Fibromyaligia is a condition that causes widespread muscle pain without inflammation. Localized pain is felt at multiple sites often on the front of the knees, elbows, hips, and encircling the neck. Patients also have trouble sleeping. Patients often have other medical conditions including migraine headaches, arthritis, irritable bowel syndrome, depression or chronic fatigue. The cause of fibromyalgia is unknown but infection, physical trauma, and emotional stress, are being investigated as causes. Some patients have higher levels of pain transmitter Substance P in the cerebrospinal fluid and lower blood levels of norepinephrine, serotonin, and growth factor-1. It is not known whether these changes are the cause or a result of fibromyalgia.

There are no medications specifically for fibromyalgia. Treatment is often a matter of trial and error as patients respond differently to medications. Analgesics and antidepressants are sometimes helpful for pain. Tramadol (Ultram) has been effective, probably because it affects serotonin and norepinephrine levels. Tricyclic antidepressants and SSRI's (such as Paxil or Prozac), alone or in combination, help relieve pain and promote sleep probably through their effect on serotonin. Anti-inflammatory drugs usually don't work very well. This is not surprising given that fibromyalgia does not involve inflammation. Other sleep medications, such as zolpidem (Ambien) or zaleplon (Sonata) improve sleep and correct distorted EEGs. Antiseizure medications such as clonazepam (Klonopin) help with restless legs, teeth grinding, and muscle twitching which can help sleep. The muscle relaxant cyclobenzaprine (Flexeril) is helpful for up to six months but seems to lose its effect over time. Guaifenesin, 600 mg twice or three times daily, is widely used. The theory is that guaifenesin helps improve phosphate excretion. There is no scientific evidence that this works.

Many natural products have been tried to treat fibromyalgia. Of these SAMe appears to be promising. It seems to improve pain, fatigue, stiffness and mood. Patients should not combine SAMe with anti-depressants. The main draw back to SAMe therapy is the cost. Capsaicin might be effective when applied topically. Interestingly, it appears to help in locations other than where it is applied. Magnesium and malic acid in combination have been used with mixed results.

Taos Pharmacy is your best source for alternative therapy information. If you are interested in natural therapies alone or in combination with your medical treatment, ask your pharmacy experts at Taos Pharmacy. Reasonably priced comprehensive drug utilization reviews and private consultations are a specialty.

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