Anti-inflammatory medicine fibromyalgia
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
Click here: Second Opinion Arthritis Treatment Kit
Fibromyalgia (FM) is a disorder characterized by hypersensitivity to environmental stimuli and is probably due to a disorder of neurotransmitter regulation.
FM may be primary or may be secondary to other rheumatic condition such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE).
FM may also occur in patients who have osteoarthritis, particularly when this problem affects the neck and low back.
Non steroidal anti-inflammatory drugs (NSAIDs) are generally not effective for the treatment of FM. In fact this is almost a helpful diagnostic test.
When a patient comes in and states they have been treated with more than six NSAIDs without any relief, then FM must be considered a diagnostic possibility.
Other problems also come up with NSAID use in FM. The first is that patients with FM often have multiple chemical hypersensitivity and cannot take NSAIDs. The second is that NSAIDs can cause fluid retention and edema. The third is NSAID may also cause dyspepsia (heartburn).
The exception is when the FM is secondary to another underlying rheumatic condition such as RA or OA. Then, NSAIDs may be helpful as an adjunctive therapy.
The standard treatment approach to FM is the following:
• Exclude other possible diseases
• Deal with co-morbid conditions which are diseases other than the primary problem. This would include obesity, etc.
• Treat concomitant related disorders such as rheumatoid arthritis, osteoarthritis
• Start a non-impact aerobic exercise program
• Begin cognitive behavioral therapy
• Initiate drug therapy with low dose selective serotonin re-uptake medication
• Consider ancillary medicines as needed
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