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Hi, & welcome - There are many non drug therapy's that deal with the underlying muscle spasms - From Dr. Podell's website www.drpodell.org Biomechanical (body work) therapies: The following body work therapies can help Fibromyalgia-- but only if done by a professional who understands the special vulnerabilities that are typical of FMS/CFS. Done too vigorously, these therapies can make you worse. Effective therapeutic massage and physical therapy techniques for FMS muscle pain go by several names: Structural Integration, Janet Travell, M.D.-style Manual Trigger Point Therapy, Myofascial Release and Deep Connective Tissue Therapy. I'm a Myofascial Release guy & have personally had good results from the therapy as your are in Colorado here is contact information for Mark F. Barnes, DPT son of John F. Barnes, creator of the Barnes method. Mark is the twin of my therapist Brian & the both have >20 years (dad put them to work at 16) Mark Barnes DPT Boulder MFR Treatment Center 2400 Spruce, #101 Boulder, CO 80302 Phone: (303) 440-3359 boulder@myofascialrelease.com www.somapt.com If he's full & not taking new patients let me know & I'll have Brian make a call & get him to squeeze you in also in Colorado Jill S. Morton, MS, OTR Brenda Pardy, OTR Denver Myofascial Release 11832 W. Asbury Place Lakewood, CO 80228 Phone: (303) 332-9171 jill@denvermyofascialrelease.com www.DenverMyofascialRelease.com 6535 S. Dayton St. #3800 Greenwood Village, CO 80111 Phone: (303) 649-9007 brenda@denvermyofascialrelease.com www.DenverMyofascialRelease.com don't know them & can't vouch for them but they are listed as Advanced MFR Practitioners I know Mark can help with Fibro folks, his twin saved my life with anyone else you want to make sure they have Fibro experience. also go to our important Links post in medicine & treatment for links to more info on treatment http://www.mdjunction.com/forums/fibromyalgia-discussions/
medicine-treatments/10021-important-links Finally, regarding exercise - it's the "Goldilocks Rule" not to much, not too little, just enough heres some info on exercise from the national guidelines link in the Important Links post: Nonpharmacologic Therapies 17. Provide all patients with basic information on FMS and treatment options, and educate them about pain management and self-management programs as an initial part of treatment. 18. Incorporate cognitive-behavioral therapy into a multimodality treatment approach to reduce pain, enhance self-efficacy, and improve function. 19. Encourage and support people with FMS to perform moderately intense aerobic exercise (60-75% of age-adjusted maximum heart rate [210 minus the person's age]) two to three times per week. (A) In individuals who are deconditioned, this rate can be achieved with very low levels of exercise. 20. Advise people with FMS to avoid exercise-induced pain by stretching to the point of slight resistance, not to the point of pain. This is especially important in a subgroup of individuals who have joint hypermobility. 21. Begin exercise programs for people with FMS at a level just below their capacity, and progress in frequency, duration, or intensity as their levels of fitness and strength increase. Exercise progression should be slow and gradual, or participants will experience a marked, exercise-induced exacerbation of pain that may lead to discontinuation of the exercise program. (Panel consensus) 22. Encourage people with FMS to perform muscle-strengthening exercise two times per week. 23. Encourage ongoing exercise to maintain exercise-induced gains. http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=7298&nbr=4342#s22 one last, I'm not anti-drug or anti-opiate just anti meds with little effectivness & big side effects. Even the best Fibro meds only work for for a subset of us & many of us have bad tolerances to many drugs I hear good reports here for Lyrica if you can tolerate it. check out this table & do like I do & only take/try the ones with an A rating (Plus Opioiad pain killers as needed & everyone needs them sometime) Note: everything has a side effect for someone (Nortryptyline keeps me from peeing so I take Flexeril no problem.) It's not just does it work but does it work for you. Try what your Dr. offers but don't make yourself sick taking it, or keep taking it if it doesn't work for you; take control of your treatment Dr. Podell Fibromyaltia Treatments—This is the “A List” of Fibromyalgia Medicines with the strongest support from double-blind studies: Lyrica (pregabalin) is an anti-seizure drug that affects calcium channels. Pain improves by 50% for about one third of those who take it. Pain improves about 30% among half of patients.. Side effects can be a problem, with a fair incidence of increased fatigue, fluid retention, tremors, dizziness and weight gain. Neurontin (gabapentin), a similar drug, probably also works but with similar side effects. Elavil (amitriptyline), a tricyclic antidepressant, acts to increase serotonin and norepinephrine brain neurotransmitters. As a fibromyalgia treatment Elavi is used, at much lower doses, than we use for depression. Elavil helps fibromyalgia in up to 50% of patients. Elavil can cause dry mouth, rapid heart rate and weight gain. Fibromyalgia doctors also recommend two medical cousins of Elavil-- Pamelor (nortriptyline) and Flexeril (cyclobenzaprine). Often these are better tolerated than Elavil itself. Cymbalta (duloxetine) is an NSRI—a norepinephrine and serotonin reuptake inhibitor. It is FDA approved for depression and for the treatment of diabetic nerve pain. Cymbalta is effective for fibromyalgia whether or not the fibromyalgia patient is also depressed. Cymbalta’s mechanism of action is similar to that of Effexor. But, in contrast to Cymbalta, Effexor—though a very good antidepressant-- has not proved effective for fibromyalgia. Namenda (memantine), another drug of this class is not yet on the market in the U.S. Xyrem (Sodium Oxybate) is approved by the FDA as a treatment for narcolepsy. However, three double blind studies show benefit for fibromyalgia pain and quality of sleep. Xyrem is the FDA approved form of GHB. On “the street” GHB has been abused as a date-rape drug. Prescription Xyrem has not been abused. Xyrem can give wonderful relief among a modest proportion of patients. However, Xyrem often has side-effects. Click here for Information About GHB and Fibromyalgia. Mirapex (pramipexole) has been approved by the FDA to treat Parkinson’s Disease. However, one very good double blind study shows major benefit for fibromyalgia pain. Mirapex is also very good for a particular disorder of sleep, periodic leg movement disorder (PLMD), also known as Restless Legs Syndrome. Fibromyalgia Treatment for Mirapex should start at a very low dose. We slowly increase the dosing over a period of several months. Ultram (tramadol) is a safer, less addictive cousin of the codeine group of opioid pain medicines. It can be taken on an as needed basis or around the clock. Fibromyalgia doctors often dose Ultraum at bed time and again if you wake during the night. Improving pain control at night often improves sleep. Prozac - like SSRI anti-depressant drugs are usually not very useful for fibromyalgia pain; but they can be very useful for coexisting depression and/or anxiety. Non-steroidal anti-inflammatories such as aspirin, Ibuprofen, and Celebrex are less effective for FMS than they are for inflammatory conditions such as osteoarathritis and rheumatoid arthritis. Prednisone/Medrol/Cortisone is usually not useful for fibromyalgia. If corticosteroids help a lot, consider the possibility of a different illness e.g. polymyalgia rheumatica or temporal arteritis. Soap Box Time Please note that Nurontin is not really on the A list. On this list he adds an aside that it "probably works" but is on no A list I've seen (personal note: I have a strong bias against Nurontin in case you can't tell, I've tried it 3x and all it did was force me to nap from 3:30PM to 7Pm every day, also gave me dry mouth so bad I couldn't speak also the mfgr plead guilty to criminal charges of off label hyping of the drug & was fined $493,000,000 - million with an M)& it is generally seen as ineffective in FMS although I've got a new symposium presentation from DL Goldenberg MD on DVD that presents a single double blind study with information to the contrary. I haven't had time to watch it yet & will let you if it changes my opinion meanwhile why take it if Lyrica is approved for Fibro & is on the A list. BUT - all the information is out there on the web if you want to look for good things on Nurontin yourself End of Soapbox Post edited by: bshapiro, at: 11/02/2007 12:50 |
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