Fibromyalgia medicine and treatment options

Approximately 4 million people in the U.S. have fibromyalgia, a condition marked by chronic fatigue, trouble sleeping and pain. More research is needed to fully understand the causes of fibromyalgia. However, while there is no cure for the condition, there are medications and treatments available for managing symptoms.

1. Avoiding triggers: For many people with fibromyalgia, symptoms come and go, and in some cases, it’s possible to identify triggers for flare-ups. Some potential triggers may include:

• Emotional or physical stress
• Hormonal changes, such as those associated with perimenopause or your menstrual cycle
• Lack of sleep
• Weather changes
• Illnesses, such as the common cold or the flu

Keeping a symptom journal may help you and your healthcare provider identify triggers over time. By taking steps to avoid or reduce your exposure to triggers, you may be able to reduce the frequency of flare-ups.

2. Pain relievers: Although fibromyalgia is not an inflammatory condition, some people do experience symptom relief by taking nonsteroidal anti-inflammatory drugs (NSAIDs). Some NSAIDs, such as aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn), are available over the counter. Acetaminophen (Tylenol), which is not an NSAID, may also help improve pain symptoms for some people. Always check with your provider first before taking over-the-counter medications and follow all package instructions carefully. Prescription-strength pain relievers may be a treatment option if your symptoms don’t respond to over-the-counter medications.

3. Antidepressants: Some drugs typically used to treat depression may help relieve fibromyalgia pain for some people. Some commonly prescribed antidepressants for fibromyalgia include duloxetine (Cymbalta) and milnacipran (Savella). In some cases, healthcare providers may also prescribe the tricyclic antidepressant amitriptyline (Elavil, Vanatrip) for patients who have difficulty sleeping due to fibromyalgia symptoms.

4. Anti-seizure medications: Drugs traditionally used to treat epilepsy and other seizure disorders are also sometimes prescribed for fibromyalgia pain. In fact, the first drug the FDA approved for the treatment of fibromyalgia was the anti-seizure medication pregabalin (Lyrica). Gabapentin (Neurontin) is another anti-seizure drug that your healthcare provider may recommend. These medicines can help with pain and poor sleep in patients with fibromyalgia.

5. Physical therapy (PT): In some cases, healthcare providers may recommend sessions with a physical therapist for people who struggle with mobility issues due to fibromyalgia. Physical therapy involves exercises and movements that build strength, improve flexibility and increase stamina. Physical therapists often teach patients exercises they can perform on their own for ongoing benefits.

Maintaining a regular exercise routine and trying water exercises, such as swimming, may positively impact symptoms of pain and enhance well-being in patients with fibromyalgia.

6. Occupational therapy (OT): If you experience more symptoms during certain activities, your healthcare provider may refer you to an occupational therapist. Occupational therapy involves teaching you how to modify your daily activities so that you can perform tasks more comfortably and independently. 

7. Cognitive behavioral therapy (CBT): A type of psychotherapy, cognitive behavioral therapy (CBT) allows you to gain an understanding of why you think and feel the way you do about things and develop strategies for coping with life issues. CBT may help people with fibromyalgia better cope with pain and feelings of depression or anxiety that may accompany other symptoms. In addition, CBT can improve your ability to manage stress, which can be beneficial if stress triggers your flare-ups.

8. Complementary therapies: Although more research is necessary to confirm the benefits of complementary therapies for fibromyalgia, there is some evidence to suggest that the following interventions may help some people with the condition:

• Massage therapy
• Biofeedback
• Mindfulness meditation
• Yoga
• Tai chi
• Deep breathing exercises

9. Lifestyle changes and self-care: Adopting healthy habits and changing your lifestyle positively may help you better manage fibromyalgia symptoms and improve treatment outcomes. Some lifestyle changes that your healthcare provider may recommend include:

• Exercising regularly
• Getting at least seven to nine hours of sleep per night
• Eating a well-balanced diet
• Managing stress
• Maintaining a healthy weight

Updated December 2024.