Though there is no cure, fibromyalgia is often treated in a multifaceted fashion, using both medications and non-medication methods to improve individual symptoms. Treatment is individualized to each person depending on their symptoms. Non-medication methods to manage symptoms include sleep hygiene, stretching and aerobic exercises, stress reduction, and massages.
Counselling can also be very helpful. Counsellors help people find ways to address problems that may be playing a role in their condition. Psychotherapy with talk therapy may also be used.
Medication is used in fibromyalgia to manage symptoms on an individual basis. Painkillers, such as acetaminophen,* and nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen and naproxen) are generally not helpful in fibromyalgia. Narcotic painkillers (except tramadol) should be avoided because of the risk of dependence and they have not been shown to be effective. Tramadol may be helpful in reducing pain for some people, although it has not been approved by Health Canada for use in fibromyalgia.
There are medications available specifically for fibromyalgia, including pregabalin and duloxetine. They work by affecting different pain pathways in the body and help to improve pain in some patients with fibromyalgia.
Severe persistent pain that's focused in one point is sometimes treated with an injection of lidocaine, which may be used in combination with hydrocortisone.
Low doses of antidepressant medications (e.g., amitriptyline, fluoxetine, paroxetine) are often used to treat fibromyalgia, but are not approved by Health Canada for fibromyalgia. Antidepressants can improve sleep and may help with the pain. In higher doses, they can also be used to treat mood disorders in people who develop them along with their fibromyalgia.
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