Posted by Cairo on January 23, 2005, at 17:01:20
In reply to Anyone else with fibromialgia?, posted by Guy on January 22, 2005, at 18:56:45
I, too, have Fibromyalgia. All of the above suggestions are valid, but it remains to be seen which may help you as I believe FMS has different etiologies in different people.
A good baseline workup should include tests and scans to rule out Lupus, Lyme's disease, hypothyroidism/Hashimotos disease, rheaumatoid arthritis, MS, etc. Hypothyroidism, for example, can present with similar physical symptoms and Synthroid may relieve the symptoms.
In many cases, all the above are normal and Fibromyalgia becomes the diagnosis by exclusion. The Rheumatologist I see specializes in FMS and says that few of her patients are helped very much by SSRIs, anti-inflammatory drugs and even Effexor. While Elavil may help, she says most of her patients can't handle the side effects and feel it's not worth it. I personally think it depends on the person.
Few meds help me other than sleep meds and LidoDerm transdermal patches. I currently use trazodone 100mg at bedtime. Cymbalta has been the only med that helps my energy, focus and some of the other symptoms of HPA axis hypofunction, which is often seen in FMS, but nothing much helps the tight muscles other than heat, stretching and not overdoing things. I avoid all stimulants (caffeine and the like) and try to avoid stress (easier said than done).
Trigger point therapy or massage works, but doesn't last with me more than a couple of hours.
A good physical therapist who knows techniques such as Paris or Maitland can release tight muscles and it's alot less painful than the trigger point shots and having someone knead painful muscles.You also need a sleep study. My doctor says that over 75% of her patients show sleep apnea. I think some are due to mechanical obstruction, but some (like me) have a more central origin. Unfortunately, antidepressants can cause or make sleep apnea worse. Using a CPAP machine for sleep apnea has helped a bit, but it may take a couple of months to see any benefit if you have a large sleep deficit.
The most important thing is to find a doctor who really knows about Fibromyalgia and the most current theories and therapies. I've had too many write me off as attention seeking or having the attitude that there's nothing that can be done.
As I said, causes are very individual and it pays to find out what is going on in your particular case.
I am going to try Botox injections into selected muscles, but I can't comment on whether this will be successful or not. It should be, but may take several courses to see any results.
Here is an interesting newsletter that keeps you up to date on FMS: http://www.fmnetnews.com/
Good luck!
Cairo
> My primary diagnosis is anxiety disorder (constant and unrelenting), but in the past few months this disorder has morphed into anxiety PLUS chronic pain syndrome, also known as fibromialgia. I have headache, neck ache, back ache, and, worst of all, terrible pain in my left shoulder. My GP says there is nothing he can do, and my pdoc also seems at a loss. I am currently taking 10 mg Zyprexa plus .5 mg clonazepam, but there is little relief and the black hole seems more and more inviting. Please, any suggestions would be greatly appreciated.
poster:Cairo
thread:445891
URL: http://www.dr-bob.org/babble/20050119/msgs/446353.html