Fibromyalgia is a very challenging condition to treat, and there is no one single treatment that works for everyone. In this brief article I will discuss what we know about possible causes, and whats available to try for treatment. I must emphasise that there are a lot of possible associations with the condition, but the actual cause is not well understood despite extensive ongoing research into the matter.
Possible causes/Risk factors:
- Gender
- more in females
- Psychological
- lack of emotional and psychological resilience
- anxiety and depression
- Immune system triggers
- Trauma
- Infection
- Vaccinations
- Auto-immune disorders
- Abnormal mast-cell function
- Gut-brain axis
- less diverse gut bacteria and with alterations of the neurotransmitter metabolism
- Immune mediated stimulation of the micro-glia, the supporting cells of the brain
- Genes:
- serotonin gene HTR2A
- Possibly role of oxidative stress from diet and environment
Below are some of the possible treatments for this condition that has benefitted some patients. It is not possible to predict the response to treatment and oftentimes we will have just have to try them one by one:
- Medications:
- duloxetine and venlafaxine
- gabapentin and pregabalin and mirogabalin
- memantine and ketamine
- naltrexone (also used for opioid overdose)
- amitriptyline and nortriptyline
- pharmaceutical grade cannabis
- under clinical trials: NYX-2925
- Complementary/Alternative Medicine (less evidence):
- Massage
- Chiropractic therapy
- Aromatherapy
- Spiritual therapy
- Melatonin
- Magnesium
- Green tea
- Fish oil
- Coenzyme Q10
- Acupuncture
- Cognitive Behavioural Therapy (CBT), mindfulness psychotherapy, attention bias modification therapy and other rehabilitative programmes
- Others:
- Transcranial magnetic stimulation
- Transcutaneous electric nerve stimulation
- Transcranial direct current stimulation
- Hyperbaric oxygen therapy
- Ozone-based autohaemotherapy
- Virtual reality and biofeedback
Fibromyalgia is complex to treat and before we embark on treatment, it is necessary to rule out other conditions like autoimmune disease, cancer or endocrine abnormalities. After that it is the gradual process of trying out different treatments until one is found that works. Speak to your doctor to find out more.
Photo by Jorge Vasconez on Unsplash