FightFM.com

Fibromyalgia and its associated syndromes can begin with any number of symptoms. Some patients report an initial experience of flu-like aching, others find their energy levels sinking lower and lower with each passing day. Personally, I knew something was wrong when I was driving home from work one night and felt a normal stress headache gradually building into something much more alarming. I had never before experienced a migraine headache, but I was about to become well acquainted with one. After a few days of an intensely painful hammering sensation behind my eyes I sought medical intervention, but nothing worked. Two months, several different painkiller prescriptions, and an MRI later, I was nearly suicidally desperate to end the pain. Eventually the migraine went away, but my body was never the same. That was the beginning of my battle against fibromyalgia (FM).

Doctors rarely seem to connect headache issues with fibromyalgia, but when a group of FM patients gets together, sooner or later the conversation almost always turns to headaches. Migraines are a commonly shared symptom, and everyone seems to have a preferred method of relieving the pain or preventing the headaches altogether. Since fibromyalgia patients often have several debilitating symptoms, it is not uncommon for patients to take a large number of prescription medications; so sufferers are always on the lookout for effective ways to manage their symptoms without adding another pill. Today’s Huffington Post has good news on that front. A new study conducted by the Miami School of Medicine and published in International Journal of Neuroscience found that massage therapy, when performed correctly, can be a very effective way to alleviate the pain of migraine headaches:

Performed by the University of Miami School of Medicine, as published by the International Journal of Neuroscience, two groups of migraine suffers were studied. The first group (control group) took their prescribed medicine for the entire month, but did not receive massage therapy. The second group took their prescribed medicine as well, but also received a weekly massage. 60% of the massaged group had absolutely no migraines or headaches for the entire month. The massage therapy also helped to alleviate sleep problems and increased serotonin levels.

The University of Miami played around with several different protocols in treating the migraine sufferers. They found the most success with the following treatment regime: between migraine attacks, deep tissue work around the base of the skull, neck, shoulders, and upper back helped to relieve tension contributing to the recurrence of migraines. A side note with regard to deep tissue work: I would never let a massage therapist go deeper on you than you can tolerate comfortably and in a relaxed way. If you can feel your body tensing, your jaw grinding, your heart racing, these are a few red flags that you are likely producing cortisol and other hormones associated with stress, thereby creating diminishing returns for yourself in the form of even more tension — and possibly an aversion to massage. If it were me on the massage table, I would say, “Too much!” or “easy there”, “back off, bruiser”, or even the old favorite, “Uncle!”

When a migraine sets in, the scientists at the University of Miami had the most success with the sufferers face up only. Deep massage anywhere near the head at this time worsened the migraine. Light touch brought on relief. However, stimulation of the hands and feet with circulation enhancing massage helped to draw blood (and pressure) from the head to the extremities, alleviating the pain significantly.

So if you’re a migraine sufferer, give massage therapy a try, and let us know how it works for you!

FDA approves Cymbalta to treat neuropathic Fibromyalgia pain

The U.S. Federal Drug Administration (FDA) this week approved the drug duloxetine HCl, sold under the name Cymbalta, for treatment of the widespread pain associated Fibromyalgia (FM).

Cymbalta has been in use as an anti-depressant since the mid-1990’s, but new test results indicate that the drug can also play a role in relieving the type of neuropathic pain commonly experienced by fibromyalgia patients. Cymbalta was originally developed by the Eli Lilly pharmaceutical corporation for use as a selective serotonin and norepinephrine re-uptake inhibitor (SNRI), a class of antidepressants meant to improve upon the previous selective serotonin re-uptake inhibitors (SSRI’s) such as Paxil, Prozac, and Zoloft. The drug works on both serotonin and norepinephrine, neurotransmitters known to be involved in both the regulation of moods and the experience of pain. These antidepressants increase the amount of neurotransmitters in the body’s circulation (think of “re-uptake” as recycling; once a neurotransmitter acts on the nerve, it is re-distributed back into the brain for further use rather than being absorbed and broken down by the body). Although SSRI’s are generally thought to produce fewer side effects because they only work on serotonin, some patients respond better to drugs which target both neurotransmitters at once.

Data Highlights

Lilly established the efficacy of Cymbalta in two pivotal three-month clinical trials involving 874 patients with fibromyalgia. In both studies, Cymbalta reduced pain at study endpoint compared with placebo as measured by the Brief Pain Inventory (BPI) 24-hour average pain scale.(vi),(vii) The BPI is a scale that measures the severity of pain.

Significant improvement in pain for Cymbalta vs. placebo was observed in the first week of each study. Fifty-one percent and 55 percent of patients on Cymbalta had a 30 percent improvement on the BPI at endpoint (clinically meaningful relief is considered at least 30 percent pain reduction(viii)).

In addition, 65 percent and 66 percent of patients taking Cymbalta 60 mg daily reported feeling better at endpoint as measured by the Patient Global Impression of Improvement (PGI-I). The PGI-I is a patient-rated scale that evaluates how much improvement has occurred since beginning treatment.

Cymbalta 60 mg was superior to placebo on the Fibromyalgia Impact Questionnaire (FIQ) Total Score. The FIQ is a scale that is used to assess and evaluate the impact of fibromyalgia on aspects of health and functioning believed to be most affected by the disorder.

In four pooled studies, the most commonly observed adverse events in Cymbalta-treated patients with fibromyalgia (greater than or equal to 5 percent and at least twice placebo) were nausea (29 percent), dry mouth (18 percent), constipation (15 percent), decreased appetite (11 percent), sleepiness (11 percent), increased sweating (7 percent) and agitation (6 percent). In the placebo-controlled clinical trials, the overall discontinuation rates due to adverse events for Cymbalta vs. placebo were 20 percent and 12 percent, respectively…

Although Cymbalta has been safely used for years, it has not escaped controversy. Serious side effects can occur in patients taking the drug, particularly if prescribers fail to consider or are unaware of potentially harmful interactions with other medications. In 2007 the FDA issued a warning against using SSRI or SNRI antidepressants with certain medications commonly prescribed for migraine headaches. However, many patients are finding the relief the drug provides from both pain and depression to be worth the risks. As with any medication, the potential risks and benefits should be discussed with a qualified physician who is aware of all medications the patient may be taking in order to minimize the risk of side effects and drug interactions.