Frequently Asked Questions About Fibromyalgia
Why did my doctor prescribe antidepressants?
The fact that your doctor prescribed antidepressants for your fibromyalgia doesn’t mean she thinks you’re depressed. Antidepressants are among the most effective medications for fibromyalgia. Different antidepressants help in different ways.
Tricyclic antidepressants – which include amitriptyline (Elavil), doxepin (Sinequan) and nortriptyline (Pamelor) – in small dosages can treat fibromyalgia by relaxing muscles and restoring often disturbed delta-wave, or deep sleep. Restored sleep allows for greater production of the growth hormones essential to muscle repair, hormones produced only during delta sleep. Tricyclics also increase the amount of serotonin – the hormone important for regulating pain and deep sleep – available to nerve cells and raise the efficiency of endorphins (a “feel good” chemical release by the body when we exercise or laugh). Both serotonin and endorphins are natural painkillers. Serotonin, often lower than normal in people with fibromyalgia, affects sleep and mood.
By promoting sleep, easing pain and relaxing muscles, tricyclics can help some people with fibromyalgia break out of the chronic pain/fatigue symptom cycle.
Selective serotonin reuptake inhibitors (SSRIs) – which include fluoxetine (Prozac), sertraline (Zoloft) and paroxetine (Paxil) – make more serotonin available in the brain, reducing fatigue, mental confusion, depression and pain. Many researchers believe that people with fibromyalgia either have low levels of serotonin or are unable to process it properly. A newer class of antidepressants, called serotonin/norepinephrine reuptake inhibitors (SNRIs), work somewhat as tricyclics do by affecting levels of neurotransmitters serotonin and norepinephrine. They appear to be effective for relieving not just pain, but also stiffness, fatigue and mood.
Will acupuncture or other alternative therapies help?
Maybe. Many people with fibromyalgia try acupuncture at specific points to relive pain. The practice is based on the Chinese theory of qi, which holds that energy flows throughout the body along 14 invisible pathways called meridians. The places where the pathways surface on the skin are called acupuncture points.
While many Western physicians remain skeptical about acupuncture because the concepts of qi and meridians do not correspond to their understanding of the human anatomy, others think that acupuncture, if done by an experienced practitioner, is safe and may be effective. Studies of acupuncture appear promising as well. In 1997, after evaluating hundreds of acupuncture studies, for example, the National Institutes of Health found acupuncture helpful for fibromyalgia pain. A 2004 review of clinical trials also drew favorable conclusions.
Other complementary and alternative therapies that could potentially help fibromyalgia, include:
Acupressure – a technique similar to acupuncture, except that practitioners apply pressure on specific points with their fingers or with tools instead of with needles.
Massage – a way of manipulating the body’s soft tissues using pressure and stroking. Studies show that massage can decrease stress hormones, depression and muscle pain, increase endorphin levels, and improve sleep and immune function.
Biofeedback – a therapy that uses electronic instruments to help you learn to relax tense muscles. In fibromyalgia, muscles are often tense because of pain, so they may contract or tighten after activity instead of relaxing like muscles normally do. Being able to make muscles relax helps relieve muscle pain and fatigue.
Yoga – an ancient Indian practice involving specific exercises, meditation and breathing techniques. When combined with relaxation techniques, yoga may promote flexibility and pain relief, alleviate depression, increase alertness and improve sleep.
Learn more about do-it-yourself pain relief .
