Alternative Treatment Options for Fibromyalgia

Treatment Option

Description

Where to Find Service/Resource

Acupuncture

Some people may benefit from acupuncture to help relive pain and improve the sleep disturbance. There is no research evidence proving it is beneficial; however, some patients report it has been helpful.*

Ask to be referred to a qualified acupuncturist with experience in treating patients with fibromyalgia.

Tender Point Injections

If a patient has one specific area which remains painful, the physician may inject tender points in that area. Tender point injections generally only offer temporary relief. If the underlying sleep disturbance is not correct, the tender points will generally reoccur. It is not practical to inject numerous tender points.

Physiatrists (Physical Medicine and Rehabilitation Specialists) and Rheumatologists (Arthritis Specialists) generally will do tender point injections.

Myofascial Release Therapy

Myofascial release therapists will manually work on tight, contracted muscles and trigger points. They will "release" or stretch out these areas.

Specially trained physical therapists and massage therapists provide this special type of therapy. Ask to be referred to a qualified therapist.

Spray and Stretch Technique

Trained physical therapists will spray the muscle with a topical anesthetic spray to numb the area before stretching out the painful, contracted muscle. Patients and family members can be trained to perform this technique. Many therapists prefer to ice the muscle, since the spray is a prescription, is flammable, and causes pollution. Ice works just as effectively.

Physical Therapists

Therapeutic Massage

Potential benefits for fibromyalgia:

• Promotes relaxation
• Loosens tight muscles
• Relieves pain and muscle spasms
• Reduces trigger points

Ask to be referred to a massage therapist who has experience in working with fibromyalgia patients. Request your therapist to work lightly and progress slowly in doing deep muscle work. It is important to work with someone who is responsive to your needs.

Treatment for Other Medical Conditions

It is important to aggressively treat migraines, depression, anxiety, irritable bowel syndrome, etc. Other related disorders can aggravate fibromyalgia symptoms if they are uncontrolled.

Ask to be referred to a specialist who treats these disorders, such as Neurologist (migraines), Gastroenterologist (Irritable Bowel Syndrome) and Psychiatrist (depression and anxiety).

Acupressure

People with fibromyalgia can be trained to use pressure on different points of the body to control symptoms.

"Acupressure for Common Ailments" by Chris Jarney/John Tindall teaches self-acupressure.

Capsaicin Cream

Capsaicin is a natural ingredient from the hot pepper plant. Studies have shown capsaicin cream has been effective in reducing pain in some patients. This tropical over-the-counter cream is known to deplete substance P, the chemical responsible for pain. Do not rub capsaicin cream all over the body. Apply it to one particular area.

Some preparations can cause burning. "Pain -Free" is a capsaicin product made it an Aloe Vera gel and doesn’t cause burning. It is sold by To Your Health, Inc. at (800) 801-1406. Arthroflex Max is available at Walgreens and other pharmacies.

Malic-Magnesium Supplements

Studies have shown patients with fibromyalgia have low magnesium levels. Ideally your physician would order blood tests to determine whether you are actually low in magnesium before you begin supplements. One study showed patients who took Malic Magnesium supplements had a reduction in pain. In the study, patients had to take 12 tablets per day.

Malic Acid is found in prepared foods as a preservative.

These supplements are sold under the names Supermalic, Malic-Magnesium, Fibroflex, Fibrocare and are sold in health foods stores and by chiropractors and nutritionists.

Melatonin

Melatonin is a hormone naturally occurring in the body. It has been studied for use in jet lag and insomnia. It can shift the body’s internal clock. The smallest effective dose should be taken. Side effects include grogginess, low sex drive, depression, mild stomach upset, headache and nightmares. It should not be taken by anyone with an auto-immune disorder. Some people with fibromyalgia report it has been helpful. The Arthritis Care Program cannot make recommendations about Melatonin. Please talk with your physician before starting Melatonin because of potential contraindications.

These dietary supplements are sold in drugstores and health food stores.

Mindfulness Meditation

Studies at Harvard have shown this type of meditation significantly reduced pain in fibromyalgia. Mindfulness meditation focuses on teaching people to be concentrating on the here and now. It uses the relaxation response, diaphragmatic breathing and yoga stretches to achieve its goals. Jon Kabat-Zinn developed the program and has written several books on the subject. Wherever You Go There You Are covers the principles of mindfulness meditation.

Relaxation Training

Deep muscle relaxation is one of the most effective pain and stress management techniques available. Diaphragmatic breathing combined with relaxation techniques helps to achieve greater deep muscle relaxation. Guided imagery is a technique where the person uses visual imagery as a tool to achieve relaxation. Audiotapes are available with relaxing music and a guide who helps the person visualize a relaxing image.

Relaxation and guide imagery tapes are widely available in bookstores and by mail order. Master the Mind offers "Release Discomfort" guided imagery tape. To order, call (800) 345-8515.

There have been no scientific studies to prove whether this natural substance improves fibromyalgia symptoms. Valerian root is known for its relaxing and sleep-enhancing effects. It has very few side effects and is believed to be safe. As with other supplements, make sure your physician is aware of any supplements you are taking.

Valerian is widely available through drug stores and health food stores.

Please ask for a referral to a counselor who is knowledgeable about fibromyalgia. Check with your health insurance coverage.

Counseling

People with fibromyalgia can benefit from psychological support for:

Stressful life conditions

Prolonged pre-diagnostic phase

Depression and/or anxiety

Abuse histories

Adjustment issue to chronic illness

Poor support system

Theracane/Backnobber

Theracane and Backnobber is used by the person with fibromyalgia to manipulate painful knots within the muscle. Your therapist can instruct you in how to use these devices. There is also a video in the Resource Library.

Relax the Back store, Life Enrichments and the Kenny Store sell the Theracane. The Backnobber is sold by the Pressure Positive Company at (610) 754-0204. Physical therapists usually sell the Theracane.

Stress Management Techniques

Stress can aggravate fibromyalgia symptoms. Each person needs to evaluate their particular stress problems and seek out resources to learn the skills to manage them. The key is to take control of stress and actively manage it on a daily basis. Some people benefit from sitting down with a counselor to help guide them in their stress management journey.

There are excellent classes, books, and audiotape series on stress management.

Self-Hypnotherapy

Self-hypnotherapy is a type of training to learn how to achieve a trance-like state. It can be used to mange stress, induce deep relaxation before bedtime, and reduce muscle pain. A psychologist trained in hypnotherapy can train the person on how to do self-hypnosis. Some patients may find self-hypnosis more effective than relaxation techniques.

Reprint permission by: Fibromyalgia Assesment Clinic, Abbot Northwestern Hosp., Arthritis Care Program.