fibromyalgia pain management?

Question

Hello. My mother has fibromyalgia and is in constant pain on a daily basis. She has tried Zoloft which worked for about a year, and then stopped. Amitriptyline helped her sleep but gave her a hangover. Effexor XR helps with her emotions, but had not helped with pain at all, and Trazodone helped her sleep, but made her very dizzy the next day. Anyway, long story short...I was wondering if anyone here has been successful treated for the pain of fibromyalgia...and what it was that worked for you. THanks

Also, my mother was not abused as a child, nor is their a link between abuse and fibromyalgia...

I am a pharmacist, I know what meds are used for what, and what off label uses they have. I don't need help with that!

I recognize that Effexor XR (SNRI) and Zoloft (SSRI), which are both antidepressants are not specific to pain. However, because of the chemicals they work on in the brain, they can alter one's perception of pain.

Her pain is very real.

She does not want to take any opiod pain medications.

Has anyone had success with anticonvulsants for treating fibromyalgia? Lyrica or Neurontin?

Answer 1

I hate, hate, HATE when people make assumptions about things they know nothing about...

There is NO link between abuse and fibromyalgia. Fibromyalgia is a REAL disease, not a catch-all (although it is used as such at times) and it's not about making money. Please, people, quit talking out of your butts!

Back to the question...

I've tried all the things your mother has, with similar results. I've found that, as far as prescriptions go, Tramadol works great, with Lortab for the worst days, and tylenol/advil always on hand.

- I take magnesium 3 times a day (a mix from solaray that also has malic acid and some other things)
- I take 1000 mg of fish oil 3 times a day (from pure encapsulations)
- Chiropractic treatments and massage help
- Heat packs and ice
- walking, stretching, and yoga
- sleep as well as possible, get a comfortable mattress
- comfortable shoes help... I swear by MBT's... ugly, expensive, but extremely comfortable and help with most of my back, hip, and leg pain.

The most important thing YOU can do is understand, believe her, and be supportive. It's very real, very painful, and can impact every aspect of your life.

Answer 2

One way to manage medications is when you take it and how much you take. For example, many patients have trouble with sleep so taking a med that knocks them out right before bed may turn a negative into a positive. If it is still knocking you out, ask your doctor for a lower dosage for example. Lyrica and gabapentin both address neuropathological pain with Lyrica specifically approved by the FDA for fibromyalgia. Gabapentin however is less expensive as it is a generic. Cymbalta is an anti-depressant that in very low doses may be effective for pain. It is also FDA approved for fibromyalgia. However, in your specific case, most pain medications cannot be taken until you stop breastfeeding. There is evidence that Swedish massage on a regular basis can have an effect - but avoid deep tissue massage. Some patients do Hatha yoga which is gentle stretching, others try accupressure or accupuncture. Most patients find that a combination of treatments works best. Mostly it is a matter of trial and error to find the combination that is most effective for you.

Answer 3

I'm sorry your mother is having such trouble - it can take a very long time to figure out which drugs help individual fibro patients.

I'm using Gabtril right now and a low dose of Celebrex. I've taken Utram in the past and used Vicodin when I broke a wrist. The Vicodin was great but difficult to get anyone to prescribe.

I'm also taking migraine meds, and many of them also help my fibro.

But for me, sleeping well is the key. I've taken Ambien with success and am now using Rozerum and Lunesta. Many people are afraid the take sleep meds, but a restful sleep is so important for someone with fibro.

Does your mom sleep well? If not you could have her start with good sleep hygiene - regular bedtime and getting up at the same time each day. Use the bedroom for sleep &sex only - no working. I have something over my windows so the sun doesn't wake me and I use white noise as well.

I also found that the hot water in our spa helps really well too. I can aim the jets at the fibro points in my neck and shoulders.

The doctor that I found to be the most helpful is my neurologist. He started working with my migraines and I'm lucky that he has other fibro patients and is willing to manage that for me as well.

I hope you can find something that helps your mom. Fibro can really make you feel miserable.

(It's not a wastebasket diagnosis - there are criteria to meet to be diagnosed with fibro. Childhood abuse has nothing to do with fibro. And doctors use low doses of depression medications because they help with sleep and pain.)

Answer 4

I have had fibro for 8 years. I take Celexa, Wellbutrin, and Klonopin for depression/anxiety. I developed this problem 6 years before my fibro diagnosis. I cannot tolerate any tricylic antidepressants (for the same reasons you listed for your mother) and neurotontin nor Zyprexa did anything for the pain. Just about from the beginning I have taken Ultram (tramadol). It has worked well for me. I take in the range of 50 - 200mg/day. I am aware of the seizure warning. Sometimes I add Tylenol (which is also available as Ultracet) which boosts the effectiveness of tramadol. If needed for bad spasms, I take Flexiril. I have a prescription for hydrocodone (Vicodin, Lortab), but only use it for very severe situations, or if I am traveling and know I am going to have to push myself a little more, be more stressed, etc. Works great. My rheumy prescribes 40 tablets w/2 refills every 6 months and it is always more than enough. Same thing for Fiorciet, which I take for the muscle tension headaches. I also take Topamax for cluster/migraine headache syndrome. I had these headaches for years, tried many treatments. Finally was given Topamax and it was like a miracle. I have had only one headache since a year ago last Sept.

I don't know why people are afraid to take narcotic drugs. You do not become addicted unless you abuse them. If they are used for pain relief, then that is how the efficacy of the drug is applied and used by the body. I have been taking hydrocodone just as I described for at least 5 years now and I am in no way addicted. At first both the Ultram, Flexiril and hydrocodone will make you sleepy, but that wears off after awhile.

I believe that my doctor and I have a good working relationship. She answers my questions, keeps up to date, and prescribes whatever I may need. She trusts me not to abuse medications and allows me to be the judge as to how much I need on a daily basis to control the pain in order to be as functional as possible. I think this is what every fibro needs. Also, I never take anything unless I have first researched it and have decided that it might be good for me.
This is such a peculiar, mysterious illness, that I believe our first step to control and reclaiming our lives is to educate ourselves and to keep up to date as much as possible.

I don't know if you are also interested in non-medicinal aids in this question, but I will be glad to answer that question another time, I have been on the computer long enough and my body is saying STOP!

I hope your mother finds what will work for her.

Answer 5

I found this article a couple of years ago and decided to try it out:

http://www.immunesupport.com/library/showarticle.cfm/id/6225


While it isn't for every person who has fibromyalgia/cfs it has helped enough of us that its really worth a try. As long as your mom doesnt have diabetes , uric acid problems or isn't pregnant it should be safe for her. DRibose has made a huge change in my quality of life. I do also take Tramadol for my pain but have been able to cut my consumption of that by half. As you know Tramadol isn't for every patient either because of the drop in the seizure level threshold.

I have made many changes in my diet, lifestyle and attitude. I would be happy to tell you more if you are interested. I still have pain but its nothing like when I was first diagnosed. I have learned alot from a support group I am a part of and I try to share that information with any person who needs some help. Fibromyalgia/cfs is a misunderstood problem and sometimes it takes another patient to help you understand what it takes to improve your level of health.

It's a puzzle and it takes a while to find the right pieces to make a difference.

Watch for Agomelatine to hit the market, it may help your mom more than any of the current meds will. She is lucky to have you to watch out for her treatment.
Email me if you want to hear the other things I have found helps me: [e-mail]

Put "Fibromyalgia " in the header so I dont delete it .

I'm including some links for those who may want to actually learn what fibromyalgia really is. I see so much disinformation when it comes to this subject.

Answer 6

All of the medications that you listed are basically anti-depressants, so I'm wondering why the Doctor is only concentrating on helping to manage the depression brought on by constant pain, and not the pain itself. I also have Fibromyalgia and I suffer from depression too. I have at one time or another tried all the medications that you listed with very similar results as what you said your Mother has had. Every time the Doctor would put me on a new anti-depressant, it seemed like a "miracle drug" for about 2-3 months and then it was the same old thing - it no longer worked for me and left me feeling hung over, lethargic, etc. Due to a back injury (I've had two surgeries to date and will have one more eventually), I ended up on pain medication. It not only helps my back (of course), but also just about erradicated all of my Fibromyalgia pain! Although anti-depressants can help with mild pain, they certainly aren't meant to be a pain medication. Tell your mother to speak to her Doctor about prescribing her some form of pain medication. If he is not comfortable with doing that, she should ask him to refer her on to a Pain Management Specialist/Doctor. They will prescribe her the proper pain medication for her condition and also help her learn how to cope any daily, chronic pain that the medication may not totally erase. It's horrible having constant pain - I know from personal experience! Good luck!

Answer 7

From a fellow sufferer who lived through years of physicians playing around with prescribing whatever the rep who gave them the best goody was selling, the only thing that has worked, and in fact worked so well that I now have a life again, is Neurontin or Gabapentin in generic, with Welbutrin. They are both available in generic and fairly cheap, so she will have to ask about them. I take 1200 mgs of Neurontin and 300 of Welbutrin, and it pretty much killed all the pain.
Its not a b/s diagnoses to you scoffers, its a real deal that makes life a living hell, therapy didnt do squat, but getting the nerve in my spine and neck that was deterioriating under control, made me able to enjoy life again.

Answer 8

Effexor and Zoloft are not for pain, so that's why they don't work. Also, fibromyalgia is a catch-all term used alot of the time to explain why people have pain in different areas for unexplainable reasons. Maybe your mom should try some non-drowsy painkillers. Or maybe she needs to be on a higher dose of anti-anxiety meds cause the pain might be psychosomatic. If all else fails, go see a PT for treatment.

Answer 9

Hello. I have had FM for a long time. I used to take Elavil and it made me too drowsy and my Dr. changed it to Pamelor, same drug class. She also had me take it 3 hours before bedtime as it is a long acting drug. A good pain med that shouldn't make her drowsy is Tramadol. Just a few suggestions.

Answer 10

Hi: For me it worked Celebrex, Tramadol and Guaifenesin. You should look forward for long term side effects. My pain is reduced with this medications and I can almost have a normal life. However ,the flares come and go, but a good attitude helps.