Fibromyalgia and Medication.

Results from recent research – it may not be what you think.

Fibromyalgia or Fibromyalgia syndrome (FMS) is a chronic (long term) condition having an unknown cause. People with fibromyalgia usually experience chronic widespread pain that is often accompanied by poor or non-refreshing sleep, cognitive dysfunction and fatigue. Fibromyalgia sufferers also often report high levels of disability and poor quality of life.

If you do a google search you will find a number of medications for fibromyalgia and some have many glowing reviews with just the odd one or two that are negative. So you might think that medication is the answer to your problems. But is this impression accurate or not?

To answer these types of questions an organization called the Cochrane Library undertakes and publishes reviews based on the results of quality studies done in the area under question. http://www.thecochranelibrary.com

There are a number of different medications used for fibromyalgia with three being listed as approved for use in USA.

Two of these medications, cymbalta and savella were recently reviewed for their effectiveness. HäuserW, Urrútia G, Tort S, ÜçeylerN, Walitt B. Serotonin and noradrenaline reuptake inhibitors (SNRIs) for fibromyalgia syndrome. Cochrane Database of Systematic Reviews 2013, Issue 1

Best estimates of what happens to people with fibromyalgia when they take duloxetine or milnacipran (cymbalta or savella) after an average of 18 weeks

Pain was reduced by 50% in:
– 29 out of 100 people taking duloxetine or milnacipran
– 19 out of 100 people taking placebo.
– Therefore, 10 more people in every 100 benefited from duloxetine or milnacipran than benefited from  placebo (10% absolute improvement).

Sleep problems and fatigue:
People taking duloxetine or milnacipran reported a slight reduction in fatigue compared to people taking placebo. There was no improvement in sleep.

Disease-related quality of life (QOL):
People taking duloxetine or milnacipran rated their quality of life at 14, just four points higher (out of 100) than people taking placebo. An improvement of just 4%.

Stopping treatment due to the side effects:
9 more people out of 100 stopped taking duloxetin or milnacipran than stopped taking fake medication because of side effects.

Serious adverse events:
There were no differences between duloxetine or milnacipran and fake medication in the number of serious adverse events. Possible side effects may include nausea, dry mouth, headache, constipation and hyperhidrosis. Rare complications may include suicidality, liver damage, abnormal bleeding, elevated blood pressure and urinary hesitation.

The third drug was reviewed separately and these are the author’s conclusions:

Pregabalin (known as lyrica) has proven efficacy in neuropathic pain conditions and fibromyalgia. A minority of patients will have substantial benefit with pregabalin, and more will have moderate benefit. Many will have no or trivial benefit, or will discontinue because of adverse events.

To sum this up , at best, it looks like if you are the lucky one in ten, then medication may reduce your pain by 50% and the side effects may be tolerable.  However, there is little improvement in quality of life. Is this good enough for you or would you like more?

For the others the pain reduction is moderate to minimal and many cannot tolerate the side effects.

Does this mean you have to put up with fibromyalgia year after year, or is there another way to go?

Well, one study (not a Cochrane review) suggests that you may be able to get a very good reduction of pain, along with better energy, be more calm inside and have overall better quality of life. This was a study of 2818 people. The study looked at the general population and was not just limited to fibromyalgia sufferers. However, in the clinical setting, when following the process utilized in the study, many fibromyalgia patients improve significantly, including sleeping better as well. Of course,  some fibromyalgia sufferers may have more difficult or multiple conditions and may not do as well, though even these will often make at least some improvement.

The process that yielded these results is Network chiropractic… (keep reading). Some people with fibromyalgia may be a little concerned at the thought of getting their neck or back manipulated or “cracked.” Fortunately, there is nothing to worry about. With Network there is no manipulation or adjusting or forceful procedures of any sort. Network is very gentle and relaxing and profoundly beneficial for the muscles, the spine and the nervous system. All of which are usually significantly affected in fibromyalgia and are crucial to correct if you really want improvement of the fibromyalgia condition.

Also of benefit in many cases of fibromyalgia is some modification to the diet. If you put poor quality fuel into the car, it just does not run as well. It is the same with your body. Likewise, some specific supplements are quite helpful and there is more to it than just taking some extra magnesium.

Our goal is to improve the overall condition of those suffering with fibromyalgia so they can have a better life, rather than putting up with the condition and “managing” with medications or “living” with it.

So if you have been putting up with fibromyalgia for some time or are not satisfied with the care you have been receiving and would like a second opinion, please call us on (03) 9793 3755We are currently providing a $50 consultation for fibromyalgia sufferers to come in and tell us about what they are experiencing and see whether our program is likely to be of assistance for them. The consultation includes a specific spinal, muscular and nervous system assessment to provide a good picture of what is going on with each individual and working out the way forward.