Hoewel er geen remedie is voor fibromyalgie, is de sleutel tot het vinden van verlichting van de pijn, vermoeidheid en andere symptomen meestal een combinatie van medicijnen en natuurlijke therapieën. De beste arts voor de behandeling van fibromyalgie is een reumatoloog, een arts die gespecialiseerd is in de behandeling van artritis en aanverwante aandoeningen. Het kan wat vallen en opstaan kosten om een effectieve combinatie van behandelingen te vinden. Hier zijn enkele opties die het proberen waard zijn:
medicijnen
Momenteel zijn er twee door de FDA goedgekeurde geneesmiddelen voor gebruik als behandelingen met fibromyalgie – duloxetine en milnacipran.
Pregabaline was oorspronkelijk ontwikkeld als een anti-epileptische medicatie, maar heeft sindsdien voordelen getoond bij het verlichten van angst, sommige slaapproblemen en pijn bij mensen met fibromyalgie. Een andere anti-epileptische medicatie, gabapentine, wordt soms off-label gebruikt als een behandeling met fibromyalgie. Off-label betekent dat het door artsen wordt gebruikt vanwege bewezen voordelen, maar is niet door de FDA goedgekeurd voor een aandoening).
Duloxetine en milnacipran zijn antidepressiva, die concentraties van neurotransmitters verhogen waarvan bekend is dat ze gevoelens van pijn remmen.
Andere antidepressiva die bruikbaar blijken te zijn bij de behandeling van fibromyalgie en die buiten het label worden gebruikt, zijn onder andere:
- • Tricyclics, zoals amitriptyline die pijn verlicht en de slaap verbetert
- • Cyclobenzaprine, dat op dezelfde manier werkt als amitriptyline
- • Selectieve serotonineheropnameremmers, of SSRI’s, zoals fluoxetine, paroxetine en sertraline, die pijn verlichten en humeur verbeteren
Deze geneesmiddelen werken om fibromyalgie te behandelen bij patiënten met en zonder depressie, dus denk niet dat uw arts voelt dat u depressief bent, alleen maar omdat zij een van deze geneesmiddelen voorschrijven.
Andere geneesmiddelen waarvan is aangetoond dat ze effectief zijn bij fibromyalgie zijn venlafaxine, tizanidine en tramadol, cannabinoïden (medicijnen die zijn afgeleid van de componenten van marihuana), gamma-hydroxybutyraat (GHB) en laag gedoseerd naltrexon.
Bescheiden doses niet-steroïde ontstekingsremmende geneesmiddelen (NSAID’s), zoals naproxen of ibuprofen, kunnen enige verlichting van de pijn veroorzaken. De meeste artsen schrijven geen pijnstillers of tranquillizers op basis van opioïden voor, met uitzondering van de ernstigste gevallen van fibromyalgie, omdat deze geneesmiddelen niet zo effectief zijn voor fibromyalgiepijn als andere soorten pijn. Ook kan het langdurig van invloed zijn op de organen.
Oefening
Fysieke activiteit is een waardevolle fibromyalgie-behandeling gebleken, maar de activiteiten moeten zorgvuldig worden gekozen en op een laag niveau worden gestart. In sommige gevallen krijgen mensen met fibromyalgie het medicijn pyridostigmine toegediend vóór de inspanning om de pijn te verminderen.
biofeedback
Biofeedback leert mensen hoe ze fysiologische functies kunnen veranderen, zoals het vertragen van een hartslag in een race of ontspannen gebalde of strakke spieren. Mensen die hun kaakspieren balanceren, kunnen temporomandibulaire gewrichts- (TMJ-) pijn hebben, wat vaak voorkomt bij mensen met fibromyalgie.
Acupunctuur
Een paar studies hebben statistisch significante verbetering van pijn met acupunctuur aangetoond, maar anderen niet. Als je nieuwsgierig bent naar acupunctuur, probeer dan drie behandelingen. Als je denkt dat je baat hebt gehad bij de sessies, ga dan door tot zes of acht behandelingen. Tegen die tijd kunt u beslissen of acupunctuur kosteneffectief genoeg is om verder te gaan.
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