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Pain Management Division, Department of Anesthesiology, Griffin Hospital, Derby, Connecticut, USA.
Twelve patients got a surgical implant to stimulate the scalp. The researchers thought this might work because it has been effective for patients with chronic migraine. Pain levels went down, fatigue and depression also improved. There were no problems with infections related to the implant that delivered the scalp stimulation.
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There is only one medication that has been approved by the Food and Drug Administration specifically for fibromyalgia. It is Lyrica; the generic name is pregabalin. Lyric is in a class of medications called anticonvulsants that were originally developed for treating seizures and also for nerve pain. Some of the benefits of Lyrica include improved sleep, less fatigue, less pain and a better quality of life. Side effects include dizziness, sleepiness, and sometimes swelling of the feet. The most commonly prescribed medication for fibromyalgia is antidepressants. Several different studies have shown that antidepressants do help with sleep, tenderness and stiffness. The most commonly prescribed antidepressant is in the tricyclic category. Studies have shown mixed results in terms of antidepressants called selective serotonin reuptake inhibitors and dual acting serotonin and noradrenaline reuptake inhibitors.
Turk DC, Vierck CJ, Scarbrough E, Crofford LJ, Rudin NJ. Fibromyalgia: combining pharmacological and non-pharmacological approaches to treating a person, not just the pain. Journal of Pain, 2007 Oct 10.
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It turns out there's a connection between restless legs syndrome and small intestinal bacterial overgrowth (SIBO). Restless legs syndrome occurs in many patients with fibromyalgia. In this study, patients who had irritable bowel syndrome received treatment to take care of the bacterial overgrowth. 10 of the 13 patients that were included in the study had at least an 80% improvement in their restless legs symptoms once the bacterial overgrowth problem was taking care of. Too bad the study didn't look at whether the fibromyalgia symptoms improved after this treatment.
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Balasubramaniam, Laudenback, and Stoopler have an article in "Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology" volume 104, issue five, November 2005, pages 589-602. Fibromyalgia: an update for Oral healthcare providers. One of the things your doctor can help you with during your regular checkup is to check for tight muscles in your jaw joints and sore spots from your teeth grinding. In addition, your dentist should avoid keeping your jaw open for long periods of time, allowing you frequent breaks and/or providing support for keeping your mouth open so you don't get sore.
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It turns out that your dentist should be looking for a few things when you go for your regular exam if you have fibromyalgia. A lot of fibromyalgia patients also have problems with job pain, headaches, and other oral complaints. The dentist should be looking at whether you have sore muscles in your jaws and any problems with your bite. The dentist should also check to see if you are grinding your teeth at night. All of these problems can contribute to your fibromyalgia pain. Headaches are reported by half to almost all of fibromyalgia patients, depending on the study. Migraines and chronic headaches are pretty common. Other oral complaints include dry mouth, a burning pain in the time, and a bad taste in the mouth. These complaints can often be related to the medicines that are prescribed for fibromyalgia.
One little gem from this article is that antidepressants called SSRIs can often increased tooth grinding at night.
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An interesting article in the Archives of Internal Medicine 2000; 160:221-227 by Leslie AAron, Mary Burke, and Dedra Buchwald "overlapping conditions among patients with chronic fatigue syndrome, fibromyalgia, and temporomandibular disorder." Here are some of the symptoms that are common to both fibromyalgia and chronic fatigue: muscle pain, aching or discomfort; problems falling or staying asleep, or sleeping too much; waking up feeling tired, and refreshed after a full night's rest; difficulty concentrating or thinking, forgetfulness ; abdominal pain relieved by a bowel movement; hard, loose, or watery stools. The symptoms that are unique to chronic fatigue include: fatigue more than six months; fatigue resulting in a 50% reduction of normal activity; unexplained weakness in muscles; migratory arthralgias without redness or swelling; burning, shooting, or throbbing muscle pain. Chronic fatigue syndrome can also include a mild fever or chills on a sore throat. Symptoms unique to fibromyalgia include that the pain can be made better by heat or massage, and that pain is made worse by sitting or standing.
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There is a lot of overlap between patients with temporomandibular disorder (TMD) and fibromyalgia. TMD usually means that you have pain in your jaw muscles, your jaw joint, inside the year, or up the side of your face. About 18% of patients with TMD also have fibromyalgia, and an amazing three fourths of patients with fibromyalgia satisfy all the clinical criteria for TMD. That is a pretty interesting statistic, and makes you think about going to your dentist and looking at your bite and your jaw in terms of the rest of the pain you're having.
See the abstract of the article from the link below.
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Tricyclic antidepressants are often given to help fibromyalgia patients with depression, pain and sleep. However, although tricyclics will make most people feel sleepy, they have not been shown to improve the quality of sleep. A multi-center, double-blinded randomized controlled trial of pregabalin (Lyrica) showed that at 450 mg pregabalin had a signifcant effect on pain, fatigue, sleep, and health-related quality of life when compared with placebo. This is from an article in Journal of Pain, Elizabeth Scarbrough and Leslie J. Crofford at the Division of Rheumatology, U of Kentucky, Lexington.
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