Treatment Of Fibromyalgia

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[edit] Treatment Of Fibromyalgia

Treatment of fibromyalgia consists of a comprehensive program, where the various factors that are observed in the patient are addressed. The sleeping disturbance, if present, is treated with cyclobenzaprine (brand name: Flexeril, Flexitec) at bedtime. This medication, which is an tricyclic antidepressant, is used mainly as a muscle relaxant, but has been found in fibromyalgia patients to restore abnormal sleep patterns.

Another medication that can be used for this is the antidepressant trazodone ( brand name: Desyrel, Trazorel), which when taken at bedtime seems to help not only to normalize the sleeping pattern, but also lift the mood (antidepressant effect) and thus help with some of the myalgias (painful muscles).

Multidisciplinary treatment approach for fibromyalgia
Target symptom:	Treatment modality:
muscle deconditioning	swimming, aquatherapy, walking, and mild stretching exercises
muscle spasm and tender spots	1) Local heat treatments, massage therapy, chiropractic adjustments and physiotherapy, aquatherapy
	2) trigger point injections by the physician
sleep disorder	cyclobenzaprine (brand name: Flexeril, Flexitec) or trazodone (brand name: Desyrel, Trazorel)
mild to moderate depression	SSRI antidepressant medication
anxiety	yoga, meditation, self-hypnosis, prayer, cognitive and behavior therapy, psychological counseling

Many of the SSRI antidepressants have a similar effect as trazodone. They also help to lift depression, which is another symptom complex that the physician will treat. Physical activities in the form of swimming, aquatherapy, walking, and mild stretching exercises are instituted. Often it might be best to do this as part of a local fibromyalgia support group, as motivation could otherwise be a problem. Local heat treatments, massage therapy, minor chiropractic adjustments for spinal malalignments are all useful modalities as is physiotherapy for flare-ups of the muscle aches and pains. Trigger point injections by the physician with 1% Xylocaine (occasionally with a small amount of cortisone mixed in) may be very useful for more painful muscles.

Meditation, self-hypnosis,yoga, cognitive and behavior modification therapy are all useful adjunctive methods to help with the associated anxiety and depression along the medications mentioned above. These latter methods help with coping strategies in the treatment of fibromyalgia (Ref. 4).

Other link re. fibromyalgia treatment.

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Fibromyalgia

References:

1. G.Littlejohn Aust Fam Physician 2001 Apr;30(4):327-333.

2. LS Brecher et al. J Am Osteopath Assoc 2001 Apr;101(4 Suppl Pt 2):S12-17.

3. The Merck Manual, 7^th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 59.

4. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999. Chapter 6. Fibromyalgia Syndrome.

5. B Mukerji et al. Angiology 1995 May;46(5):425-430.

6. Ferri: Ferri's Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.

7. Rakel: Conn's Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier