Fibromyalgia              You
have options to find fibromyalgia relief. Learn more about treatment
through medication and self-management of muscle aches and pains.        Newly 
Diagnosed? Learn More About Fibromyalgia Need to know more about how 
fibromyalgia will affect you or someone you care for?  Learn all the basics 
here:     » Introduction to Fibromyalgia     » The Fibromyalgia Problem     » 
Symptoms of Fibromyalgia     » Diagnosis of Fibromyalgia      » Fibromyalgia 
Treatments      » Fibromyalgia Prognosis     FibromyalgiaResearch Two Drugs 
Combine for Moderate Fibromyalgia Pain Relief     One of the mostfrustrating 
aspects of fibromyalgia has been the lack of viable medications to treat its 
symptoms...  » Read More    Living Forward Retire or Re-career? One of Life’s 
Major Crossroads     If
you ask Ken Dychtwald, “Most of the studies that I’ve done show that
about half of today’s retirees are bored out of their wits"...  » Read 
More             Treatment  by Teresa Kaldis, MD  MedicationsAnti seizureLyrica 
(pregabalin) is the first and only treatment approved by the FDA for the 
management of Fibromyalgia.Neurontin (gabapentin) can be helpful to treat 
pain.AnalgesicsAnalgesic
medications like Tylenol (acetaminophen) or NSAIDS (like motrin, aleve,
advil, ibuprofen) or ultram or Ultracet (ultram/acetaminophen) may used
to treat the pain of fibromyalgia.Antidepressants1. Tricyclic
Antidepressants like amitriptyline (Elavil), nortriptyline (Pamelor) or
doxepin (Sinequan) can be helpful to treat sleep anddepression. 2. Selective
serotonin reuptake inhibitors (SSRIs) antidepressants like fluoxetine
(Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram
(Celexa) are very effective in treating depression.3. Other antidepressants 
like duloxetine (Cymbalta) or venlafaxine (Effexor) may also be helpful in 
fibromyalgia.  Muscle relaxantsMuscle
relaxants cyclobenzaprine (Flexeril) or methocarbamol (Robaxin) are
used to treat the muscle pain and spasm associated with fibromyalgia.
They tend to work better during acute flares, rather than with chronic
use. Tizanadine (Zanaflex) may help both muscle spasm and pain.  Dopamine 
agonistPramipexole (Mirapex) has been shown to help some patients with 
fibromyalgia.  Other medicationsMedications
like benzodiazepines, narcotics, and steroids (like prednisone) have a
limited role in treating fibromyalgia and have not shown long term
benefits.Benzodiazepines and alcohol can affect quality of deep sleep.
Some people believe that guaifenesin helps with their pain.   Trigger point 
injectionsThese
are injections into painful areas in your muscles. This can be safely
performed in your doctor’s office. They may use medications such as
lidocaine or steroids. These injections usually provide temporary
relief.  Nonpharmacologic treatment and Self-managementEducation
and counseling: This is very important for persons with fibromyalgia to
have the information they need to help manage their disease over a
lifetime. This helps improve outcome, outlook, and coping with chronic
issues.  Biofeedback and Cognitive behavioral therapy: These interventions have 
been shown to decrease pain, depression, sense of disability, and improve 
self-esteem.  Exercise:
Studies have shown that regular aerobic exercise can improve
strength,mobility, physical function, aerobic capacity, and depression
in persons with fibromyalgia.  It can also help prevent bone loss
associated with inactivity.    Nutrition and Diet: A
well-balanced diet is recommended for all persons with fibromyalgia.
There is no proven nutritional supplement for persons with
fibromyalgia. Some patient report decreased symptoms and feeling better
when they follow a low carbohydrate diet.  Stress reduction:
It is important to have a stress reduction plan. You must integrate
these techniques into your daily life and practice them. This involves
planning time to relax and rest. You must individualize this program
for yourself.   Sleep: It is very important for
persons with fibromyalgia to have good sleep hygiene. This means a
nightly routine that includes relaxation, a regular bedtime, and
allowing at least 8-10 hours for sleep. More sleep may be needed during
acute flares.Some persons may benefit from a nap during the day.  Prayer and 
Spirituality: Research suggests that interaction between minds, body, and 
spirit have effects on our health.  Rehabilitation TreatmentBasic 
principlesRehabilitation
refers to the process of helping a person return to as much normal
function as possible. There are many ways to help improve function.   
Rehabilitation professionalsRehabilitation
is provided by many different professionals depending on your symptoms
or problems. Often, these professionals work as a team to help
coordinate the care they provide.  Physical Medicine and Rehabilitation (PMR) 
physician or Physiatrist: A doctor who focuses on overall function and symptom 
complex to suggest treatment and make appropriate referrals for therapy.  
Physical therapist (PT):
A therapist who focuses on mobility and adaptive equipmentused for
mobility like canes, walkers, wheelchairs; exercise and modalities to
treat pain and improve or maintain function.  Occupational therapist (OT):
A therapist who focuses on activities of daily living (ADLs) or ability
to perform certain tasks like dressing, cooking, bathing; energy
conservation; and adaptive equipment.  Speech therapist (ST): A therapist who 
focuses on cognition, language skills, voice and swallowing. Orthotist: A 
professional who makes splints and braces.  Neuropsychologist:
A professional who focuses on in-depth evaluation of brain and brain
functioning, including administering extensive testing. They also
provide treatment and support counseling to adjust and cope with your
situation. Therapy programAn individualized therapy
program is very important for persons with fibromyalgia. Therapy
programs are divided into skilled therapy treatmentand maintenance home
exercise program. Therapy is available in various settings including in
the hospital, inpatient rehabilitation unit, outpatient clinic, or at
home with home health services. A course of therapy with a skilled
therapist can improve mobility and ability to perform activities of
daily living. Your doctor will need to write a prescription and refer
you for therapy. It is usually covered by your health insurance. A
therapy program seems to give patients a greater sense of control which
is helpful in dealing with the psychological effects of having chronic
symptoms and improves their sense of well being. Education is a big
part of the treatment plan. Patients should be referred for evaluation
and should have periodic reevaluation as their clinical course changes
or progresses. Inactivity results in deconditioning and therapy and
exercise can reverse the weakness associated with lack of use. It is
important to find the right balance between rest andactivity.  Energy 
conservation and pacingA
physical or occupational therapist can instruct you in an individual
program of pacing yourself. This means scheduling and managing activity
and tasks so that you do not over-do-it on good days and then have
increased symptoms. It also includes breaking big tasks up into smaller
jobs or adapting the way you do something.  ExerciseA
general exercise program is beneficial for a person with fibromyalgia.
A complete program should include aerobic, strengthening, and
stretching exercises. Exercise is important for maintaining and even
improving mobility, flexibility, balance, and range of motion. It can
also help with depression. An exercise program addresses the problems
of decreased flexibility, muscle atrophy, decreased strength,
difficulty using hands, and aerobic deconditioning. Certain exercises
like swimming, walking, low-impact aerobics, yoga, Pilates, and Tai-chi
may help reducejoint pain and stiffness.  StretchingStretching
is critical to maintaining flexibility and range of joint motion. Loss
of joint range of motion or tightness in the muscles can lead to
increased pain.  MassageMassage may offer temporary relief of muscle pain and 
spasm. Massage may have the secondary benefit of offering stress relief.  
Aquatic therapy A
therapeutic exercise program can be based on land, in the water, or
both. An aquatic program may be helpful for persons with fibromyalgia.
The warm water also helps joint and muscle pain and stiffness.  Weight 
reductionIt
is very important for person with fibromyalgia to maintain ideal body
weight. Excessive weight can lead to pain and decreased function.  Support 
groupsFor
many people, supports groups can be very helpful. They provide
education, support, and advice for living with the disease
andopportunities to meet others who have similar experiences. These
groups can be a source of practical information for living better with
fibromyalgia. These groups offer additional benefit to persons with
fibromyalgia since the disease is not well understood and dealing with
the medical community can be frustrating.  OrthoticsTemporary bracing or 
splinting may be used to treat a specifically painful area.  Assistive 
devicesThese
are devices to improve walking or mobility and a consult with a
physical therapist will help you select the most appropriate mobility
aid for you. There are many gadgets to improve activities of daily
living (reacher, sock aid, button hook, jar opener, book holder) and a
consult with an occupational therapist with help you with individual
needs.  ModalitiesHot and cold modalities have
been used for many centuries (if you have poor circulation, consult
your doctor before usingcold or heat). In chronic conditions, both are
very helpful and usually patient preference determines whether hot or
cold is used. These should be used carefully to avoid injury or burns.
Most applications should be limited to 20 minutes at a time but can be
applied multiple times in a day.  CryotherapyCold treatment with ice, cold 
water, and biofreeze.  Hot treatment 1. Moist: bath or shower2. Dry: heating 
pad3. Superficial: paraffin, whirlpool, hot packs4. Deep: ultrasound, 
diathermy.  Transcutaneous
electrical nerve stimulation (TENS): This device is used to treat pain.
A therapist can provide a trial of a TENS unit for a patient, and if
beneficial, instruct the patient in use of the device at home. A
doctor’s prescription is required.  Acupuncture: Performed
by a licensed acupuncture therapist. This may be beneficial for some
patients for treatment of their pain. The number oftreatments and
frequency of treatment are variable.  Chiropractic care has offered some 
patients with fibromyalgia relief.  Osteopathic Manipulation has offered some 
patients with fibromyalgia relief.  Medical SpecialistsThere
are many different medical specialists that need to be involved in your
care to maximize symptom management and improve quality of life.  Physical 
Medicine and Rehabilitation physician (Physiatrist)A
physician who specializes in treatment of conditions that affect
mobility, self care, and interfere with the ability to perform given
roles at home, work, and in the community.  Rheumatologist A
physician who specializes in diseases of the musculoskeletal system.
They can be experts in diagnosis and treatment of fibromyalgia.  Pain 
SpecialistThere are physicians who specialize specifically in the treatment of 
pain. NeurologistA physician who specializes in conditions of the nervous 
system. InternistA physician that provides general health care to adults.  
PsychiatristA
physician who specializes in the treatment of conditions that affect
emotional well-being and cognitive disturbances. They are experts in
treating depression and are very knowledgeable in medication and
medication side effects. They can be helpful for persons experiencing
chronic pain.Group [EMAIL PROTECTED] [EMAIL PROTECTED]@yahoogroups.comWelcome 
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