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Fibromyalgia Provider Treatments

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How and when to see a provider

If you have fibromyalgia, you should see a doctor to help you treat symptoms like bodywide pain, fatigue, insomnia, and cognitive problems. Your doctor will likely refer you to a specialist in fibromyalgia, like a rheumatologist.

It can take trial and error to find the right combination of medications that work for you, so your doctor may need to try different medications. Your doctor will also recommend lifestyle changes and home remedies like hot baths or cold compresses, moderate exercise, changes to your diet, and stress reduction.

Medical tests & labs

Your doctor will diagnose fibromyalgia based on your symptoms. During a physical exam a doctor can check for muscle tenderness, but doctors no longer base a diagnosis on the number of “tender points” you have. There are no blood or diagnostic tests for fibromyalgia.

But your doctor may want to do tests to check for other disorders that may have similar symptoms. These include inflammatory rheumatic diseases, lupus, arthritis, localized pain syndromes, celiac disease, and thyroid disease.

If you have sleep issues, chronic fatigue, or restless limbs, you may be referred for a sleep evaluation. If you have symptoms of a mood disorder, you may be referred to a mental health provider to be evaluated.

What to expect from your doctor visit

  • Your primary care doctor may be able to treat you, but if your symptoms are not improving after about a month, they will likely refer you to a rheumatologist or a chronic pain doctor.
  • Your doctor will help educate you on potential triggers and what lifestyle changes you can make to reduce flare-ups.These may include getting enough sleep, eating less inflammatory foods, getting regular exercise, and finding ways to reduce stress, like yoga or meditation.
  • They may also discuss dietary supplements like magnesium, Vitamin D, melatonin, probiotics, and St John’s Wort.
  • You may be given prescription medications, like an antidepressant, anticonvulsant, or muscle relaxer. It may take up to a month before you will know that a new medication is working.
  • Your doctor may decide to try different medications or combinations of drugs.

Prescription fibromyalgia medications

The FDA has approved 3 medications to treat fibromyalgia.

  • Duloxetine (Cymbalta)—an SNRI antidepressant
  • Milnacipran (Savella)—an SNRI antidepressant
  • Pregabalin (Lyrica)—an anti-seizure medication

There are non–FDA-approved medications that are also prescribed to treat fibromyalgia.

  • SSRI antidepressants (Celexa, Lexapro, Prozac, Paxil, Zoloft)
  • Tricyclic class of antidepressants like amitriptyline (Elavil)
  • Muscle relaxers like cyclobenzaprine (Flexeril)

Types of providers

  • Your primary care physician may be able to diagnose you and help you manage symptoms with lifestyle changes or taking one medication. However, sometimes the diagnosis is tricky, or you aren’t responding to treatments and a specialist is needed.
  • Rheumatologist. These are physicians who specialize in treating diseases that affect muscles, bones, joints, tendons, and ligaments.
  • Psychiatrist. These are doctors who can diagnose and prescribe medications for mental health disorders.
  • Physical medicine and rehabilitation doctors, such as pain management specialists, are trained to diagnose and treat fibromyalgia.
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