, I couldn't handle the Elavil at all--it was way too sedating for me, but Zanaflex works great.

    But, the Cymbalta has greatly helped by fibro pain, as does Neurotin.

    Tramadol never did anything for me either. In fact, I take a narcotic (Lortab) for my back pain, but it doesn't seem to do much for my fibro pain.

    And .... exercise! I know it's supposed to be good for us, but it's a real killer for me--especially my back--I guess I just have too many back problems. However, when I used to take the warm-water arthritis aerobic classes, I enjoyed them and after the initial soreness wore off, they really helped me. In fact, after class, I would just walk around the pool and do bends and stretches in the water and I felt better then than I ever have.

  3. Suzan

    Suzan New Member

    That the toughest part for him and this illness is that there isn't much he can do! He did go down the road with me in the beginning of elavil..then nortriptyline...and then wanted to try something along the line of Prozac to which I said no. He tried several times...and I kept talking and bringing him medical research that showed that it wasn't reliable enough a drug for me to take the risks of it. the end..we cam down to treating my pain as the main focus. If I have other symptoms that make life difficult, we will address them as they come up. I think it took a couple years of us talking..for him to have a good sense of who I was...and how I felt..and how I wanted to deal with it.
    As for exercise..I do try and do some movement oriented things daily..often housework related...but often it causes intense pain and hard to "exercise" as suggest at this point.
  4. Fudge43

    Fudge43 New Member

    It is impossible to create an overall "general" treatment plan for us with fibro. Each individual not only suffers from the fibromyalgia, but a host of "tag along" conditions .. thyroid problems, MVP,CF,ME,RA, .. on and on .. just out right COMPLICATIONS that make this even worse for us ..
    I think I can safely say that I have not heard of one case that is fibromyalgia ALONE.

    So .. not only is there the fibro, but at least a few other disorders to treat at the same time .. it is a miracle we don't throw in the towel or just plain go crazy !

    Chalk up trying to find a doctor that first of all believes the condition exists and actually KNOWS some of the affective treatments but also is willing to LISTEN to you if you come up with different information and want to try other methods than what is conventional .. now that can be close to a miracle as well !

    Having stated the obvious to us all .. we have the option to do the research and keep trying different things for ourselves .. medical and nonmendical.

    I'm one of the lucky ones that has a fairly flexible doctor but when it comes to new medications she is not familar with she does recomends that I see the rheumatologist who would be more knowledgable in that area.

    What works for me .. the elavil .. muscle relaxants .. oxycontin 12 hour release .. zopiclone .. L-Tryptophan .. meds for break through pain .. for which I am very grateful for !
    I do micro nutrients (green drink) .. supplements .. try to eat well .. but fall off the wagon MANY times ! haha
    Yoga ... my individual routine is unusual .. tailored to what I can do and feel comfortable with .. one of the most important devices that helps with that is a good heating pad to warm and relax the lower back muscles before I do the stretching .. and when I haven't done it for a few nights .. the difference in the morning is incredible .. such stiffness and pain .. I had a herniated disc in my lower back over 10 years ago .. I have a bone graft and 4 screws in the area .. I know PAIN .. I was told I would most likely have more to come if I didn't take care of myself .. another add on threat to the whole scenario ..

    I didn't mean to be so long winded here .. my point is that each individual has to find out what works best for them .. each case is very different .. each body chemistry is also ..
    This board is great for ideas and suggestions ..
    What it means in the end, is that it is up to you, to do some work even through the pain and exhaustion .. otherwise it will only get worse faster .. we all have "down" periods, we all need space from trying so hard .. but when that passes you have to get back up on the horse and try again !

    I wish all of us GOOD LUCK !
    Fudge : )

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