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David Baxter PhD

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Getting the best treatment for your fibromyalgia
by Kelly Bilodeau, Harvard Health Blog
Sept 11, 2020

Imagine being in pain and having your doctor tell you it’s all in your head. Unfortunately, this is not an uncommon experience for many of the six million Americans living with fibromyalgia, a chronic, painful condition.

People with fibromyalgia experience widespread pain, aches, and stiffness in muscles and joints throughout the body, as well as unusual tiredness. No one knows what causes this condition, and no apparent physical cause has been identified thus far. The most likely culprit is a brain malfunction that amplifies normal nerve responses, causing people with fibromyalgia to experience pain or other symptoms when nothing seemingly triggers them.

For those seeking relief, finding help can sometimes be a challenge. The best way to find a successful treatment strategy is to seek out a doctor who understands fibromyalgia, knows how to treat it, and can help you understand and cope with this condition. There are ways that you can improve your chances of finding the right match.

Understand your condition
The first step in this process is to arm yourself with the facts.

  • Fibromyalgia is a real disorder. The American College of Rheumatology has created criteria that doctors can use to diagnose it (see this link for a patient-friendly version). It is recognized by national and international health agencies, including the World Health Organization.
  • Fibromyalgia often coexists with mental health conditions such as anxiety and depression, but it is not caused by a mental illness.
  • Fibromyalgia is not “in your head,” but it is related to brain activity. Differences in how the brain processes pain can be seen on functional MRI scans of people with fibromyalgia.
  • The FDA has approved three drugs specifically for treating fibromyalgia: pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella). These drugs are effective against nerve pain, and are used for other conditions as well.
Seek referrals to providers who understand fibromyalgia
To find the right healthcare provider, it may help to go to those who already have experience in this area. Support groups provide a natural starting point. The National Fibromyalgia Association website lists support groups in each state that can help you find these initial connections. The organization can also provide a list of “fibro friendly” doctors in your state.

You can also look to your primary care doctor to help steer you in the right direction. Many doctors will be able to recommend a specialist who can help you manage your condition.

Once you settle on a prospective provider, make sure she or he is the right fit. Ask the office staff whether the doctor frequently sees patients with fibromyalgia and treats them on an ongoing basis. Also ask what treatments the doctor typically prescribes. Find out what type of services they provide; for example, do they offer telemedicine appointments? What services will they provide remotely, and which ones will require an office visit? If the answers aren’t what you’re looking for, or the office doesn’t seem receptive to your concerns, don’t be afraid to look elsewhere.

Connect your medical team
Once you do find the right provider, make certain that she or he is willing to communicate with your other providers. Many people with fibromyalgia need multiple doctors to manage their symptoms. Seeing multiple specialists can increase the risk of medication errors or harmful interactions of drugs prescribed by different doctors. In addition, your doctors may duplicate laboratory tests or other services. This can unnecessarily increase the cost of your care.

Finding the right doctor for your needs may not always be easy, but it’s worth the extra effort to increase your chances of successfully managing your condition.
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