Non-Pharmaceutical Treatment Options For Fibromyalgia

Four-million adults in the United States suffer from the effects of fibromyalgia, a condition that causes widespread pain and irritation in targeted points of the body. These pains can often cause patients to have nightly insomnia and reduced quality of life. However, while this condition affects roughly 2% of the United States adult population, diagnosis of this pain causing condition remains an elusive prospect for physicians who desire to find cause and an effective treatment for their patients.

Although this condition certainly has a psychological component, Fibromyalgia is a legitimate condition and can result in debilitating pain. Those who claim they’ve experienced the pain of fibromyalgia and seek medical attention or treatment are often met with skepticism from their physicians who have no clinical method of diagnosing the condition or finding the cause. 

Nonetheless, non-pharmaceutical treatment options that can efficiently reduce pain, tenderness, and discomfort exist. That is why it is crucial for both patients and healthcare providers to research the causes, symptoms, and therapeutic options available. 

In this guide, we’ll look at what fibromyalgia is, how it manifests itself, and how non-drug treatments such as Relatyv’s Neurofunctional Pain management programs can help.

What Is Fibromyalgia?

Fibromyalgia is considered to be an “invisible illness” because its symptoms are not immediately outwardly visible. Nonetheless, for patients affected by this condition, fibromyalgia pain is real and debilitating.

Fibromyalgia is defined as a chronic disorder that causes widespread musculoskeletal pain and tenderness. As a result patients also experience fatigue, muscle weakness, sleep disturbances, and alterations in mood and memory. 

While the causes of fibromyalgia are often unknown, this condition tends to derive from abnormalities in how the brain processes sensory signals. In turn, you may experience pain as a result of stimuli that should normally be painful or feel excessive pain from sensations that should only cause mild discomfort. 

In some cases, fibromyalgia arises as a spontaneous condition without an identifiable trigger.  It often develops after a traumatic event or injury. 

Below, we’ll look at the symptoms and causes of fibromyalgia, as well as the non-pharmaceutical treatment option available to today’s patients. Let’s get started.

Symptoms Of Fibromyalgia

Much like the condition of peripheral neuropathy, the symptoms of fibromyalgia pain may be widespread across the body, but all the pain is referred inward to the central nervous system. This creates an opportunity to treat that pain at a centralized location rather than spot check around the body. 

While peripheral neuropathy often manifests in adults who have been diagnosed with diabetes, we see that fibromyalgia manifests more commonly in patients who may have been diagnosed with anxiety or depression. 

However, these conditions affect the nerves of the body in different places and result in widespread pain that presents as multiple localized pain issues occurring at the same time.

Some of the most common symptoms of fibromyalgia include:

• Pain that is spread across several areas of the body and lasts at least 3 months. This pain is continuous and may flare up occasionally. Patients describe their pain as dull, aching, burning, or stabbing. 
• Extreme sensitivity to touch, which manifests itself as hyperalgesia (experiencing severe or long-lasting pain in response to sensations that should be mildly uncomfortable) and allodynia (experiencing pain in response to stimuli that should be painless, i.e.: brushing your hair).
• Prolonged fatigue, often deriving from the fact that the pain causes sleep disturbances and insomnia. 
• Impaired cognitive functions, such as memory loss, attention deficit, and problems with thinking, concentration, and reasoning. This symptom is commonly referred to as “fibro-fog” and affects over half of the patients with fibromyalgia.  

Fibromyalgia is likely to coexist with other disorders, including anxiety, depression, temporomandibular joint (TMJ) dysfunction, tension headaches, and irritable bowel syndrome. When this happens, you may experience other symptoms, including:

• Frequent headaches
• Mood swings and emotional imbalances
• Digestive issues like constipation and diarrhea
• Bladder conditions like interstitial cystitis
• Pain in the face or in the jaw
• Poor sleep quality

Where Does Fibromyalgia Hurt?

Fibromyalgia symptoms may vary from one person to another. This, coupled with the “invisible” nature of this illness, has made it a difficult condition to diagnose and treat. 

In an attempt to improve the diagnostic criteria for fibromyalgia, in 1990, the American College of Rheumatology identified 18 spots in the body that tend to be painful or tender in people with this condition. 

These spots have been used as part of a diagnostic test for fibromyalgia until 2010. During this time, people who experienced pain in at least 11 of the 18 spots were diagnosed with fibromyalgia. 

These spots are located in the following regions:

• Upper regions (left or right): arm (near the elbow), back of the shoulders, edge of the upper breast
• Lower regions (left or right): knee, upper buttock
• Axial regions: front lower neck, back of the neck, base of the skull, hip bone

Although this may vary from one patient to another, the points above indicate the areas of the body most often affected by fibromyalgia pain.

How It’s Diagnosed

Since the 1990s, the body of research surrounding fibromyalgia has grown considerably. Today, it is well understood that fibromyalgia pain moves around and varies in intensity. 

For example, when using the diagnostic criteria highlighted in 1990, patients were only diagnosed with fibromyalgia if, at the time of the appointment, they experienced pain when the doctor pressed on the different points. 

As the research on this condition expanded, the American College of Rheumatology changed the diagnostic criteria for this condition in 2010.

Today, fibromyalgia is diagnosed through several examinations, which include a thorough assessment of a patient’s medical history. Additionally, a doctor may recommend undergoing several laboratory tests to rule out other conditions or understand whether you are affected by more than one condition at once. 

These tests include:

• Blood tests or a complete blood count
• Rheumatoid factor
• Thyroid function assessments
• Tests to diagnose celiac disease
• Tests to check for deficiencies, such as vitamin D

As the research around fibromyalgia grows, more accurate and efficient diagnostic tests emerge. Let’s look at what the research says about this condition.

What The Research Says About The Condition

The enigmatic nature of this disabling condition frustrates physicians across the United States. However, fibromyalgia is recognized and has an entry in the 10th edition of The International Classification of Diseases which is seen as one of the most reputable sources for diagnosis of disability.

The fact that this condition is real, serious, and debilitating does not change the fact that little is known about what causes it or how to treat it. Fortunately, new studies conducted internationally have started to show promising results. Let’s look at these below.

Theories On The Causes Of Fibromyalgia

Research on the causes of fibromyalgia has been carried out since this disease was discovered in the 1970s. However, to this day, many patients deal with an idiopathic condition, or a disorder that has no defined cause. 

So far, studies have shown that fibromyalgia may be connected to disturbances in how the brain processes pain signals. These abnormalities may be due to anomalies in the brain or spinal cord. Additionally, patients with a family history of fibromyalgia are more likely to suffer from this condition, which indicates that fibromyalgia may have genetic components. 

While this theory is generally accepted, new research is looking at other possible causes of fibromyalgia. 

For example, a 2020 study explored the connection between gut microbiome composition and the prevalence of this disease. Additionally, a study conducted in 2021 by the IoPPN at King’s College London has shown that fibromyalgia may be caused by abnormalities in a person’s immune response.

According to this theory, pain may be caused by antibodies that increase the activity of the sensory nerves in charge of delivering pain signals to the brain. This study has profound implications because it shows that the root cause of fibromyalgia is within the immune system and not in the brain as previously believed. 

In most patients, the development of fibromyalgia is triggered by other health events, such as trauma, injury, or mental health problems such as anxiety or depression.

Theories on The Nature of Fibromyalgia

A 2018 review analyzed the myths and facts surrounding fibromyalgia and looked at whether this condition can be considered a pain disease. While this condition certainly causes pain, the review highlights how the painful sensations may be the manifestation of somatic or psychological distress. At the same time, fibromyalgia is more than simply a mask for depression or somatic symptom disorder, and it is not a brain disorder or a form of neuropathy.

Theories on The Prognosis for Fibromyalgia

Fibromyalgia may cause a range of symptoms, including constant pain, memory problems, sleep disturbances, and digestive issues. This is where obtaining an accurate diagnosis can help patients understand and accept their condition. 

According to guidelines published in 2017, patients may benefit from obtaining certain pieces of information, including:

• The symptoms of fibromyalgia are based on functional disorders, not by an organic disease
• Their disease is legitimate and real
• The symptoms are persistent, and total relief from pain is only rarely achieved
• It is possible for patients to adapt to their symptoms over time
• It is possible for patients to manage the intensity of their symptoms with self-management techniques

Above all, patients should be offered an overview of what their prognosis will be like. Although total relief can’t always be achieved, fibromyalgia does not lead to disability and does not shorten life expectancy. Additionally, through treatment, patients can experience a reduction in symptoms and boost their quality of life. Let’s look at these treatment options in more detail below.

Fibromyalgia And Mental Health

Speculation for a psychiatric origin of the disability is not new and mental illness has been determined by some physicians to be the primary cause of this debilitating pain.  

Because the condition cannot be diagnosed by conventional clinical diagnostics, Dr. Bernstein concedes that, “ . . . it is possible that fibromyalgia is more psychiatric than musculoskeletal”, and that perhaps “ . . . patients have been encouraged to anchor their lives around their misery. Yet none of these factors make fibromyalgia any less real”. 

Dr. Bernstein’s claim that perhaps patients are “encouraged” to center their lives around the pain suggests that he may believe that the conditions of fibromyalgia are driven by psychosomatic means– psychosomatic meaning a physical manifestation of symptoms from mental distress. 

Perhaps it is the mental distress– the depression, anxiety, or stress– that is causing a manifestation of widespread pain. Physicians Fatmanur Kocak and Emine Eda Kurt have determined in a 2018 study that “[i]ndividuals with fibromyalgia often have comorbid anxiety, depression, and/or other pain syndromes[.]” 

These determinations suggest that some who suffer from fibromyalgia may wish to seek psychiatric attention. This does not detract from the physical pain that patients experience. While the search for the causes of fibromyalgia continues, doctors and patients look for effective treatment, both pharmaceutical and non-pharmaceutical.

For the patients, the pain is real; and for some doctors, the pain is a physical manifestation of poor mental health. Dr. Bernstein analyzes this relationship between the doctor and their patients and asks the question to his peers:

“Can we say that this illness experience is ‘in your mind’ without infuriating the patient? Not today, not yet, given the social construction of ‘in your mind’ and the social construction of ‘fibromyalgia’” (2016).

These “social constructions” are all too familiar with patients who suffer from the effects of fibromyalgia. They are aware of the stigma that surrounds the disability and will often turn from physicians who seek a scientific approach to treatment outside the medical community. 

Bernstein continues with his analysis of the affected doctor/patient relationship, concluding that this judgment, “ . . . drives these patients toward sectarian practitioners who have no proclivity to challenge them, and little if any success in returning them to their premorbid state[.]” 

But do patients wish to be “challenged” by their physicians, or would they rather have an effective and lasting solution to their pain, regardless of that pain’s origin?

Treating Fibromyalgia Without Pharmaceuticals

Doctors Kocak and Kurt, while discussing the possible causes of fibromyalgia and how they are possibly psychiatric in nature, discuss the nonpharmacologic treatment of the disease and its efficacy. 

One of the major nonpharmacologic treatments of fibromyalgia– which may come as a surprise to those seeking treatment– is simple exercise. Physicians Kocak and Kurt attribute pain, which in patients with fibromyalgia, “ . . . may be associated with the central nervous system . . .” (2018). 

They continue to expound upon the efficacy of exercise and that it will “ . . . contribute to improvements in pain. In addressing conditions experienced by FM [fibromyalgia] patients, exercise training was reported to be used successfully”. 

Many who exercise regularly can attest to its physical as well as mental benefits and will often turn to the use of heat and cold to relieve the muscles that have been overworked and are in pain. 

Because of this, many who suffer from fibromyalgia believe that the application of heat or cold to the affected area will relieve the pain they experience because of their condition. 

However, doctors Kocak and Kurt conclude that, “[a]lthough local cold therapy application with ice cubes or cooling sprays is useful in other muscle pains, they do not have any influence in FM . . . [t]here are no data available about long-term efficacy.” 

For the use of heat as a treatment for pain, the physicians conclude that the “ . . . real efficacy of both superficial and deep heat is still a topic for further studies”.

Can Fibromyalgia Be Treated?

Fibromyalgia may be a lifelong condition for which there is not yet a definitive cure. Nonetheless, as research progresses, patients are now gaining access to a wide range of fibromyalgia treatments that can help them prevent pain flare-ups, reduce the intensity of symptoms, and boost their overall quality of life. 

According to studies, one of the best ways to ease your fibromyalgia pain is to exercise regularly. Leading an active lifestyle can improve your mental health and reduce the symptoms associated with depression and anxiety. Additionally, keeping active will lower the risk of conditions that represent risk factors for fibromyalgia, including obesity. 

However, when the pain becomes too much, exercising may not be desirable. In the event of flare-ups, patients often resort to the application of heat or cold compresses as well as over-the-counter pain relievers. 

While these solutions may seem efficient in the short term, there is a lack of research proving their effectiveness. What’s more, in the case of medications, patients taking pain relievers and non-steroidal anti-inflammatory drugs (NSAIDs) for long periods of time may be exposing themselves to risks such as gastrointestinal ulcers, heart problems, strokes, and dependency. 

Naturally, both patients and healthcare providers are likely to feel frustrated at the lack of solutions. However, thanks to today’s advances in regenerative medicine, patients have a greater range of options available to them, which don’t include surgery or medications. 

Let’s look at why pharmaceutical treatments may not be effective enough and what non-pharmaceutical options are available today.

Conservative Pharmaceutical Treatment

Depending on what is believed to cause their fibromyalgia, patients may be prescribed several lines of treatment. Beyond cold therapy, light stretches, strength training, and therapies like sleep therapy, people with fibromyalgia often end up taking medications regularly to manage their pain. 

Two of the most common pharmaceutical treatments prescribed are:

• Pain relievers – Pain medications and (NSAIDs) such as ibuprofen and Tylenol may work in the short term to relieve pain, but they come with severe side effects, including an increased risk of stroke, myocardial infarction, peptic ulcers, and dependency. 
• Antidepressants – If fibromyalgia is related to mental health conditions such as anxiety or depression, patients may be prescribed antidepressants. These medications are also muscle relaxants and promote sleep. Antidepressants can cause changes in personality, mood swings, digestive issues, or headaches.
• Antiepileptic drugs – One of the first drugs approved for the treatment of fibromyalgia is pregabalin (Lyrica), which is an anti-seizure medication. These drugs may seem to help ease the overactive transmission of pain signals that cause fibromyalgia pain and extreme sensitivity to touch. These medications may lead to severe side effects such as dizziness, sleepiness, mood changes, abdominal pain, or irritability.

While these therapies may seem effective in the short term, many who have learned to manage their pain through the pharmacy, experience dependency and even addiction from these methods and so a more natural, and applicable means of managing pain is all the more desirable. 

It is not surprising that many who experience this pain and wish to relieve it with the use of simple means, such as the application of heat and ice, may feel defeated to learn that these methods are ineffectual. 

Physicians also experience this frustration when there are little to no non-pharmacological solutions to manage the pain and will result in suggesting that their patients improve their mental health, hoping that it will alleviate the pain in time. However, these suggestions to patients often cause a rift between the doctor and their patients.

Available Non-Pharmaceutical Treatment Options

The inconclusive evidence for pain management may frustrate the many millions of adults suffering from fibromyalgia who wish to treat their pain, barring pharmacological means.

Fortunately, the body of research surrounding valid treatment options for fibromyalgia continues to grow and offer patients new, non-pharmaceutical, and non-invasive options. 

Below, we’ll look at the treatment options that patients with fibromyalgia are often offered.

Clinical trials are looking at the effectiveness of biofeedback to ease pain in patients with fibromyalgia. 

Biofeedback refers to a mind-body exercise that can help patients gain control over some of their body’s functions. During a biofeedback therapy session, patients are connected to specialized electrical pads that are used to monitor vital functions such as heart rate, breathing patterns, and blood pressure. A trained professional will then analyze a patient’s physical response to stressors and help the person in therapy control involuntary bodily responses. 

This technique can help you better manage stress and improve your quality of life and perception of pain.

Massage

Massages may help patients deal with painful sensations deriving from fibromyalgia. Massages can lower the levels of cortisol (the stress hormone) and trigger the production of serotonin. Serotonin is the neurotransmitter in charge of promoting feelings of satisfaction, optimism, and happiness. 

In the context of fibromyalgia, massage therapy that helps the release of serotonin may act as an antidepressant, modulate mood, and reduce sensations of pain.

Trigger Point Injections

Another treatment offered by many providers is localized trigger point injections of various pain-relieving ingredients, some natural and some medication based. 

Though these trigger point injections are short-term options, it often is the only option available that isn’t a pain prescription or a more invasive procedure.

How Fibromyalgia Pain Is Managed

Fibromyalgia pain can be effectively managed through several therapies. Below, we’ll look at the options available to patients today.

Physical Therapy

Physical therapy plays an essential role in helping patients ease their pain and regain their quality of life. According to a review published in 2000, physical therapy – coupled with regular exercise and cardiovascular fitness training – lowers pain levels, improves energy levels, and boosts work capacity. What’s more, physiotherapy can help reduce the overloading of the muscle system, improve posture, and strengthen weak muscles.

A physical therapist may also help people with fibromyalgia fight stiffness and pain through light stretches and strengthening exercises.

Occupational Therapy

Occupational therapy is an approach to pain management that allows individuals with fibromyalgia to cope with the symptoms of their condition. A 2017 review showed that a multidisciplinary intervention including cognitive-behavioral therapies, stress management, and emotional disclosure could help people with fibromyalgia reduce pain, depressive symptoms, and fatigue.

Stress Management

Stress management techniques work by lowering the levels of cortisol, which can help reduce inflammation, and promote the release of feel-good hormones, such as serotonin. Some relaxation techniques that may help people with fibromyalgia cope with their symptoms include progressive muscle relaxation, massages, acupuncture, autogenic training, breathing exercises, and body-mind activities like yoga or tai chi.

Patient Education

Patient education should be considered the first step to a successful pain-management approach for people with fibromyalgia. According to a 2021 review, patients who were educated about the basics of fibromyalgia, body practices, physical activities, and treatment options were able to better cope with their condition and its symptoms.

Improving Quality Of Sleep

Studies have shown that an estimated 96% of people with fibromyalgia are also problem sleepers. Among the most common sleep disturbances are insomnia, non-restorative sleep, and trouble falling asleep. 

This complication of fibromyalgia is often due to the increased sensitivity to pain and touch, which makes it difficult to relax at nighttime. In turn, a lack of sleep can decrease a patient’s pain threshold and worsen daytime fatigue. 

Some ways for patients to improve their sleep and better cope with the symptoms of fibromyalgia include exercising regularly, using relaxation techniques such as body scans and meditation, taking vitamin D supplements, and sticking to a structured sleep schedule.

Treating Mental Health Conditions

As seen above, fibromyalgia may arise as a symptom of other conditions, such as depression or anxiety. Patients who have received a differential or dual diagnosis for mental health conditions or fibromyalgia may benefit from working with a specialized mental health professional.

A Non-Pharmacological Solution For Fibromyalgia Pain

In the sections below, we’ll look at what patients should expect when choosing Relatyv’s Neurofunctional Pain Management approach.

The Phases Of The Neuralgesia Pain Protocol

Neurofunctional Pain Management is a proprietary and fully customizable pain management protocol that uses natural therapies to support the body’s natural healing process. Beyond providing pain relief in the long term, this approach helps patients boost their quality of life, regain mobility, and restore their health.

Here is how Neurofunctional Pain Management programs help with fibromyalgia pain:

• Phase 1: High-Pulse Electrical Stimulation

High-pulse electrical stimulation is an FDA-approved treatment that involves the use of electrical current to ease pain. When applied to the area in need, the electrical current “floods” the nervous system and prevents pain signals from reaching the brain. Additionally, electrical stimulation boosts the supply of blood, oxygen, and nutrients to the pain point, relieves inflammation, and supports the release of feel-good hormones such as endorphins.

• Phase 2: Hydration Therapy

Through hydration and IV therapies, patients can address nutritional deficiencies that may be worsening their condition. After a thorough initial evaluation, IV therapies are designed around a patient’s unique needs. Hydration therapies may also help lower chronic inflammation, thus easing fibromyalgia pain.

• Phase 3: Lifestyle And Nutritional Counseling

The team of specialized healthcare providers at Relatyv will also look at the lifestyle factors that may be worsening your condition, including a sedentary lifestyle, improper conditioning, poor posture, obesity, repeated stress, and nutrition. Based on a thorough evaluation, patients will receive tailored guidelines that aim to reduce these risk factors for fibromyalgia pain.

Find A Solution For Managing Fibromyalgia Pain

Fibromyalgia can have a profound impact on all aspects of your life and cause debilitating chronic pain. Fortunately, painkillers and medications such as antidepressants are no longer the only options to restore your health, ease pain, and return to living your life to the fullest.

Our mission at Relatyv is to relieve pain, restore health, and magnify quality of life without medications, surgery, or invasive procedures. It is our vision to be the first thought, first choice, and first step in the journey of chronic pain management and health restoration.