Fibromyalgia - Lifestyle Changes

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People who try meditation for the first time should understand that it can be difficult to quiet the mind, and should not be discouraged by lack of immediate results. Some recommend meditating for no longer than 20 minutes in the morning after awakening and then again in early evening before dinner. Even once a day is helpful. A person should probably not meditate before going to bed, since it causes some people to wake up in the middle of the night, alert and unable to return to sleep.

Hypnosis. In one controlled study, hypnosis was more effective than physical therapy in improving function and reducing pain.

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Massage Therapy. Massage therapy is thought to stimulate the parasympathetic nervous system, which slows down the heart and relaxes the body. In a 2002 study, patients who were given 30-minute sessions twice a week experienced lower stress and anxiety and less pain after 5 weeks compared to a group receiving an alternative therapy called transcutaneous electrical stimulation (TENS).

Alternative Treatments

Because of the difficulties in treating fibromyalgia, many patients seek alternative therapies. Everyone should be wary of those who promise a quick cure or urge the purchase of expensive but potentially dangerous treatments. Major analyses have indicated that mind-body therapies, such as biofeedback or hypnosis, are more effective than no treatment at all but less effective than moderate to intense exercise. In one analysis, evidence was weakest on the advantages of so-called manipulative ("hands-on") approaches such as massage and chiropractic treatments.

Acupuncture. Studies continue to report conflicting results on acupuncture's ability to relieve pain. Several small studies suggest it offers some benefit, especially to those who can not take medicines because of their side effects. However, a large controlled study published in the July 2005 Annals of Internal Medicine found that inserting needles at fibromyalgia-related pressure points was no better at relieving pain for fibromyalgia than randomly inserting needles ("sham acupuncture").

Click the icon to see an image of acupuncture.

Chiropractic or Osteopathic Manipulation. Chiropractic or osteopathic manipulation may also help some patients. In one study, 21 patients improved after 4 weeks of chiropractic spinal manipulation compared to those receiving only medications. It may be less effective in older patients with severe symptoms. Other studies have reported pain relief and improved sleep with osteopathic manipulation. Osteopathic techniques may include manipulation of the spine or muscle tissue release. Note that there is always some very small risk for adverse effects from any of these techniques. For example, in rare cases manipulation of the neck has caused stroke or damage to the large blood vessels in the neck.

Hydrotherapy and Similar Treatments. Hydrotherapy, also called balneotherapy, involves soaking in water, such as hot tubs, pools, or baths, to help relieve pain. In one 2002 study, hydrotherapy using a daily 20-minute bath reduced tender-point pain.

Herbal or Natural Remedies. Some alternative agents are being investigated for fibromyalgia:

• S-adenosylmethionine (SAMe) is a natural substance that has antidepressant, anti-inflammatory, and analgesic properties. It has shown some benefit in controlled studies.
• Melatonin, a natural hormone associated with the sleep-wake cycle, may have benefits for some patients with fibromyalgia.
• In one 2000 study, collagen hydrolysat, a food supplement, significantly decreased pain in fibromyalgia patients who had temporomandibular joint problems. The temporomandibular joint connects the lower jaw to the skull.

It is extremely important for patients to realize that any herbal remedy or natural medicine that has positive effects most likely has negative side effects and toxic reactions, just as any conventional drug does. You should consult a doctor before using any untested products or dietary supplements. You should also discuss with your doctor any potential interactions between the supplements and any medications you take.

Review Date: 12/15/2006
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital