Treating fibromyalgia

There is no cure for fibromyalgia, but treatment aims to ease your symptoms and improve your quality of life.

Your treatment will be decided between you and your GP, depending on what you prefer and what is available. Several different healthcare professionals may also be involved, such as:

• a rheumatologist (a specialist in conditions which affect muscles and joints)
• a neurologist (a specialist in conditions of the central nervous system)

As fibromyalgia has a number of different symptoms, no single treatment will work for all of them. You will need to try a variety of treatments to find a mix that suits you. This will normally be a combination of medication and lifestyle changes.

Information and support

You may find it helpful to research fibromyalgia to improve your understanding of the condition. Many people also find support groups helpful. Just talking to someone who knows what you are going though can make you feel better.

You can visit UK Fibromyalgia’s support group section for a list of fibromyalgia support groups across the country.

Medicines for fibromyalgia

You may need to take several different types of medicines for fibromyalgia, including painkillers and antidepressants. Different medicines are described in more detail below.

Painkillers

If you have fibromyalgia, you can treat your pain using simple painkillers, such as paracetamol, available over the counter from a pharmacy. Always read the manufacturer’s instructions.

If paracetamol is not effective, your GP (or another healthcare professional treating you) may prescribe a stronger painkiller, such as codeine or tramadol. Research has found that tramadol can improve pain and may also help you function better in your daily activities.  

Side effects of tramadol include:

• diarrhoea 
• fatigue (extreme tiredness)
• withdrawal symptoms if you stop taking it

Antidepressants

Antidepressant medicines for fibromyalgia are not prescribed specifically to treat depression. They are used to boost the levels of certain neurotransmitters, such as serotonin, noradrenaline and dopamine. Neurotransmitters are chemicals that carry messages to and from the brain.

It is thought that low levels of neurotransmitters may be a factor in causing fibromyalgia, and that raising their levels may help to treat the condition and ease pain.

There are different types of antidepressants. The choice of medicine will depend on the type of fibromyalgia you have, the severity of your symptoms and any side effects the medicine may cause.

Antidepressants used to treat fibromyalgia include:

• tricyclic antidepressants – such as amitriptyline, which raises levels of serotonin and noradrenaline 
• serotonin-noradrenaline reuptake inhibitors – such as duloxetine, which raise levels of serotonin and noradrenaline
• selective serotonin reuptake inhibitors (SSRIs) – such as fluoxetine and paroxetine, which raise levels of serotonin

There are also two other types of medicine that affect the levels of neurotransmitters and are sometimes used :

• pramipexole 
• tropisetron

Antidepressants can cause a number of side effects, including:

• nausea (feeling sick)
• dry mouth
• dizziness
• disturbed sleep
• constipation (feeling unable to empty your bowels)

For more information on the side effects of your particular medication, see the patient information leaflet that comes with it, or read our Medicines info page.

Medicines to help you sleep

As fibromyalgia can affect your sleeping patterns, you may wish to try medicines to help you sleep. If you are sleeping better, you may find that your other symptoms are not as severe.

Speak to your GP if you think you could benefit from a medicine to help you sleep. They may recommend an over-the-counter medicine, or prescribe a short course of a stronger medication.

Read more information on treating insomnia including good sleeping techniques and medicines to help you sleep.

Muscle relaxants

If you have muscle stiffness or spasms (when the muscles contract painfully) as a result of fibromyalgia, your GP may prescribe a muscle relaxant to ease your symptoms. These medicines may also help you sleep more deeply at night because they can have a sedative (sleep-inducing) effect.

Anticonvulsants

You may also be prescribed an anticonvulsant (anti-seizure) medicine, as these can be beneficial in treating fibromyalgia.

The most common anticonvulsant used for fibromyalgia is pregabalin, which is normally used to treat epilepsy (a condition that causes seizures). One review of research into pregabalin found that 40% of people who used it for fibromyalgia reported feeling ‘much or very much’ improved.

You may be able to take pregabalin as a brand called Lyrica. Possible side effects include:

• dry mouth
• constipation
• nausea
• vomiting
• dizziness
• blurred vision
• weight gain

Antipsychotics

Antipsychotic medicines, also called neuroleptics, are sometimes used to treat conditions that cause chronic (long-term) pain, such as fibromyalgia. Their effectiveness is not clear.

You may also be prescribed an antipsychotic as a pain reliever.

 Possible side effects include:

• drowsiness
• tremors (shaking)
• restlessness

Other treatment options

Other treatment options which can be used to help cope with the pain of fibromyalgia include:

• swimming, sitting or exercising in a heated pool or warm water
• an individually tailored exercise programme (see Fibromyalgia – self-help for more information)
• cognitive behavioural therapy (CBT) – a talking therapy that changes the way you think about things so you can deal with problems more positively
• psychotherapy – a talking therapy that helps you understand and deal with your thoughts and feelings
• relaxation techniques (see Fibromyalgia – self-help for more information)
• physiotherapy – techniques such as massage are used to improve physical problems, such as muscle stiffness or weakness
• psychological support – any kind of counselling or support group that helps you deal with the issues caused by fibromyalgia 

Read more information on self-help for fibromyalgia.

Alternative therapies

Some alternative therapies, such as acupuncture (where thin needles are inserted into certain points around the body to help relieve pain), claim to relieve or prevent fibromyalgia symptoms. So far, there is a lack of evidence supporting their effectiveness.

Until more research has verified that alternative therapies may have some benefit, they are not recommended for treating fibromyalgia.

Research into some complementary medicines, such as plant extracts, has found that they are not effective for fibromyalgia. If you decide to use any complementary or herbal remedies, check with your GP first. Some remedies can react unpredictably with other medication, or make it less effective.

Treating other conditions

If you have been diagnosed with another condition as well as fibromyalgia, such as depression, you may be recommended separate treatment including additional counselling or medication.