When Fibromyalgia Painkillers Stop Working

It’s not uncommon for the effects of fibromyalgia pain medications to wane over time. But what can you do about it? Here are seven different treatment options to explore.

If you are one of the approximately five million Americans with fibromyalgia, you know that pain can be severe, unpredictable, and exhausting. It can be constant for a period of time and then get better for a while — but it tends to just keep coming back.

Additionally, a painkiller that worked before may stop working, and what works for some symptoms may not work for others. Pain management needs to be constantly adjusted and may require a team of specialists who are familiar with fibromyalgia.

Common pain symptoms of fibromyalgia include stabbing, burning, shooting, or throbbing pain in any area of the body. Pain is usually worse in the morning. People with fibromyalgia may have tender areas on their neck, shoulders, back, or legs that are painful when touched.

And fibromyalgia pain can become even worse with physical or emotional stress. Common stressors that may make your fibromyalgia pain worse include a traumatic event, such as a car accident, repetitive physical traumas, or a physical illness.

Getting this pain under control is not easy. But it is possible.

“Pain medications for fibromyalgia tend to wane and lose their effectiveness over time,” explains Micha Abeles, MD, a rheumatologist at the University of Connecticut Health Center in Farmington. “It is often necessary to wean a patient off one medication and add new medications over time. If pain medication is not working, it is [also] necessary to evaluate the patient to identify any psychosocial events that could be acting as stressors and making their pain worse.”

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Switching to a new fibromyalgia pain medication is easier if you taper one medicine gradually before starting a new one. Always follow your doctor’s directions carefully and never stop a medication on your own.

7 Treatment Options for Fibromyalgia

Important options for treating fibromyalgia include finding the right pain medication, getting the proper psychological support, trying complementary therapies, and finding the right treatment team. If your fibromyalgia treatment is not working, ask your doctor to help you explore these options:

  • Pain medications. There are a number of medications now approved for fibromyalgia pain, including pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella). The narcotic-like painkiller tramadol (Ultram) has also been effective for fibromyalgia. “Switching between medications may be necessary and can be made easier with samples or vouchers to decrease the financial cost for the patient,” advises Dr. Abeles.
  • Antidepressant medications. Tricyclic antidepressants and selective serotonin reuptake inhibitor antidepressants are frequently used for fibromyalgia and have been successful in controlling symptoms of pain, sleep disturbances, fatigue, and depression.
  • Sleep management. People with fibromyalgia often have trouble getting enough sleep — and lack of sleep can make fibromyalgia symptoms worse. Make sure you avoid caffeine and stick to a strict sleep schedule. Ask your doctor if a sleep aid medication might help.
  • Social and psychological support. The stress of living with a chronic painful disease like fibromyalgia can make your symptoms worse. Research shows that increasing social support reduces fibromyalgia symptoms, such as pain. You may benefit from a fibromyalgia support group. Professional counseling to help you develop coping skills and better manage your symptoms has also been shown to be helpful.
  • Exercise. Exercise is an important part of feeling better if you have fibromyalgia. Studies show that exercise can help you improve your fitness level, feel better about yourself, and reduce the number of painful pressure points in fibromyalgia.
  • Acupuncture. One survey found that about 20 percent of people diagnosed with fibromyalgia and treated at a university-based clinic tried acupuncture within a two-year period. Some studies have found that acupuncture can help relieve fibromyalgia pain, but other reports say the effects are not long-lasting and the treatment doesn’t help with the fatigue or sleep problems common with fibromyalgia.
  • Other alternative treatments. Although there’s no strong evidence for most alternative treatments for fibromyalgia, many people who have tried these alternative approaches report significant improvement in their symptoms. These treatments include therapeutic message, yoga, biofeedback, hypnosis, chiropractic manipulation, and nutritional supplements. Always let your medical team know about any alternative treatments you’re contemplating.

If you are being treated for fibromyalgia and your pain medications are not as effective as in the past, you have options. Remember that it is common for people with fibromyalgia to try different types of medications and other management strategies. It is also important to make sure you have a sympathetic, knowledgeable team of experts to help you manage your fibromyalgia symptoms.

Fibromyalgia is an unpredictable disease that requires a flexible treatment plan. One of the best things you can do is to educate yourself about fibromyalgia so that you can work closely with your treatment team and be a good advocate for yourself.


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