Get Online Fibromyalgia Treatment to Manage Your Pain Today

There is no cure for fibromyalgia, so treatment focuses on managing symptoms such as pain, poor sleep, and fatigue. Most people do best with a combination of treatments.

• Prescription medicines: Antidepressants and medicines for nerve pain can help reduce the pain signals involved in fibromyalgia.
• Regular low-impact exercise: Activities such as walking, cycling, swimming, or water aerobics can help reduce pain and fatigue.
• Cognitive behavioral therapy (CBT): CBT can help you manage pain, handle flare-ups, pace your activities, and cope with stress.
• A regular sleep routine: Going to bed and waking up at the same time, avoiding caffeine after lunch, and limiting screens before bed can improve sleep.
• Treating other health conditions: Depression, anxiety, irritable bowel syndrome, and sleep apnea can make fibromyalgia symptoms harder to manage, so treating them may also help.
• Weight loss when appropriate: For people who are overweight or have obesity, losing weight may help improve pain and mood.

Over-the-counter pain relievers are not usually very helpful for fibromyalgia. Current evidence does not show a meaningful benefit from NSAIDs such as ibuprofen or naproxen, and opioids are generally avoided because they are not effective for this type of chronic pain.

A board-certified doctor reviews your symptoms and medical history, then sends a prescription to your pharmacy when treatment is medically appropriate.

• SNRI antidepressants, such as duloxetine (Cymbalta) and milnacipran (Savella). Both are FDA-approved for fibromyalgia. Duloxetine usually starts at 20 to 30 mg each morning with food and is raised slowly to a maximum of 60 mg a day.
• Tricyclic antidepressants, such as amitriptyline, taken at a low dose one to three hours before sleep to ease pain and help you stay asleep.
• Muscle relaxants, such as cyclobenzaprine, started at 5 mg at bedtime when muscle pain and disturbed sleep are the main complaints.
• Nerve-pain medication, such as gabapentin, builds up gradually when widespread pain and poor sleep dominate.

Fibromyalgia pain is usually widespread rather than limited to one area, and it can change from day to day. A doctor may look for patterns such as:

• Pain in many parts of the body that has lasted for at least three months, rather than pain in just one joint.
• Aching, burning, or throbbing pain throughout the body.
• Pain that feels like it comes from the joints, even though the joints themselves are not damaged.
• Stiffness and pain that are worse in the morning, which may improve during the day but return later.
• Sensitivity to touch or pressure, so things like a hug or tight clothing may hurt.
• Flare-ups triggered by physical activity, cold or damp weather, or stress and anxiety.
• Fatigue, poor sleep, and trouble with memory or concentration, sometimes called “fibro fog,” along with the pain.

No single cause has been found. Fibromyalgia is understood as a problem with the way the central nervous system processes pain signals, and several things can set it off or make it worse.

• A change in pain processing called central sensitization, in which the nervous system amplifies signals so that ordinary sensations register as pain.
• Family history. Fibromyalgia runs in families, and close relatives of someone with it are far more likely to develop it.
• Physical or emotional trauma, including injury, surgery, and long stretches of stress.
• Infections, such as Lyme disease, appear to trigger symptoms in some people.
• Another rheumatic condition, such as lupus, rheumatoid arthritis, osteoarthritis, or ankylosing spondylitis, raises the risk.
• Sex and age. Women are about twice as likely as men to be diagnosed, and the risk climbs as you get older.
• Disturbed sleep, which does not cause fibromyalgia on its own but reliably deepens the pain once it is there.

Fibromyalgia does not damage muscles or joints, and blood tests and scans come back normal. That does not make the pain any less real.

There is no blood test or scan that confirms fibromyalgia. The diagnosis is based on your symptom history once other causes of widespread pain have been ruled out.

• A detailed history of the pain: how long it has lasted, where it sits, and what makes it better or worse.
• The core requirement is at least three months of widespread pain together with ongoing sleep problems, fatigue, or trouble with thinking and memory.
• A physical exam that usually comes back normal. Counting tender points is no longer needed to make the diagnosis.
• Blood tests, typically a complete blood count with CRP or ESR and a thyroid check, used to rule out other conditions rather than to confirm this one.
• Extra tests, such as vitamin D or vitamin B12, added only when your history points to them.
• A sleep study when sleep apnea or another sleep disorder looks likely, since untreated sleep problems keep the pain going.

Your online doctor can order the blood work, send you the lab requisition, review the results with you, and start treatment once other causes are ruled out.