Foods to eat and avoid

Fibromyalgia causes ongoing pain and fatigue. There is currently no cure, but some medications and lifestyle remedies can help relieve the symptoms. Dietary choices may also make a difference.

Doctors do not yet know what causes fibromyalgia. One theory is that changes in a person’s pain pathways cause them to feel pain more intensely than other people do.

Health professionals do not consider fibromyalgia an inflammatory disease, but some believe that it may involve inflammation of the nerves.

Some experts suggest using a multimodal approach to manage symptoms. This can involve medication, exercise, complementary therapies, and appropriate dietary choices.

In this article, learn more about how making certain dietary changes can affect fibromyalgia.

Dietary changes are not part of the standard treatment for fibromyalgia.

However, favoring some foods over others may help manage the symptoms.

For example, there is evidence to suggest that adopting an anti-inflammatory diet can help people with chronic pain. An anti-inflammatory diet is not a specific eating plan, but its guidelines can help people make suitable choices.

A plant based diet may also be helpful for reducing fibromyalgia symptoms. This is because many plant based foods contain antioxidants, which help the body dispose of “free radicals.” These are waste products that the body produces naturally.

High levels of free radicals in the body can lead to oxidative stress and inflammation.

In this article, learn more about foods that are rich in antioxidants.

Many people with fibromyalgia also have obesity. Excess weight may increase the risk of inflammation and oxidative stress. If fibromyalgia does involve inflammation, adopting a diet that encourages a person to reach or maintain a healthy weight may help.

The DASH diet can help control blood sugar, but it also has overall health benefits. Learn more here.

The following guidelines can help a person make anti-inflammatory diet choices.

Eat eight to nine servings of fruits and vegetables per day: Eating a variety of colorful fruits and vegetables can ensure the greatest range of nutrients. Foods that are particularly rich in nutrients include broccoli and berries.

Choose whole grains: Whole-grain foods include barley, buckwheat, oats, quinoa, brown rice, rye, wheat, and spelt. These foods provide vitamins, protein, and fiber.

Choose healthful oils: Olive oil is a good choice.

Incorporate herbs and spices: Many herbs and spices contain antioxidants, which may help reduce inflammation. Turmeric, bay leaves, cinnamon, and many others can offer benefits.

Turmeric may help people with inflammatory diseases, such as rheumatoid arthritis. Find out more here.

Vitamin D

According to the National Institutes of Health (NIH), there may be a link between fibromyalgia symptoms and a vitamin D deficiency.

Some good dietary sources of vitamin D include:

• egg yolks
• low fat yogurt fortified with vitamin D
• orange juice fortified with vitamin D
• swordfish and salmon
• tuna, canned in water
• whole-grain cereals fortified with vitamin D

Foods containing vitamin D may not reduce symptoms in everyone with fibromyalgia, but they have overall benefits, such as building healthier bones.

The Mediterranean diet is rich in fish, fruits, vegetables, and anti-inflammatory foods. Learn more about this diet here.

A number of additives and ingredients may worsen the symptoms of fibromyalgia. We cover these in more detail in the sections below.

Meat and dairy products

For people with fibromyalgia, it may help to limit excess dairy intake. This is because many dairy products contain saturated fat. People should try to opt for low fat versions or dairy alternatives such as soy milk.

It may also help to limit the consumption of red meat. Instead of eating red meat every day, opt for turkey, fish, and vegetable based substitutes.

Why is it best to limit red meat? Find out here.

Additives

According to the Arthritis Foundation, food additives called excitotoxins may worsen some of the symptoms of fibromyalgia.

Examples of these include monosodium glutamate (MSG), which is a flavor enhancer, and aspartame, which is an artificial sweetener.

Research from 2012 found that people with fibromyalgia and irritable bowel syndrome (IBS) who stopped using MSG and aspartame saw a 30% reduction in symptoms. However, the symptoms returned when they started consuming these additives again.

Gluten

People with celiac disease must avoid gluten, or they may become very sick.

However, recent research suggests that gluten might also affect the outlook for various inflammatory conditions.

A 2014 study looked at what happened when 20 people with fibromyalgia avoided gluten for between 5 and 31 months. Fifteen people stopped having widespread, chronic pain, and three were able to stop using opioids altogether.

None of the participants had celiac disease, but some had other conditions, such as IBS.

Also, research from 2017 revealed that people with signs of both fibromyalgia and gluten sensitivity responded well to a gluten free diet.

In 2018, scientists proposed that there may be a link between fibromyalgia and nonceliac gluten sensitivity.

People should always speak to their doctor before eliminating a major food type, such as gluten, from their diet. Cutting out gluten, for example, can lead to a low intake of whole grains. This can result in a low intake of fiber and other nutrients.

What are the possible benefits and risks of adopting a gluten free diet? Learn more here.

Other ingredients

Other ingredients that may trigger inflammation include:

• saturated fats and trans fats
• refined starches
• foods with added sugar

It may help to keep a food journal and record any symptoms that occur after eating particular food items. If any patterns emerge, it may be worth considering avoiding those foods for a while to see how this affects symptoms.

It is important to remember that avoiding any or all of these foods is unlikely to eliminate all fibromyalgia symptoms.

Also, when cutting out foods, people should ensure that they are getting the nutrients that those items provide from other foods or supplements.

Some researchers have looked at whether the following may help manage the symptoms of fibromyalgia:

• soy
• s-adenosyl-L-methionine
• creatine

There is not yet enough evidence to confirm that these will help with fibromyalgia, however.

It is important to talk to a doctor before starting to take any supplements, even the “natural” ones. Some supplements can have adverse effects, while others can interact with medications the person may be taking.

For example, some people with fibromyalgia use antidepressants, such as sertraline (Zoloft) or fluoxetine (Prozac). St. John’s wort can interact with these types of drug.

Which supplements have an anti-inflammatory effect? Find out here.

There is some evidence to suggest that other complementary methods help with fibromyalgia. These include:

Exercise

According to the American Academy of Family Physicians, engaging in aerobic exercise for 20–30 minutes per day on 2–3 days per week may help reduce symptoms and fatigue in people with fibromyalgia.

Other physical activities that may help include:

People with fibromyalgia may also wish to speak to a yoga instructor about adapting poses to suit their physical needs and abilities. This may include the use of a cushion to support the body in some activities.

Learn more here about yoga for fibromyalgia.

Sleep hygiene

Getting regular, quality sleep can also help people manage the symptoms of fibromyalgia.

Tips for good sleep include:

• waking up and going to sleep at the same time each day
• building a relaxing activity into the bedtime routine, such as reading a book, listening to music, or meditating
• maintaining a cool, dark, and comfortable sleep environment
• leaving cell phones and other devices outside the bedroom

Alternative therapies

Share on PinterestAcupuncture is an alternative therapy that may help ease fibromyalgia symptoms.

Other stress relieving activities that may help relieve fibromyalgia symptoms include:

• acupuncture
• massage therapy
• meditation
• relaxation training
• balneotherapy
• homeopathy
• magnetic therapies
• reiki
• counseling or therapy

Most of these are safe to try, even if scientific evidence to support them is currently lacking. For treatments such as homeopathy and acupuncture, people should check that the provider they choose has approved qualifications.

Can essential oils help relieve fibromyalgia? Find out here.

No single treatment can relieve or cure fibromyalgia, but making healthful dietary choices may help.

Ensuring that the diet contains a variety of fresh fruits and vegetables may be a good place to start.

Foods to eat and avoid

Fibromyalgia causes ongoing pain and fatigue. There is currently no cure, but some medications and lifestyle remedies can help relieve the symptoms. Dietary choices may also make a difference.

Doctors do not yet know what causes fibromyalgia. One theory is that changes in a person’s pain pathways cause them to feel pain more intensely than other people do.

Health professionals do not consider fibromyalgia an inflammatory disease, but some believe that it may involve inflammation of the nerves.

Some experts suggest using a multimodal approach to manage symptoms. This can involve medication, exercise, complementary therapies, and appropriate dietary choices.

In this article, learn more about how making certain dietary changes can affect fibromyalgia.

Dietary changes are not part of the standard treatment for fibromyalgia.

However, favoring some foods over others may help manage the symptoms.

For example, there is evidence to suggest that adopting an anti-inflammatory diet can help people with chronic pain. An anti-inflammatory diet is not a specific eating plan, but its guidelines can help people make suitable choices.

A plant based diet may also be helpful for reducing fibromyalgia symptoms. This is because many plant based foods contain antioxidants, which help the body dispose of “free radicals.” These are waste products that the body produces naturally.

High levels of free radicals in the body can lead to oxidative stress and inflammation.

In this article, learn more about foods that are rich in antioxidants.

Many people with fibromyalgia also have obesity. Excess weight may increase the risk of inflammation and oxidative stress. If fibromyalgia does involve inflammation, adopting a diet that encourages a person to reach or maintain a healthy weight may help.

The DASH diet can help control blood sugar, but it also has overall health benefits. Learn more here.

The following guidelines can help a person make anti-inflammatory diet choices.

Eat eight to nine servings of fruits and vegetables per day: Eating a variety of colorful fruits and vegetables can ensure the greatest range of nutrients. Foods that are particularly rich in nutrients include broccoli and berries.

Choose whole grains: Whole-grain foods include barley, buckwheat, oats, quinoa, brown rice, rye, wheat, and spelt. These foods provide vitamins, protein, and fiber.

Choose healthful oils: Olive oil is a good choice.

Incorporate herbs and spices: Many herbs and spices contain antioxidants, which may help reduce inflammation. Turmeric, bay leaves, cinnamon, and many others can offer benefits.

Turmeric may help people with inflammatory diseases, such as rheumatoid arthritis. Find out more here.

Vitamin D

According to the National Institutes of Health (NIH), there may be a link between fibromyalgia symptoms and a vitamin D deficiency.

Some good dietary sources of vitamin D include:

• egg yolks
• low fat yogurt fortified with vitamin D
• orange juice fortified with vitamin D
• swordfish and salmon
• tuna, canned in water
• whole-grain cereals fortified with vitamin D

Foods containing vitamin D may not reduce symptoms in everyone with fibromyalgia, but they have overall benefits, such as building healthier bones.

The Mediterranean diet is rich in fish, fruits, vegetables, and anti-inflammatory foods. Learn more about this diet here.

A number of additives and ingredients may worsen the symptoms of fibromyalgia. We cover these in more detail in the sections below.

Meat and dairy products

For people with fibromyalgia, it may help to limit excess dairy intake. This is because many dairy products contain saturated fat. People should try to opt for low fat versions or dairy alternatives such as soy milk.

It may also help to limit the consumption of red meat. Instead of eating red meat every day, opt for turkey, fish, and vegetable based substitutes.

Why is it best to limit red meat? Find out here.

Additives

According to the Arthritis Foundation, food additives called excitotoxins may worsen some of the symptoms of fibromyalgia.

Examples of these include monosodium glutamate (MSG), which is a flavor enhancer, and aspartame, which is an artificial sweetener.

Research from 2012 found that people with fibromyalgia and irritable bowel syndrome (IBS) who stopped using MSG and aspartame saw a 30% reduction in symptoms. However, the symptoms returned when they started consuming these additives again.

Gluten

People with celiac disease must avoid gluten, or they may become very sick.

However, recent research suggests that gluten might also affect the outlook for various inflammatory conditions.

A 2014 study looked at what happened when 20 people with fibromyalgia avoided gluten for between 5 and 31 months. Fifteen people stopped having widespread, chronic pain, and three were able to stop using opioids altogether.

None of the participants had celiac disease, but some had other conditions, such as IBS.

Also, research from 2017 revealed that people with signs of both fibromyalgia and gluten sensitivity responded well to a gluten free diet.

In 2018, scientists proposed that there may be a link between fibromyalgia and nonceliac gluten sensitivity.

People should always speak to their doctor before eliminating a major food type, such as gluten, from their diet. Cutting out gluten, for example, can lead to a low intake of whole grains. This can result in a low intake of fiber and other nutrients.

What are the possible benefits and risks of adopting a gluten free diet? Learn more here.

Other ingredients

Other ingredients that may trigger inflammation include:

• saturated fats and trans fats
• refined starches
• foods with added sugar

It may help to keep a food journal and record any symptoms that occur after eating particular food items. If any patterns emerge, it may be worth considering avoiding those foods for a while to see how this affects symptoms.

It is important to remember that avoiding any or all of these foods is unlikely to eliminate all fibromyalgia symptoms.

Also, when cutting out foods, people should ensure that they are getting the nutrients that those items provide from other foods or supplements.

Some researchers have looked at whether the following may help manage the symptoms of fibromyalgia:

• soy
• s-adenosyl-L-methionine
• creatine

There is not yet enough evidence to confirm that these will help with fibromyalgia, however.

It is important to talk to a doctor before starting to take any supplements, even the “natural” ones. Some supplements can have adverse effects, while others can interact with medications the person may be taking.

For example, some people with fibromyalgia use antidepressants, such as sertraline (Zoloft) or fluoxetine (Prozac). St. John’s wort can interact with these types of drug.

Which supplements have an anti-inflammatory effect? Find out here.

There is some evidence to suggest that other complementary methods help with fibromyalgia. These include:

Exercise

According to the American Academy of Family Physicians, engaging in aerobic exercise for 20–30 minutes per day on 2–3 days per week may help reduce symptoms and fatigue in people with fibromyalgia.

Other physical activities that may help include:

People with fibromyalgia may also wish to speak to a yoga instructor about adapting poses to suit their physical needs and abilities. This may include the use of a cushion to support the body in some activities.

Learn more here about yoga for fibromyalgia.

Sleep hygiene

Getting regular, quality sleep can also help people manage the symptoms of fibromyalgia.

Tips for good sleep include:

• waking up and going to sleep at the same time each day
• building a relaxing activity into the bedtime routine, such as reading a book, listening to music, or meditating
• maintaining a cool, dark, and comfortable sleep environment
• leaving cell phones and other devices outside the bedroom

Alternative therapies

Share on PinterestAcupuncture is an alternative therapy that may help ease fibromyalgia symptoms.

Other stress relieving activities that may help relieve fibromyalgia symptoms include:

• acupuncture
• massage therapy
• meditation
• relaxation training
• balneotherapy
• homeopathy
• magnetic therapies
• reiki
• counseling or therapy

Most of these are safe to try, even if scientific evidence to support them is currently lacking. For treatments such as homeopathy and acupuncture, people should check that the provider they choose has approved qualifications.

Can essential oils help relieve fibromyalgia? Find out here.

No single treatment can relieve or cure fibromyalgia, but making healthful dietary choices may help.

Ensuring that the diet contains a variety of fresh fruits and vegetables may be a good place to start.

Foods to eat and avoid

Fibromyalgia causes ongoing pain and fatigue. There is currently no cure, but some medications and lifestyle remedies can help relieve the symptoms. Dietary choices may also make a difference.

Doctors do not yet know what causes fibromyalgia. One theory is that changes in a person’s pain pathways cause them to feel pain more intensely than other people do.

Health professionals do not consider fibromyalgia an inflammatory disease, but some believe that it may involve inflammation of the nerves.

Some experts suggest using a multimodal approach to manage symptoms. This can involve medication, exercise, complementary therapies, and appropriate dietary choices.

In this article, learn more about how making certain dietary changes can affect fibromyalgia.

Dietary changes are not part of the standard treatment for fibromyalgia.

However, favoring some foods over others may help manage the symptoms.

For example, there is evidence to suggest that adopting an anti-inflammatory diet can help people with chronic pain. An anti-inflammatory diet is not a specific eating plan, but its guidelines can help people make suitable choices.

A plant based diet may also be helpful for reducing fibromyalgia symptoms. This is because many plant based foods contain antioxidants, which help the body dispose of “free radicals.” These are waste products that the body produces naturally.

High levels of free radicals in the body can lead to oxidative stress and inflammation.

In this article, learn more about foods that are rich in antioxidants.

Many people with fibromyalgia also have obesity. Excess weight may increase the risk of inflammation and oxidative stress. If fibromyalgia does involve inflammation, adopting a diet that encourages a person to reach or maintain a healthy weight may help.

The DASH diet can help control blood sugar, but it also has overall health benefits. Learn more here.

The following guidelines can help a person make anti-inflammatory diet choices.

Eat eight to nine servings of fruits and vegetables per day: Eating a variety of colorful fruits and vegetables can ensure the greatest range of nutrients. Foods that are particularly rich in nutrients include broccoli and berries.

Choose whole grains: Whole-grain foods include barley, buckwheat, oats, quinoa, brown rice, rye, wheat, and spelt. These foods provide vitamins, protein, and fiber.

Choose healthful oils: Olive oil is a good choice.

Incorporate herbs and spices: Many herbs and spices contain antioxidants, which may help reduce inflammation. Turmeric, bay leaves, cinnamon, and many others can offer benefits.

Turmeric may help people with inflammatory diseases, such as rheumatoid arthritis. Find out more here.

Vitamin D

According to the National Institutes of Health (NIH), there may be a link between fibromyalgia symptoms and a vitamin D deficiency.

Some good dietary sources of vitamin D include:

• egg yolks
• low fat yogurt fortified with vitamin D
• orange juice fortified with vitamin D
• swordfish and salmon
• tuna, canned in water
• whole-grain cereals fortified with vitamin D

Foods containing vitamin D may not reduce symptoms in everyone with fibromyalgia, but they have overall benefits, such as building healthier bones.

The Mediterranean diet is rich in fish, fruits, vegetables, and anti-inflammatory foods. Learn more about this diet here.

A number of additives and ingredients may worsen the symptoms of fibromyalgia. We cover these in more detail in the sections below.

Meat and dairy products

For people with fibromyalgia, it may help to limit excess dairy intake. This is because many dairy products contain saturated fat. People should try to opt for low fat versions or dairy alternatives such as soy milk.

It may also help to limit the consumption of red meat. Instead of eating red meat every day, opt for turkey, fish, and vegetable based substitutes.

Why is it best to limit red meat? Find out here.

Additives

According to the Arthritis Foundation, food additives called excitotoxins may worsen some of the symptoms of fibromyalgia.

Examples of these include monosodium glutamate (MSG), which is a flavor enhancer, and aspartame, which is an artificial sweetener.

Research from 2012 found that people with fibromyalgia and irritable bowel syndrome (IBS) who stopped using MSG and aspartame saw a 30% reduction in symptoms. However, the symptoms returned when they started consuming these additives again.

Gluten

People with celiac disease must avoid gluten, or they may become very sick.

However, recent research suggests that gluten might also affect the outlook for various inflammatory conditions.

A 2014 study looked at what happened when 20 people with fibromyalgia avoided gluten for between 5 and 31 months. Fifteen people stopped having widespread, chronic pain, and three were able to stop using opioids altogether.

None of the participants had celiac disease, but some had other conditions, such as IBS.

Also, research from 2017 revealed that people with signs of both fibromyalgia and gluten sensitivity responded well to a gluten free diet.

In 2018, scientists proposed that there may be a link between fibromyalgia and nonceliac gluten sensitivity.

People should always speak to their doctor before eliminating a major food type, such as gluten, from their diet. Cutting out gluten, for example, can lead to a low intake of whole grains. This can result in a low intake of fiber and other nutrients.

What are the possible benefits and risks of adopting a gluten free diet? Learn more here.

Other ingredients

Other ingredients that may trigger inflammation include:

• saturated fats and trans fats
• refined starches
• foods with added sugar

It may help to keep a food journal and record any symptoms that occur after eating particular food items. If any patterns emerge, it may be worth considering avoiding those foods for a while to see how this affects symptoms.

It is important to remember that avoiding any or all of these foods is unlikely to eliminate all fibromyalgia symptoms.

Also, when cutting out foods, people should ensure that they are getting the nutrients that those items provide from other foods or supplements.

Some researchers have looked at whether the following may help manage the symptoms of fibromyalgia:

• soy
• s-adenosyl-L-methionine
• creatine

There is not yet enough evidence to confirm that these will help with fibromyalgia, however.

It is important to talk to a doctor before starting to take any supplements, even the “natural” ones. Some supplements can have adverse effects, while others can interact with medications the person may be taking.

For example, some people with fibromyalgia use antidepressants, such as sertraline (Zoloft) or fluoxetine (Prozac). St. John’s wort can interact with these types of drug.

Which supplements have an anti-inflammatory effect? Find out here.

There is some evidence to suggest that other complementary methods help with fibromyalgia. These include:

Exercise

According to the American Academy of Family Physicians, engaging in aerobic exercise for 20–30 minutes per day on 2–3 days per week may help reduce symptoms and fatigue in people with fibromyalgia.

Other physical activities that may help include:

People with fibromyalgia may also wish to speak to a yoga instructor about adapting poses to suit their physical needs and abilities. This may include the use of a cushion to support the body in some activities.

Learn more here about yoga for fibromyalgia.

Sleep hygiene

Getting regular, quality sleep can also help people manage the symptoms of fibromyalgia.

Tips for good sleep include:

• waking up and going to sleep at the same time each day
• building a relaxing activity into the bedtime routine, such as reading a book, listening to music, or meditating
• maintaining a cool, dark, and comfortable sleep environment
• leaving cell phones and other devices outside the bedroom

Alternative therapies

Share on PinterestAcupuncture is an alternative therapy that may help ease fibromyalgia symptoms.

Other stress relieving activities that may help relieve fibromyalgia symptoms include:

• acupuncture
• massage therapy
• meditation
• relaxation training
• balneotherapy
• homeopathy
• magnetic therapies
• reiki
• counseling or therapy

Most of these are safe to try, even if scientific evidence to support them is currently lacking. For treatments such as homeopathy and acupuncture, people should check that the provider they choose has approved qualifications.

Can essential oils help relieve fibromyalgia? Find out here.

No single treatment can relieve or cure fibromyalgia, but making healthful dietary choices may help.

Ensuring that the diet contains a variety of fresh fruits and vegetables may be a good place to start.

Foods to eat and avoid

Fibromyalgia causes ongoing pain and fatigue. There is currently no cure, but some medications and lifestyle remedies can help relieve the symptoms. Dietary choices may also make a difference.

Doctors do not yet know what causes fibromyalgia. One theory is that changes in a person’s pain pathways cause them to feel pain more intensely than other people do.

Health professionals do not consider fibromyalgia an inflammatory disease, but some believe that it may involve inflammation of the nerves.

Some experts suggest using a multimodal approach to manage symptoms. This can involve medication, exercise, complementary therapies, and appropriate dietary choices.

In this article, learn more about how making certain dietary changes can affect fibromyalgia.

Dietary changes are not part of the standard treatment for fibromyalgia.

However, favoring some foods over others may help manage the symptoms.

For example, there is evidence to suggest that adopting an anti-inflammatory diet can help people with chronic pain. An anti-inflammatory diet is not a specific eating plan, but its guidelines can help people make suitable choices.

A plant based diet may also be helpful for reducing fibromyalgia symptoms. This is because many plant based foods contain antioxidants, which help the body dispose of “free radicals.” These are waste products that the body produces naturally.

High levels of free radicals in the body can lead to oxidative stress and inflammation.

In this article, learn more about foods that are rich in antioxidants.

Many people with fibromyalgia also have obesity. Excess weight may increase the risk of inflammation and oxidative stress. If fibromyalgia does involve inflammation, adopting a diet that encourages a person to reach or maintain a healthy weight may help.

The DASH diet can help control blood sugar, but it also has overall health benefits. Learn more here.

The following guidelines can help a person make anti-inflammatory diet choices.

Eat eight to nine servings of fruits and vegetables per day: Eating a variety of colorful fruits and vegetables can ensure the greatest range of nutrients. Foods that are particularly rich in nutrients include broccoli and berries.

Choose whole grains: Whole-grain foods include barley, buckwheat, oats, quinoa, brown rice, rye, wheat, and spelt. These foods provide vitamins, protein, and fiber.

Choose healthful oils: Olive oil is a good choice.

Incorporate herbs and spices: Many herbs and spices contain antioxidants, which may help reduce inflammation. Turmeric, bay leaves, cinnamon, and many others can offer benefits.

Turmeric may help people with inflammatory diseases, such as rheumatoid arthritis. Find out more here.

Vitamin D

According to the National Institutes of Health (NIH), there may be a link between fibromyalgia symptoms and a vitamin D deficiency.

Some good dietary sources of vitamin D include:

• egg yolks
• low fat yogurt fortified with vitamin D
• orange juice fortified with vitamin D
• swordfish and salmon
• tuna, canned in water
• whole-grain cereals fortified with vitamin D

Foods containing vitamin D may not reduce symptoms in everyone with fibromyalgia, but they have overall benefits, such as building healthier bones.

The Mediterranean diet is rich in fish, fruits, vegetables, and anti-inflammatory foods. Learn more about this diet here.

A number of additives and ingredients may worsen the symptoms of fibromyalgia. We cover these in more detail in the sections below.

Meat and dairy products

For people with fibromyalgia, it may help to limit excess dairy intake. This is because many dairy products contain saturated fat. People should try to opt for low fat versions or dairy alternatives such as soy milk.

It may also help to limit the consumption of red meat. Instead of eating red meat every day, opt for turkey, fish, and vegetable based substitutes.

Why is it best to limit red meat? Find out here.

Additives

According to the Arthritis Foundation, food additives called excitotoxins may worsen some of the symptoms of fibromyalgia.

Examples of these include monosodium glutamate (MSG), which is a flavor enhancer, and aspartame, which is an artificial sweetener.

Research from 2012 found that people with fibromyalgia and irritable bowel syndrome (IBS) who stopped using MSG and aspartame saw a 30% reduction in symptoms. However, the symptoms returned when they started consuming these additives again.

Gluten

People with celiac disease must avoid gluten, or they may become very sick.

However, recent research suggests that gluten might also affect the outlook for various inflammatory conditions.

A 2014 study looked at what happened when 20 people with fibromyalgia avoided gluten for between 5 and 31 months. Fifteen people stopped having widespread, chronic pain, and three were able to stop using opioids altogether.

None of the participants had celiac disease, but some had other conditions, such as IBS.

Also, research from 2017 revealed that people with signs of both fibromyalgia and gluten sensitivity responded well to a gluten free diet.

In 2018, scientists proposed that there may be a link between fibromyalgia and nonceliac gluten sensitivity.

People should always speak to their doctor before eliminating a major food type, such as gluten, from their diet. Cutting out gluten, for example, can lead to a low intake of whole grains. This can result in a low intake of fiber and other nutrients.

What are the possible benefits and risks of adopting a gluten free diet? Learn more here.

Other ingredients

Other ingredients that may trigger inflammation include:

• saturated fats and trans fats
• refined starches
• foods with added sugar

It may help to keep a food journal and record any symptoms that occur after eating particular food items. If any patterns emerge, it may be worth considering avoiding those foods for a while to see how this affects symptoms.

It is important to remember that avoiding any or all of these foods is unlikely to eliminate all fibromyalgia symptoms.

Also, when cutting out foods, people should ensure that they are getting the nutrients that those items provide from other foods or supplements.

Some researchers have looked at whether the following may help manage the symptoms of fibromyalgia:

• soy
• s-adenosyl-L-methionine
• creatine

There is not yet enough evidence to confirm that these will help with fibromyalgia, however.

It is important to talk to a doctor before starting to take any supplements, even the “natural” ones. Some supplements can have adverse effects, while others can interact with medications the person may be taking.

For example, some people with fibromyalgia use antidepressants, such as sertraline (Zoloft) or fluoxetine (Prozac). St. John’s wort can interact with these types of drug.

Which supplements have an anti-inflammatory effect? Find out here.

There is some evidence to suggest that other complementary methods help with fibromyalgia. These include:

Exercise

According to the American Academy of Family Physicians, engaging in aerobic exercise for 20–30 minutes per day on 2–3 days per week may help reduce symptoms and fatigue in people with fibromyalgia.

Other physical activities that may help include:

People with fibromyalgia may also wish to speak to a yoga instructor about adapting poses to suit their physical needs and abilities. This may include the use of a cushion to support the body in some activities.

Learn more here about yoga for fibromyalgia.

Sleep hygiene

Getting regular, quality sleep can also help people manage the symptoms of fibromyalgia.

Tips for good sleep include:

• waking up and going to sleep at the same time each day
• building a relaxing activity into the bedtime routine, such as reading a book, listening to music, or meditating
• maintaining a cool, dark, and comfortable sleep environment
• leaving cell phones and other devices outside the bedroom

Alternative therapies

Share on PinterestAcupuncture is an alternative therapy that may help ease fibromyalgia symptoms.

Other stress relieving activities that may help relieve fibromyalgia symptoms include:

• acupuncture
• massage therapy
• meditation
• relaxation training
• balneotherapy
• homeopathy
• magnetic therapies
• reiki
• counseling or therapy

Most of these are safe to try, even if scientific evidence to support them is currently lacking. For treatments such as homeopathy and acupuncture, people should check that the provider they choose has approved qualifications.

Can essential oils help relieve fibromyalgia? Find out here.

No single treatment can relieve or cure fibromyalgia, but making healthful dietary choices may help.

Ensuring that the diet contains a variety of fresh fruits and vegetables may be a good place to start.

Foods to eat and avoid

Fibromyalgia causes ongoing pain and fatigue. There is currently no cure, but some medications and lifestyle remedies can help relieve the symptoms. Dietary choices may also make a difference.

Doctors do not yet know what causes fibromyalgia. One theory is that changes in a person’s pain pathways cause them to feel pain more intensely than other people do.

Health professionals do not consider fibromyalgia an inflammatory disease, but some believe that it may involve inflammation of the nerves.

Some experts suggest using a multimodal approach to manage symptoms. This can involve medication, exercise, complementary therapies, and appropriate dietary choices.

In this article, learn more about how making certain dietary changes can affect fibromyalgia.

Dietary changes are not part of the standard treatment for fibromyalgia.

However, favoring some foods over others may help manage the symptoms.

For example, there is evidence to suggest that adopting an anti-inflammatory diet can help people with chronic pain. An anti-inflammatory diet is not a specific eating plan, but its guidelines can help people make suitable choices.

A plant based diet may also be helpful for reducing fibromyalgia symptoms. This is because many plant based foods contain antioxidants, which help the body dispose of “free radicals.” These are waste products that the body produces naturally.

High levels of free radicals in the body can lead to oxidative stress and inflammation.

In this article, learn more about foods that are rich in antioxidants.

Many people with fibromyalgia also have obesity. Excess weight may increase the risk of inflammation and oxidative stress. If fibromyalgia does involve inflammation, adopting a diet that encourages a person to reach or maintain a healthy weight may help.

The DASH diet can help control blood sugar, but it also has overall health benefits. Learn more here.

The following guidelines can help a person make anti-inflammatory diet choices.

Eat eight to nine servings of fruits and vegetables per day: Eating a variety of colorful fruits and vegetables can ensure the greatest range of nutrients. Foods that are particularly rich in nutrients include broccoli and berries.

Choose whole grains: Whole-grain foods include barley, buckwheat, oats, quinoa, brown rice, rye, wheat, and spelt. These foods provide vitamins, protein, and fiber.

Choose healthful oils: Olive oil is a good choice.

Incorporate herbs and spices: Many herbs and spices contain antioxidants, which may help reduce inflammation. Turmeric, bay leaves, cinnamon, and many others can offer benefits.

Turmeric may help people with inflammatory diseases, such as rheumatoid arthritis. Find out more here.

Vitamin D

According to the National Institutes of Health (NIH), there may be a link between fibromyalgia symptoms and a vitamin D deficiency.

Some good dietary sources of vitamin D include:

• egg yolks
• low fat yogurt fortified with vitamin D
• orange juice fortified with vitamin D
• swordfish and salmon
• tuna, canned in water
• whole-grain cereals fortified with vitamin D

Foods containing vitamin D may not reduce symptoms in everyone with fibromyalgia, but they have overall benefits, such as building healthier bones.

The Mediterranean diet is rich in fish, fruits, vegetables, and anti-inflammatory foods. Learn more about this diet here.

A number of additives and ingredients may worsen the symptoms of fibromyalgia. We cover these in more detail in the sections below.

Meat and dairy products

For people with fibromyalgia, it may help to limit excess dairy intake. This is because many dairy products contain saturated fat. People should try to opt for low fat versions or dairy alternatives such as soy milk.

It may also help to limit the consumption of red meat. Instead of eating red meat every day, opt for turkey, fish, and vegetable based substitutes.

Why is it best to limit red meat? Find out here.

Additives

According to the Arthritis Foundation, food additives called excitotoxins may worsen some of the symptoms of fibromyalgia.

Examples of these include monosodium glutamate (MSG), which is a flavor enhancer, and aspartame, which is an artificial sweetener.

Research from 2012 found that people with fibromyalgia and irritable bowel syndrome (IBS) who stopped using MSG and aspartame saw a 30% reduction in symptoms. However, the symptoms returned when they started consuming these additives again.

Gluten

People with celiac disease must avoid gluten, or they may become very sick.

However, recent research suggests that gluten might also affect the outlook for various inflammatory conditions.

A 2014 study looked at what happened when 20 people with fibromyalgia avoided gluten for between 5 and 31 months. Fifteen people stopped having widespread, chronic pain, and three were able to stop using opioids altogether.

None of the participants had celiac disease, but some had other conditions, such as IBS.

Also, research from 2017 revealed that people with signs of both fibromyalgia and gluten sensitivity responded well to a gluten free diet.

In 2018, scientists proposed that there may be a link between fibromyalgia and nonceliac gluten sensitivity.

People should always speak to their doctor before eliminating a major food type, such as gluten, from their diet. Cutting out gluten, for example, can lead to a low intake of whole grains. This can result in a low intake of fiber and other nutrients.

What are the possible benefits and risks of adopting a gluten free diet? Learn more here.

Other ingredients

Other ingredients that may trigger inflammation include:

• saturated fats and trans fats
• refined starches
• foods with added sugar

It may help to keep a food journal and record any symptoms that occur after eating particular food items. If any patterns emerge, it may be worth considering avoiding those foods for a while to see how this affects symptoms.

It is important to remember that avoiding any or all of these foods is unlikely to eliminate all fibromyalgia symptoms.

Also, when cutting out foods, people should ensure that they are getting the nutrients that those items provide from other foods or supplements.

Some researchers have looked at whether the following may help manage the symptoms of fibromyalgia:

• soy
• s-adenosyl-L-methionine
• creatine

There is not yet enough evidence to confirm that these will help with fibromyalgia, however.

It is important to talk to a doctor before starting to take any supplements, even the “natural” ones. Some supplements can have adverse effects, while others can interact with medications the person may be taking.

For example, some people with fibromyalgia use antidepressants, such as sertraline (Zoloft) or fluoxetine (Prozac). St. John’s wort can interact with these types of drug.

Which supplements have an anti-inflammatory effect? Find out here.

There is some evidence to suggest that other complementary methods help with fibromyalgia. These include:

Exercise

According to the American Academy of Family Physicians, engaging in aerobic exercise for 20–30 minutes per day on 2–3 days per week may help reduce symptoms and fatigue in people with fibromyalgia.

Other physical activities that may help include:

People with fibromyalgia may also wish to speak to a yoga instructor about adapting poses to suit their physical needs and abilities. This may include the use of a cushion to support the body in some activities.

Learn more here about yoga for fibromyalgia.

Sleep hygiene

Getting regular, quality sleep can also help people manage the symptoms of fibromyalgia.

Tips for good sleep include:

• waking up and going to sleep at the same time each day
• building a relaxing activity into the bedtime routine, such as reading a book, listening to music, or meditating
• maintaining a cool, dark, and comfortable sleep environment
• leaving cell phones and other devices outside the bedroom

Alternative therapies

Share on PinterestAcupuncture is an alternative therapy that may help ease fibromyalgia symptoms.

Other stress relieving activities that may help relieve fibromyalgia symptoms include:

• acupuncture
• massage therapy
• meditation
• relaxation training
• balneotherapy
• homeopathy
• magnetic therapies
• reiki
• counseling or therapy

Most of these are safe to try, even if scientific evidence to support them is currently lacking. For treatments such as homeopathy and acupuncture, people should check that the provider they choose has approved qualifications.

Can essential oils help relieve fibromyalgia? Find out here.

No single treatment can relieve or cure fibromyalgia, but making healthful dietary choices may help.

Ensuring that the diet contains a variety of fresh fruits and vegetables may be a good place to start.

Fibromyalgia Diet: What to Eat, What to Avoid

“No drug on the market is as important to optimal health as a well-balanced and healthy diet,” Dr. Holton says. “While many people like to call nutrition ‘alternative medicine,’ in reality it is the basis of all human health. We can’t be optimally healthy without giving our bodies the nutrients they need, and that applies to anyone with fibromyalgia.”

10 Tips for Choosing Foods for Fibromyalgia

Holton’s research has focused largely on the effects of dietary excitotoxins, chemicals that “excite”; neurons in the brain and that can be toxic if consumed in excess. The most common forms of dietary excitotoxins in the Western diet are food additives used to enhance or sweeten the flavor of foods.

Some early research showed that eliminating excitotoxic food additives from the diets of some individuals with fibromyalgia reduced their symptoms. While results of subsequent research have been mixed, eliminating food additives from the diet remains a low-cost treatment option with few if any side effects and the potential to help. (1)

Here, Holton shares her top tips on choosing foods for fibromyalgia.

1. Avoid Foods That Contain Added Glutamate

Glutamate is a neurotransmitter that occurs naturally in the body and in some foods, but it is also added to foods as a flavor enhancer.

The most common form of dietary glutamate is monosodium glutamate (MSG), which must be listed on the label when it’s included in foods.

Ingredients that include the terms “hydrolyzed,” “autolyzed,” “protein concentrate,” or “protein isolate” are also likely to contain naturally occurring monosodium glutamate. (2)

In a study published in 2012, 37 people with fibromyalgia and irritable bowel syndrome (IBS) — which is common in people with fibromyalgia — followed a diet free of added MSG and aspartame for four weeks. Most reported that more than 30 percent of their fibromyalgia symptoms had resolved during that time. Those whose symptoms improved then consumed either MSG or a placebo for three consecutive days per week for two weeks. The group assigned to the MSG experienced a significant return of symptoms. (3)

Foods that commonly contain MSG include Chinese foods, canned soups and vegetables, some types of chips or similar crunchy snacks, and processed meats. To avoid MSG and other sources of added glutamate, read food labels carefully, and don’t buy those that list MSG or ingredients high in glutamate.

2. Choose Whole Foods Instead of Processed Ones

Steer clear of processed foods and choose more whole foods, advises Holton.

Processed foods typically have more additives and less fiber and nutrients than unprocessed foods. Refined carbohydrates — such as white flour, white pasta, and white rice — are examples of processed foods that have been stripped of naturally occurring nutrients.

When choosing carbohydrate-containing foods for your meals, choose whole grains such as quinoa, amaranth, whole wheat berries, buckwheat groats, or brown or wild rice, or have a sweet potato or plain potato in place of bread, pasta, or rice.

“I try to eat whole, real food,” says Wildman. “That means cauliflower from a fresh head, corn from an ear, and cage-free eggs.”

3. Try the DASH or Mediterranean Eating Plan

Both the DASH Diet (dietary approaches to stop hypertension) and Mediterranean diet have been shown to have real health benefits, including lower blood pressure and cholesterol.

The two diets are slightly different in their specifics, but both are rich in fruits and vegetables, lean proteins, whole grains, nuts, seeds, legumes, and low-fat or no-fat dairy foods.

Many components of the DASH diet reduce inflammation in the body, which can be helpful in controlling many chronic conditions.

4. Avoid Cured Meats

When you buy meat, avoid processed products with added salt or preservatives or meats that have been smoked or cured. This list includes canned meat, sausage, bacon, hot dogs, ham, deli meat, corned beef, and beef jerky.

Also beware of meat products with the words “natural flavor added” on the label. An example of such a product is turkey breast infused with broth (to give it more flavor). Natural flavors are derived from natural sources such as plants, meats, and seafood and may be high in naturally occurring monosodium glutamate.

5. Eat Cold-Water Fish and Fortified Foods for Vitamin D

According to the National Center for Complementary and Integrative Health, vitamin D supplementation may reduce pain in people with fibromyalgia who are deficient in this nutrient. (4)

You can get vitamin D naturally in swordfish, tuna, sockeye salmon, and eggs, and some foods, such as orange juice and milk, are fortified with vitamin D. Vitamin D can also be taken as a supplement or in cod liver oil, which provides both vitamin D and omega-3 fatty acids.

Spending time outside also increases your body’s vitamin D levels, although too much sun exposure increases the risk of skin cancers and eye disease. (5)

6. Choose Dark, Leafy Greens, Nuts, and Seeds for Magnesium

Magnesium citrate supplementation may reduce symptoms of fibromyalgia, according to a 2013 study that showed it was even more effective when paired with amitriptyline, a tricyclic antidepressant. (6)

“Magnesium is necessary for helping to prevent the excitoxicity caused by glutamate,” says Holton.

Magnesium is found in many healthy foods, including legumes (dried beans and lentils), nuts and seeds, avocado, yogurt, bananas, fatty fish, dark chocolate, and dark, leafy greens.

RELATED: 8 Foods High in Magnesium

7. Add in Fish, Flaxseed, and Chia for Omega-3 Fatty Acids

Omega-3 fatty acids may reduce levels of oxidative stress, as well as lower levels of inflammation and boost immunity. Oxidative stress takes place when the body has too many free radicals, or unstable molecules, that damage cells. It is implicated in the development of many medical conditions.

Omega-3s are abundant in wild-caught seafood, walnuts, chia seeds, and flaxseeds. It can also be taken as a supplement.

However, omega-3 capsules are not recommended since they contain gelatin, which contains the amino acid aspartate. Aspartate may active a glutamate receptor on nerve cells that’s implicated in fibromyalgia. Gelatin also contains glycine, a co-activator of that receptor. (7)

8. Include Good Sources of Antioxidants in Your Meals

To combat the effects of dietary excitotoxins on fibromyalgia symptoms, you may need more antioxidants in your diet, as excitotoxins also create oxidative stress.

“To keep this simple, look for foods that add color to your diet, in the fruits and vegetables category,” says Holton. “Focus on increasing consumption of items with bright red, green, orange, yellow, and purple hues to give yourself an antioxidant boost. “

9. Read the Labels on Packaged Foods

If the ingredients list on a food packaging label is long and complex, put the product back on the shelf, Holton advises. You won’t likely see “glutamate” on that label, but you will see other additives that may hide glutamate. Labels should be short, easy to read, and should list ingredients that you could add to a dish when cooking.

Don’t be fooled by the words “spices” or “flavorings,” since the U.S. Food and Drug Administration doesn’t dictate that manufacturers explain what those terms mean on a food label, she says.

10. Avoid Artificial Sweeteners and Limit Sugars

Holton recommends avoiding artificial sweeteners such as aspartame, acesulfame-K, saccharin, and sucralose. Use regular sugar or honey sparingly to sweeten foods.

“It’s much easier to wean yourself off sugar if you aren’t using artificial sweeteners,” she says.

“As you cut back on sugar, you’ll taste sweetness in foods more easily. Even Stevia is hundreds of times sweeter than sugar — which makes you want more sweetness in your food.”

For general good health, avoid high-fructose corn syrup. When you’re fatigued from fibromyalgia, don’t choose sugar or the corn-syrup alternative to boost energy. High sugar intake increases risk of weight gain, diabetes, and other inflammatory diseases, including heart disease and cancer.

“Sugar is my nemesis,” Wildman says. “It makes me more tired, raises my insulin levels, and makes me supersensitive to things. When I’ve had sugar, something can startle me, and I’ll jump sky high.”

“Research suggests excitotoxicity requires a great deal of energy in the body,” says Dr. Holton. “High sugar intake may ‘fuel’ this process.”

Foods to Avoid with Fibromyalgia

Sensitivity to pain is a well-known symptom of fibromyalgia. A lesser-known symptom is an enhanced sensitivity to various substances, including food.

See Characteristic Symptoms of Fibromyalgia

Following an anti-inflammatory diet and being aware of food sensitivities can help people with fibromyalgia get the most out of their food while avoiding symptom flare-ups.

See An Anti-Inflammatory Diet for Arthritis

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Foods Likely to Make Symptoms Worse

The following foods may worsen symptoms by increasing inflammation, aggravating food sensitivities, or both.

• Sugar. Reducing or eliminating sugar can have a significant impact on health for two reasons. First, the medical literature has shown that eating foods high in sugar is linked to increased fibromyalgia pain.¹

  Second, limiting sugar helps control weight. Being overweight puts extra stress on the body, contributing to fatigue, and stored fat may lead to inflammation in some cases. Sugar is a well-known ingredient in candy and soft drinks, but is also in foods considered to be healthy—such as yogurt. When checking nutrition labels, it is helpful to know that glucose, fructose, and sucrose are other names for sugar.

See The Ins and Outs of an Anti-Inflammatory Diet

• Carbohydrates. Refined carbohydrates such as cookies, many breads, pastries, and white rice are digested quickly, causing blood sugar levels to spike. The effect does not last, however, and blood sugar soon drops, making the individual hungry again. These fluctuations can make the fatigue and pain of fibromyalgia worse and contribute to overeating.²

  When eating carbohydrates, whole wheat sources should be chosen. Whole wheat foods digest more slowly, avoiding the highs and lows that occur with other carbohydrates.

  See Celiac Disease and Low Thyroid vs. Fibromyalgia

  One small research study focused on women diagnosed with fibromyalgia who also had irritable bowel syndrome (IBS) and a food intolerance. (Many people with fibromyalgia also have irritable bowel syndrome.)

  When the women cut back on eating a specific group of carbohydrates, they reported a 50% reduction in irritable bowel symptoms and a 22% decrease in other symptoms, including pain. The restricted carbohydrates were a type not well absorbed in the small intestine. Such carbohydrates include lactose (an ingredient in milk and other dairy foods), fructose (in some fruits and vegetables, honey, and other sweeteners), and grains. ³

• Processed foods. Sugar and unhealthy fats, which increase inflammation, are a large part of many processed foods. Flavorings and preservatives commonly used in processed foods also may trigger food sensitivities.

See What Are Anti-Inflammatory Foods?

• Unhealthy fats. Vegetable oils, such as corn oil, safflower oil, and peanut oil, have an inflammatory effect, especially when used to fry food. The medical literature has linked fried foods to worsening of fibromyalgia symptoms.¹ Unhealthy oils are a common ingredient in many processed foods, such as cookies, doughnuts, and crackers. Pizza and cheese are also major sources of unhealthy fats.
• Alcohol. While some research has found moderate alcohol use can ease symptoms,⁴ some people with fibromyalgia report alcohol causes symptoms to flare. Drinking alcohol while taking certain medications prescribed for fibromyalgia—such as anti-convulsants, antidepressants, and acetaminophen (an ingredient in many medications) could cause harmful interactions.

In This Article:

This is not a comprehensive list of foods that may trigger symptoms. Other foods and ingredients that may cause symptoms for some people include, but are not limited to:

• Gluten
• Red meat
• Fruits and vegetables in the nightshade family, such as tomatoes, white potatoes, green peppers, and goji berries.
• Dairy products
• Eggs
• Caffeine

See How Gluten Can Cause Joint Pain

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Learning About the Body’s Reaction to Certain Foods

If a food appears to trigger symptoms in an individual, eliminating the food entirely for several weeks is a good way to determine its impact. Keeping a detailed food log to track symptoms when the food is removed and added back may also be helpful.

Reducing sugar and sugary foods can have an additional benefit, helping the individual overcome a craving for sweets for the long term.

The doctor can be a good resource on food sensitivities and should be informed of problems encountered with different foods and ingredients. In some cases, the doctor may suggest testing for food sensitivities or allergies to narrow the list of potential problem foods.

See Doctors Who Treat Fibromyalgia

References

• 1.Timmerman GM, Calfa NA, Stuifbergen AK. Correlates of body mass index in women with fibromyalgia. Orthop Nurs. 2013;32(2):113-9.
• 2.Ernst A, Shelley-Tremblay J. Non-Ketogenic, Low Carbohydrate Diet Predicts Lower Affective Distress, Higher Energy Levels and Decreased Fibromyalgia Symptoms in Middle-Aged Females with Fibromyalgia Syndrome as Compared to the Western Pattern Diet. Journal of Musculoskeletal Pain. Volume 21, 2013, Issue 4. Page 365-370. dx.doi.org/10.3109/10582452.2013.852649.
• 3.Maruma AP, Moreirab C, Saraivaa F, Tomas-Carusc P, Sousa-Guerreiroa C. A low fermentable oligo-di-mono saccharides and polyols (FODMAP) diet reduced pain and improved daily life in fibromyalgia patients. Scandinavian Journal of Pain. Volume 13, October 2016, Pages 166–172. dx. doi.org/10.1016/j.sjpain.2016.07.004.
• 4.Kim CH, Vincent A, Clauw DJ, et al. Association between alcohol consumption and symptom severity and quality of life in patients with fibromyalgia. Arthritis Res Ther. 2013;15(2):R42.

90,000 what is the right diet and diet for people with fibromyalgia?

4.9 / 5 (74)

Do you suffer from fibromyalgia and are wondering which diet is right for you? Research has shown that many people with fibromyalgia can have very positive effects from eating right and following these dietary tips that we present here, so we hope that you will also benefit from the “fibromyalgia diet” that we are writing about in this article. , based on a large survey study.This article will discuss nutrition and diet in terms of what foods you should eat and what foods you should avoid – often due to anti-inflammatory or anti-inflammatory effects.

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Study Report: The Best Fibromyalgia Diet

Fibromyalgia is known to be a diagnosis of chronic pain that causes severe muscle and skeletal pain, as well as poor sleep and often cognitive impairment (for example, memory and fibrous fog). Unfortunately, there is no cure, but research can be used to find out what can alleviate the diagnosis and its symptoms. Diet plays a key role in curbing inflammatory responses in the body and reducing pain in painful muscle fibers. This article is based on a large review study by Holton et al., Consisting of 29 studies.

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Many people with fibromyalgia know how important it is to listen to their bodies to avoid peaks of pain and“ flare-ups ”(episodes with significantly more symptoms). Therefore, many people are very concerned about their diet because they know that the right diet can reduce the pain of fibromyalgia, but they also know that the wrong type of food can worsen the pain and symptoms of fibromyalgia. In short, you want to avoid pro-inflammatory (anti-inflammatory) foods and try to eat more anti-inflammatory (anti-inflammatory) foods. A review study (meta-analysis) published in the renowned research journal Pain concluded that a number of nutrient deficiencies can lead to an increased frequency of symptoms and that eating well can help reduce pain and symptoms. See the research link at the bottom of the article. (1)

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Too many people suffer from chronic pain that disrupts daily life – so we recommend you Share this article on social networks, Feel free to love our Facebook page and Say, “Yes, more research on fibromyalgia.” In this way, it is possible to make the symptoms associated with this diagnosis more visible and to ensure that more people are taken seriously and thus get the help they need.We also hope that this increased focus could lead to increased funding for research on new methods of assessment and treatment.

Les også: – Researchers may have found the cause of the fibrous fog!

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Believe it or not: in the old days, fibromyalgia was thought to be a mental illness.

Many years ago, doctors believed that fibromyalgia was a purely mental illness. It wasn’t until 1981 that the first study confirmed the symptoms of fibromyalgia, and in 1991, the American College of Rheumatology wrote a guide to diagnosing fibromyalgia. Research and clinical research is constantly progressing and we can now partially treat fibromyalgia in combination with other treatments through the so-called fibromyalgia diet.

We now take a closer look at what people with fibromyalgia should include in their diet – and what foods they should avoid – based on a large study by Holton et al. (2016). Let’s start with the food to eat.

Les også: – 7 exercises for rheumatists

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Food you should eat if you have fibromyalgia

Fruits and vegetables (including low and low footer)

Conditions such as irritable bowel, obesity, and autoimmune diagnoses are common among those diagnosed with fibromyalgia.

Some of the best researchers in the field agree that foods that are low in calories and high in fiber also contain high levels of antioxidants and phytochemicals (nutrients that are beneficial to plants). We find significant amounts of them in fruits and vegetables, which is why it is recommended that such natural foods be an integral part of the diet of people with fibromyalgia. Those who are especially sensitive should also try a low-feed approach to eliminate any vegetables and fruits they cannot tolerate.

Examples of good vegetables for those with low fibromyalgia:

• cucumber
• eggplant
• broccoli
• Butternut Gourd
• carrot
• Green beans
• ginger
• parsnips
• parsley
• Brussels sprouts
• salad
• Sellery
• spinach
• sprouts
• squash
• Tomat

All vegetables in the low-footed folder are considered very safe and good for people with fibromyalgia and IBS.

Examples of vegetables that might be good with fibromyalgia (high leg folder):

• asparagus
• Arti Cooking
• Avocado
• broccoli
• beans
• peas
• dill
• collard green
• Jerusalem artichoke
• chickpeas
• Cal
• lentils
• bow
• Corn
• leek
• Brussels sprouts
• beets
• SOPP
• sugar peas
• Chives

These are examples of high food content vegetables. This means they can give you a lot of healthy fibromyalgia nutrition, but you can also react to some of the different vegetables. We recommend that you make a plan and test yourself – one at a time.

Examples of nutritious fruits for people with fibromyalgia of the lower extremities:

• Pineapple
• orange
• banana
• Drew
• apple
• Galya
• cantaloupe
• Cantaloupmelon
• clementine
• passion fruit
• lemon

It is important to note that people with fibromyalgia have a better tolerance for ripe bananas compared to greener bananas.

Examples of nutritious fruits for people with fibromyalgia (folder with high feet):

• apple
• Mango
• lime
• Mango
• nectarines
• Papaya
• plum
• flask
• lemon
• Dried fruits (e.g. raisins)
• watermelon

If there are things on the FODMAP list that you react to that make your symptoms worse, then you know what to stay away from.

Examples of antioxidant-rich berries for people with fibromyalgia:

• blueberries
• raspberry
• strawberry
• cranberries

Les også: What you need to know about fibromyalgia

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Food rich in omega-3

Omega-3 is an essential fatty acid. It is a nutrient that your body needs to, among other things, fight inflammatory responses, but it cannot make on its own.Hence, you need to get omega-3s in the diet that you eat.

Fatty cold water fish, walnuts, flax seeds and tofu are considered the best sources of omega-3s. Mackerel has the highest omega-3 content, so eating tomato mackerel on large breads, for example, might be a good idea to meet that need. Salmon, trout, herring, and sardines are other very good sources of omega-3s.

Examples of high omega-3 foods for people with fibromyalgia:

• Avocado
• blackberry
• cauliflower
• blueberry
• shellfish
• raspberry
• broccoli
• Broccoli sprouts
• beans
• Chia Seeds
• Fish Caviar
• vegetable oil
• Krabbe
• Lax
• flaxseed
• bow
• mackerel
• shellfish
• Brussels sprouts
• spinach
• cod
• tuna
• walnuts
• trout
• Osters

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High lean protein

Fatigue, decreased energy levels and fatigue are common symptoms among those who suffer from fibromyalgia. Therefore, it is very important to limit your carbohydrate intake and increase the proportion of protein in your diet.

The reason you want to eat foods high in lean protein if you have fibromyalgia is because it helps your body regulate your blood sugar and keep it stable throughout the day. As you know, uneven blood sugar levels can lead to more fatigue and a strong craving for sugar-containing foods.

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Examples of foods high in lean protein for people with fibromyalgia:

• beans
• cashew
• Cottage cheese (although made from skim milk, so if you react to dairy products you should stay away)
• Egg
• peas
• Fisk
• Greek yogurt
• Lean Meat
• turkey
• Chicken
• Lax
• lentils
• almonds
• Quinoa
• sardines
• Low fat soy milk
• Tofu
• tuna

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Some recommended snacks based on what we’ve learned so far

Based on what we’ve learned so far, we have some suggestions for light snacks you can try throughout the day.

Avocado with Berry Smoothie

As mentioned, avocados contain healthy fats that provide essential energy for people with fibromyalgia. They also contain vitamin E, which can help with muscle pain, as well as vitamins B, C, and K, as well as important minerals iron and manganese. Therefore, we recommend that you try the smoothie, which is composed of avocados combined with berries that are full of antioxidants.

Salmon with walnuts and broccoli

Fish for dinner.We highly recommend eating fatty fish, preferably salmon, at least 3 times a week if you suffer from fibromyalgia. We believe that you should try to eat it up to 4-5 times a week if you have this diagnosis of chronic pain. Salmon contains high levels of anti-inflammatory omega-3s as well as protein that provides the right kind of energy. Add antioxidant broccoli and walnuts to that. Both healthy and incredibly good.

Lemon juice with chia seeds

Another good suggestion in the fibromyalgia diet.Namely, lemon juice contains vitamins and minerals that can act as anti-inflammatory and therefore pain-relieving. Chia seeds are high in protein, fiber, omega-3s, and minerals, making them one of the best forms of nutrition you can get.

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Foods to Avoid in Fibromyalgia

Sugar

Sugar is pro-inflammatory, which means it causes and causes inflammatory reactions.Thus, consuming a lot of sugar is not the best option when you have fibromyalgia. In addition, high sugar content often leads to weight gain, which in turn puts more stress on the joints and muscles of the body. Here are some examples of foods and drinks that are surprisingly high in sugar:

• cereals
• vitamin water
• Beam
• Frozen pizza
• Ketchup
• BBQ sauce
• Done Soups
• Dried Fruit
• bread
• Cakes, biscuits and biscuits
• Bagels and Churros
• Iced tea
• Sauce on a can

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Alcohol

Many people with fibromyalgia report worsening symptoms when drinking alcohol.It also happens that a number of anti-inflammatory and analgesic drugs do not react particularly well with alcohol – and thus they may have side reactions or a diminished effect. Alcohol is also high in calories and often sugar, which can increase inflammation and pain in the body.

Foods high in carbohydrates

Biscuits, biscuits, white rice and white bread can spike blood sugar and then infuriate him.These uneven levels can lead to fatigue and worse pain levels in individuals with fibromyalgia. Over time, this unevenness can damage the insulin receptors and make it difficult for the body to control blood sugar and therefore energy levels.

Know About These Carbohydrate Bombs:

• Bar
• Pommes frites
• Cupcakes
• cranberry syrup
• Pai
• Cocktails
• date
• pizza
• Energy Bars
• Sweets and sweets

Unhealthy fatty and fried foods

When you fry oil, it causes inflammation, which also applies to fried foods.Studies have shown that such foods (such as french fries, chicken nuggets, and spring rolls) can worsen the symptoms of fibromyalgia. This also applies to processed foods such as donuts, many types of cookies, and pizza.

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Other dietary advice for people with fibromyalgia

Vegetarian diet for fibromyalgia:“ Become a vegan ”

There are a number of scientific studies (including Clinton et al, 2015 and Kaartinen et al, 2001), who showed that a vegetarian diet high in naturally occurring antioxidants can help reduce fibromyalgia pain as well as symptoms due to osteoarthritis.

A vegetarian diet is not suitable for everyone and is difficult to follow, but it is nonetheless highly recommended to include a large amount of vegetables in the diet. It will also help you reduce your calorie intake and therefore excess weight. Due to the pain associated with fibromyalgia, movement often becomes very difficult, and therefore extra pounds appear. If desired, active weight loss work can bring great health benefits and positive results, such as less pain in daily life, better sleep, and less depression.

Drink lots of good Norwegian water

In Norway, we can have the best water in the world right at the tap. A good advice that dietitians often give to those diagnosed with fibromyalgia or other chronic pain is to drink plenty of water and drink water throughout the day. It is true that a lack of hydration can greatly affect people with fibro due to the fact that energy levels are often lower than others.

Living with fibromyalgia requires making adjustments – just like others should pay attention to you (which we talk about in the article we link to below).The right diet may work well for some, but it may not be as effective for others – we are all different, even if we have the same diagnosis.

Les også: 7 tips for coping with fibromyalgia

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Again, we want ask to nicely share this article on social media or through your blog (feel free to link directly to the article). Understanding and increased attention is the first step towards a better daily life for people with fibromyalgia.

Fibromyalgia is a diagnosis of chronic pain that can be extremely damaging to humans. The diagnosis can lead to decreased energy, daily pain and everyday problems that far exceed those of Kari and Olu Nordmann.We kindly ask you to like and share this to increase attention and conduct more research on the treatment of fibromyalgia. Many thanks to everyone who loves and shares – maybe one day we can find a cure together?

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Fibromyalgia incurable. What foods are banned? | Medicine and technology

We continue the cycle of publications on the channel about the incurable disease fibromyalgia.

Brief information about fibromyalgia

The incidence is 3-5% of the world’s population and women are more susceptible than men.

There are several main symptoms such as sleep disturbances, irritable bowel syndrome, rheumatic headaches, headaches and chronic fatigue, which can seriously affect the patient and his daily life.

Symptoms vary in intensity and duration for each patient – they may subside over time, but never go away.

Nutritional considerations for fibromyalgia

Most recommendations do not offer a specific therapeutic diet for this disease. However, it is known that all patients with rheumatoid forms have nutritional deficiencies.

The diet for fibromyalgia thus focuses on:

• Preventing nutritional deficiencies.
• Include components of a healthy and balanced diet to maintain a healthy weight.
• Regular physical activity to maintain a healthy diet and rest.

What foods should fibromyalgia patients avoid?

Some of the foods that fibromyalgia patients should definitely avoid include:

• Aspartame – enhances pain perception by increasing the pain receptor of the nervous system (NMDA receptors).As the pain progresses from acute to chronic, NMDA receptors are activated by aspartame. Patients with fibromyalgia already have over-activated NMDA receptors, and aspartame thus worsens the condition. Aspartame is found in artificial sweeteners.
• Nutritional supplements such as MSG (monosodium glutamate) and nitrates – have the same effect as aspartame on fibromyalgia. They are often found in sausage products.
• Simple carbohydrates such as sugar, fructose and glucose.Complex carbohydrates from plant sources are best for fibromyalgia patients. Sugar-rich foods should be avoided to maintain weight and reduce fatigue as they are absorbed more quickly than complex carbohydrates.
• Caffeine – Many fibromyalgia patients can use caffeine in energy drinks, colas and coffee to combat fatigue. However, these agents can quickly and transiently increase activity, after which fatigue returns abruptly.
• Yeast and Gluten – The gluten present in wheat should be avoided by patients with gluten intolerance.
• Dairy – Some fibromyalgia patients cannot tolerate dairy and lactose. These patients should avoid milk and related products.
• Certain vegetables may cause flare-ups in fibromyalgia patients. These include tomatoes, chili, eggplant, and bell peppers. This also varies between patients.

What conclusions can be drawn?

There is no scientific evidence that there is a special diet that helps with this pathology. However, most patients have certain foods that exacerbate fibromyalgia.

Thus, the ideal diet for each patient is individualized. It has been linked to comorbid conditions in fibromyalgia, including gluten intolerance, gout, and irritable bowel syndrome.

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90,000 15 Natural Treatments for Fibromyalgia – Blog

By Eric Madrid, MD

Fibromyalgia, sometimes called fibromyalgia syndrome or FMS, is a chronic pain syndrome characterized by muscle aches, pain throughout the body, and increased fatigue. Muscle pains called myalgias are usually diffuse and felt throughout the body.Fibromyalgia affects approximately 10 million people in the United States. Fibromyalgia affects more than 100 million people worldwide, 90 percent of whom are women. Research shows that 68 percent of people with fibromyalgia try to relieve symptoms of the disease with nutritional supplements.

Traditional medicine has not yet identified a specific cause of fibromyalgia. Many integrative and functional medicine practitioners believe that the problem lies in the mitochondria, or the “powerhouses” of our cells.This theory is supported by a 2011 clinical case of a patient with mitochondrial disease who was initially diagnosed with fibromyalgia.

The cause of fibromyalgia is considered unclear, however, it is known that patients suffering from SFM have 40 percent less coenzyme Q10 in the blood and reduced antioxidant activity.

In patients with SM, there is also a decrease in the number of mitochondria in blood cells. Mitochondria are the parts of our cells that give us energy by creating a molecule that serves as an energy source – adenosine triphosphate (ATP).Other researchers have noted that an overgrowth of microflora in the small intestine (known as SIBO or small intestinal bacterial overgrowth) is present in 90-100 percent of patients with fibromyalgia. Many experts believe that SIBO, increased intestinal permeability and decreased production of coenzyme Q10 may be among the causes of fibromyalgia.

Associated diseases

Patients with fibromyalgia often suffer from other related diseases.These include migraine headaches, irritable bowel symptoms (bloating, abdominal pain, diarrhea and / or constipation), and interstitial cystitis. Poor sleep or insomnia are also common complaints.

Fibromyalgia symptoms

• Pain throughout the body
• Muscle weakness and hypersensitivity to pain
• Fatigue
• Depression
• Anxiety
• Irritable bowel syndrome
• Increased intestinal permeability
• Cravings for sweets

How to Reverse Fibromyalgia

Detoxify the body

Over the past 100 years, companies have created and released thousands of chemicals into water sources, air and even homes.That being said, we still know almost nothing about how most of these chemicals affect us. However, we know for sure that many of them have negative health effects, including fibromyalgia. Toxic chemicals accumulate in every person’s body, and this cannot be completely avoided. But you can try to minimize the long-term effects of their exposure. Detoxifying the body is critical to strengthening and healing it. Learn more about body detoxification.

Take care of the intestines

Irritable bowel syndrome (IBS) has been diagnosed in many patients with fibromyalgia. Evidence suggests that gastrointestinal problems may be the cause of fibromyalgia, and not just related illnesses. Studies show that leaky gut syndrome, or small intestinal overgrowth (SIBO), plays a role in fibromyalgia. In 2004, Dr. Mark Pimentel in his study showed that patients with a predominant “bad” bacteria in the gut experienced more pain associated with fibromyalgia.Dr Alex Vasquez also noted that the LSP (lipopolysaccharide-binding protein) protein in these bacteria, when injected into a human, could mimic the pain felt by fibromyalgia patients.

Tidy up your diet

For any chronic illness, it is important to avoid highly processed foods. Processed foods contain chemicals that are foreign to the human body (xenobiotics) and have effects on our physiology that we do not fully understand.These substances include food preservatives and food colorings.

A good start is switching to a diet high in fruits and vegetables. If possible, pesticide-free (organic) fruits and vegetables should be purchased. Also, buy grass-fed meat that is free of antibiotics and hormones. While this meat will be more expensive, there is potential for cost savings if it helps prevent chronic disease and improve quality of life.

Artificial sweeteners and MSG should also be avoided. Aspartame (NutraSweet) has been reported to not only cause migraine headaches but has been linked to other neurological problems. Studies have shown improvement in fibromyalgia symptoms in patients with sensitivity to aspartame and MSG (monosodium glutamate) when these chemicals are eliminated from the diet.

A 2017 study published in the journal Nutricion Hospitalaria found that fibromyalgia patients who were on a low FODMAP diet had decreased pain caused by fibromyalgia.A diet low in FODMAP often helps improve digestion in patients with IBS and leaky gut.

Physical activity

Exercise has been shown to benefit patients with fibromyalgia. Various studies have confirmed that aerobic exercise can help reduce pain levels as well as improve overall functional ability. Exercise helps improve mitochondrial health.

FDA-approved drugs for the treatment of fibromyalgia

In my opinion, the use of medication should be the last resort, used only after it turns out that dietary and lifestyle changes are not enough.Medication is not meant to treat fibromyalgia, but it allows you to live comfortably with the medication indefinitely.

The FDA has approved the following drugs for fibromyalgia:

Duloxetine (Simbalta) – 60 mg per day. The cost of a monthly course in the United States is $ 320.

Pregabalin (lyrics) – 150-225 mg twice a day.The cost in the US ranges from $ 415 to $ 445.

Milnacipran (Savella) 50 mg twice daily The cost in the US is $ 397.

Other commonly used drugs not approved by the FDA include gabapentin, amitriptyline, and fluoxetine. These drugs are not patented, but they show similar results at a lower cost.

Fibromyalgia is often treated with drugs (opiates), although there is no evidence that such treatment is effective.In fact, drugs are more harmful and appear to increase overall pain levels in the long term. Opiates include tramadol, fentanyl, hydrocodone, oxycodone, and morphine.

Supplements for fibromyalgia

Various supplements have been shown to be helpful in relieving symptoms of fibromyalgia.Many people take one supplement at a time, don’t notice the difference, and stop taking it. Supplements can have synergistic effects. Successful people often start with one supplement, add a second, and possibly a third, until they see improvement. It is important to focus on diet and lifestyle changes first, as noted above.

Vitamin D – The most common symptom of vitamin D deficiency is muscle pain. Research shows that patients with fibromyalgia have lower vitamin D levels than controls.A study published in the journal Clinical Rheumatology in 2017 found that when vitamin D levels were replenished, pain relief was reduced in patients with fibromyalgia. Many other studies have shown similar results. Correcting vitamin D deficiency is critical before diagnosing fibromyalgia, as low vitamin D also causes muscle pain. Recommended dose: 2000-5000 IU per day. Learn more about vitamin D.

Magnesium – Research shows that magnesium, which naturally relaxes muscles, may be beneficial for patients with fibromyalgia.A 2013 study published in the journal Rheumatology International found that oral magnesium citrate reduced pain in patients with fibromyalgia. In addition, a 2015 study reported in the Journal of Integrative Medicine showed that there was also a reduction in pain when magnesium chloride was applied to the skin. Several studies also support the benefits of combining magnesium and malic acid.Magnesium is available in capsules, sprays and lotions. Recommended Oral Dose: Magnesium Chelate 125-500 mg or as directed on the label.

Melatonin is a sleep hormone secreted by the pineal gland every night. This hormone has antioxidant properties and also promotes restful sleep. A 2016 study published in the compilation Pain and Therapy, found melatonin to reduce pain caused by fibromyalgia.A 2015 study showed similar results. Recommended dose: 3-10 mg of melatonin every evening.

Coenzyme Q10 – Mitochondrial dysfunction is a popular theory for the cause of fibromyalgia and appears to contribute to its symptoms. A 2012 study by the scientific journal PLOS ONE, found that coenzyme Q10 was lacking in fibromyalgia patients, and supplementation of this coenzyme helped reduce headaches in these patients.A Spanish study found that women with fibromyalgia who took 300 mg of CoQ10 daily had marked improvement in symptoms. Recommended dose: 100-300 mg CoQ10 per day.

S-adenosylmethionine (SAM-e) – A double-blind, placebo-controlled study conducted in 1991 showed that SAM-e may be beneficial for patients with fibromyalgia. Recommended dose: 800 mg SAM-e per day.

Thiamin (Vitamin B1) – Several studies show thiamine is beneficial for patients with fibromyalgia.A study published in 2013 in BMJ Case Reports almanac showed improvement in fibromyalgia symptoms with the addition of 300 g of thiamine per day, gradually increasing to 1,800 mg per day.

5-Hydroxytryptophan (5-HTP ) – A 1990 study published in the Journal of International Medical Research found that 5-HTP may improve symptoms of fibromyalgia.A 1992 study showed similar results. Recommended Dose: Take as directed on the label.

L-Carnitine – According to a 2007 study, this supplement is beneficial for reducing pain symptoms in fibromyalgia syndrome. Recommended Dose: Take as directed on the label.

Spirulina – A small study has shown that spirulina can help reduce the symptoms of fibromyalgia.Perhaps this is due to the prebiotics it contains (food for healthy gut bacteria) and the ability to remove toxins from the body.

Essential oils for fibromyalgia

Essential oils can be applied to painful muscles and joints. Recommended oils for fibromyalgia include frankincense, wintergreen, lavender, rosemary, clove and chamomile essential oils. Learn more about essential oils and their benefits.

Other alternative treatments

Massage, yoga, acupuncture, qigong, and traditional Chinese medicine (TCM) are other fibromyalgia treatments that help improve quality of life and should be included in the healing process.

Fibromyalgia symptoms can be improved.

In general, fibromyalgia is a very complex disease that causes suffering to many people. The most important thing is to restore balance and strive for recovery. It is recommended to avoid foods that worsen the condition and switch to a diet rich in fruits and vegetables. An elimination diet is also helpful – start by eliminating dairy, gluten, and corn products. Drugs can make a person feel better, but when taken for a long time, they only worsen the pain caused by fibromyalgia.Research has shown the benefits of exercising, possibly related to the production of extra mitochondria and the ability to reduce chronic inflammation. Supplements can also be very helpful. Start by replenishing your vitamin D levels, then add additional supplements every 1 to 2 weeks until symptoms improve. Eat healthy food, be healthy, and stay healthy.

Reference information:

1. An internet survey of 2,596 people with fibromyalgia.Bennett RM, Jones J, Turk DC, Russell IJ, Matallana L. BMC Musculoskelet Disord. 2007 Mar 9; 8 (): 27.
2. Abdullah M, Vishwanath S, Elbalkhi A, Ambrus JL. Mitochondrial myopathy presenting as fibromyalgia: a case report. Journal of Medical Case Reports. 2012; 6: 55. doi: 10.1186 / 1752-1947-6-55.
3. Cordero MD, De Miguel M, Moreno Fernández AM, et al. Mitochondrial dysfunction and mitophagy activation in blood mononuclear cells of fibromyalgia patients: implications in the pathogenesis of the disease.Arthritis Research & Therapy. 2010; 12 (1): R17. doi: 10.1186 / ar2918.
4. Pimentel M, Wallace D, Hallegua D, et al. A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing. Annals of the Rheumatic Diseases. 2004; 63 (4): 450-452. doi: 10.1136 / ard.2003.011502.
5. Vasquez A. Fibromyalgia in a Nutshell: A Safe and Effective Clinical Medicine Strategy. Philadelphia, PA: BookBaby; 2012.
6. Clin Exp Rheumatol.2010 Nov-Dec; 28 (6 Suppl 63): S131-3. Epub 2010 Dec 22.
7. Ann Pharmacother. 2001 Jun; 35 (6): 702-6.
8. Nutr Hosp. 2017 Jun 5; 34 (3): 667-674. doi: 10.20960 / nh.703.
9. Benefit of exercise in fibromyalgia- Accessed December 2, 2017 http://www.cochrane.org/CD003786/MUSKEL_exercise-for-fibromyalgia
10. Price for prescription drugs is based on December 2017 pricing from goodrx.com Site accessed December 2, 2017 https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia
11. Makrani AH, Afshari M, Ghajar M, Forooghi Z, Moosazadeh M.Vitamin D and fibromyalgia: a meta-analysis. The Korean Journal of Pain. 2017; 30 (4): 250-257. doi: 10.3344 / kjp.2017.30.4.250.
12. Clin Rheumatol. 2017 Dec; 36 (12): 2825-2833. doi: 10.1007 / s10067-017-3754-y. Epub 2017 Aug 15.
13. Rheumatol Int. 2013 Jan; 33 (1): 167-72. doi: 10.1007 / s00296-011-2334-8. Epub 2012 Jan 22.
14. J Integr Med. 2015 Sep; 13 (5): 306-13. doi: 10.1016 / S2095-4964 (15) 60195-9.
15. Danilov A, Kurganova J. Melatonin in Chronic Pain Syndromes.Pain and Therapy. 2016; 5 (1): 1-17. doi: 10.1007 / s40122-016-0049-y.
16. De Zanette SA, Vercelino R, Laste G, et al. Melatonin analgesia is associated with improvement of the descending endogenous pain-modulating system in fibromyalgia: a phase II, randomized, double-dummy, controlled trial. BMC Pharmacology & Toxicology. 2014; 15:40. doi: 10.1186 / 2050-6511-15-40.
17. Mitochondrion. 2011 Jul; 11 (4): 623-5. doi: 10.1016 / j.mito.2011.03.122. Epub 2011 Apr 7.
18. Cordero MD, Cano-García FJ, Alcocer-Gómez E, De Miguel M, Sánchez-Alcázar JA.Oxidative Stress Correlates with Headache Symptoms in Fibromyalgia: Coenzyme Q10 Effect on Clinical Improvement. Mendelson JE, ed. PLoS ONE. 2012; 7 (4): e35677. doi: 10.1371 / journal.pone.0035677.
19. Alcocer-Gómez, E., Culic, O., Navarro-Pando, J. M., Sánchez-Alcázar, J. A. and Bullón, P. (2017), Effect of Coenzyme Q10 on Psychopathological Symptoms in Fibromyalgia Patients. CNS Neurosci Ther, 23: 188-189. doi: 10.1111 / cns.12668
20. Scand J Rheumatol. 1991; 20 (4): 294-302.
21. Costantini A, Pala MI, Tundo S, Matteucci P. High-dose thiamine improves the symptoms of fibromyalgia. BMJ Case Reports. 2013; 2013: bcr2013009019. doi: 10.1136 / bcr-2013-009019.
22. J Int Med Res. 1990 May-Jun; 18 (3): 201-9.
23. J Int Med Res. 1992 Apr; 20 (2): 182-9.
24. Rossini M, Di Munno O, Valentini G, Bianchi G, Biasi G, Cacace E, Malesci D, La Montagna G, Viapiana O, Adami S. Double-blind, multicenter trial comparing acetyl l-carnitine with placebo in the treatment of fibromyalgia patients.Clin Exp Rheumatol. 2007; 25: 182-188.
25. Merchant RE, Andre CA. A review of recent clinical trials of the nutritional supplement Chlorella pyrenoidosa in the treatment of fibromyalgia, hypertension, and ulcerative colitis. Altern Ther Health Med. 2001; 7: 79-80.82-91.
26. Sawynok J, Lynch ME. Qigong and Fibromyalgia circa 2017. Liu W, Litscher G, eds. Medicines. 2017; 4 (2): 37. doi: 10.3390 / medicines4020037.
27. Cao H, Liu J, Lewith GT. Traditional Chinese Medicine for Treatment of Fibromyalgia: A Systematic Review of Randomized Controlled Trials.Journal of Alternative and Complementary Medicine. 2010; 16 (4): 397-409. doi: 10.1089 / acm.2009.0599.

This article was written by Eric Madrid, MD, Fellow of the American Council for Integrative and Holistic Medicine, and certified by the American Council of Family Medicine and the American Council of Integrative and Holistic Medicine. He is the author of Vitamin D Prescription, Healing Sun Energy.Eric Madrid graduated from Ohio State University Medical School. He is a partner of the Rancho Family Medical Group and leads patient visits in Menifi, California. More information about Dr. Madrid here.

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90,000 How I Live With Enduring Pain – Wonderzine

Unfortunately, the restrictions imposed by this disease are no longer just restrictions, but a completely new way of life.I used to be able to put things in order during the day, go to the store, cook something and talk to someone else in the evening. Now there are good days when I can do something on the to-do list, and bad days when I have to just lie down. Of course, there are also trips or moving – it’s all very painful and inconvenient. It is important to carry your recipes with you. In Berlin, where my diagnosis was confirmed, but they also don’t know how to treat, I was mercifully given opioid pain relievers – of course, if they are with me, then it’s better to keep the prescription in my bag.

Also, since you look like a healthy person, it can be very difficult to ask for help. But now I don’t give a damn about everyone and don’t lift my bag at all; I go up to any person, I ask for help, and they help me. There are completely awkward situations. In Moscow, at the station, it seems, Leningradsky, I did not catch the train and had to wait for the next one. Of course, I was in great pain, albeit under the pills. There is a fence, behind which there are chairs, but only people with disabilities are allowed there.I have no disability, because it is impossible to prove it in Russia. I know Americans and Europeans who have it – and it makes life much easier at times like this.

At first I expected that they would find this unknown diagnosis and tell me why everything hurts so much. Then I found out the diagnosis and realized that there was no medicine. I probably still haven’t fully accepted it. For a year and a half after the diagnosis, I just lay face down in the pillow. There were times when I couldn’t wash myself because of the pain.VGIK began to disappear from my life, where I am studying to be a screenwriter. There are a lot of projects – and I’m just lying at home. Month after month. I can’t make an appointment – what if there will be an aggravation? I need to work, I need to write scripts and make films, but I don’t know how. To be honest, I’m not a hero, I’m not a #fibrofighter (there is such a top tag on Instagram) – I’m afraid of everything and I see my weakness. It’s very difficult for me – but I continue to live from day to day.

I think that even with constant pain, or bipolar disorder, which I also have, or systemic lupus erythematosus, which can start at any time, you need to try to get up every morning and do something.Yes, for the first year and a half I lay face down in a pillow and was in a wheelchair; even now it can be hard to shower. But there are also days when I get up and go to shoot a movie, I’m on the set and ready to drink all the drugs in the world, just to stay on the wave – this is the only thing that helps. I made my first film with Pyotr Mamonov, showed it at world festivals, received awards, I am preparing the next work – all with the same fibromyalgia as in the beginning. It is very important for me to have something to live for.You don’t have to be Lady Gaga, but finding the meaning to get up every morning with such pain is a must.

90,000 Fibromyalgia: 10 Commandments for Those with Chronic Pain | Health

Chronic pain is a familiar condition, and fibromyalgia is a common type. This is a chronic condition with symptoms such as muscle and tissue pain, fatigue, depression and sleep problems. The relationship between fibromyalgia and diet has been little researched, but it can still be beneficial to stick to a diet.

Chronic pain is a familiar condition to many, and fibromyalgia is a common type. This is a chronic condition with symptoms such as pain in the muscles and tissues, fatigue, depression and sleep problems. The relationship between fibromyalgia and diet has not been well researched yet, it will still be beneficial to adhere to this dietary protocol. Among other things, these tips may come in handy if you have chronic pain.

Recommendations for fibromyalgia

Diet principles

• Limit sugar intake as much as possible.Increased insulin usually aggravates pain significantly. For this reason, it is important to minimize the consumption of a wide range of sugary foods – this also applies to fruit juices.

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Fresh fruits are preferably eaten whole, excluding their culinary processing.

• If you are overweight, high blood pressure, high cholesterol, diabetes, it makes sense to minimize your intake of grains, because they are broken down similarly to sugar.This also applies to organic unprocessed grains. Most importantly, avoid wheat and gluten-free grains.
• Eat fresh food. A diet of fresh foods without food additives (all kinds of preservatives, stabilizers, colors, flavors) will ease symptoms triggered by concurrent ailments such as irritable bowel syndrome.
• Ideally, it is recommended to purchase organic food, as this is the optimal option to avoid the negative effects of pesticides and chemicals.
• Say no to caffeine. It is believed that fibromyalgia is related to an imbalance in the chemicals in the brain that “control” mood, often caused by sleep deprivation and fatigue. Caffeine certainly provides a short-term boost of energy, but it is not a substitute for proper rest.
• Avoid Solanaceae. Vegetables of the nightshade family (tomatoes, potatoes and eggplants, in certain individuals can provoke arthritis and pain.
• Be careful with fats.Animal-derived omega-3s (DHA, EPA) are beneficial for heart function and may relieve pain. These substances can reduce inflammation and optimize brain function. In parallel with this, it makes sense to remove trans fats and fried from the diet.
• Moderate use of yeast. The use of yeast in cooking can favor the development of yeast colonies, which is likely to result in pain.
• Avoid pasteurized dairy products. Individuals with fibromyalgia have difficulty digesting milk and milk products.
• Minimize carbohydrate intake. About 90% of people with fibromyalgia have decreased adrenal function. And this negatively affects the metabolism of carbohydrates and suggests the risk of hypoglycemia.
• Avoid aspartame. A synthetic sugar substitute found in a number of drinks and sweets belongs to a group of compounds called excitotoxins. The latter activate neurons that increase the sensitivity to pain.
• Remove junk food from the diet.It is necessary to give up fast food, processed foods. These food saboteurs have the properties of irritating muscles, negatively affecting the quality of sleep and weakening the body’s immune response.

Determining your food type is important in fibromyalgia

It should be said right away that food type is not a diet. It’s just a way to find out which of the 3 groups you belong to. There are protein, carbohydrate, mixed types of food.

Eating in accordance with the indicated types helps to reduce the manifestations of fibromyalgia.But, nutrition by its nutritional type does not act as a comprehensive solution to the existing problem.

10 Commandments of the Diet

General dietary principles that are absolute and immutable in other fibromyalgia conditions.

1. Avoid synthetic sweeteners.

2. Diet variety including fresh, organic, whole foods. Unprocessed fruits and vegetables are high in antioxidants that have anti-inflammatory effects.

3. Maximum of raw products – sources of enzymes and biophotons. Heat treatment of food at t above 50 ° kills enzymes.

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4. Drink a sufficient amount of filtered water without fluoride (F).

5. Exclude all kinds of chemical additives and processed foods.

6. Minimize or eliminate the consumption of sugar and caffeine in any variation.

7.Refuse to drink alcohol.

8. Strive to introduce into the menu the maximum amount of omega-3 fatty acids of animal origin (sources – fish oil, krill oil). Omega-3s relieve inflammation, joint pain, swelling and act as natural pain relievers.

9. To consume coconut and coconut oil – they are useful for people suffering from fibromyalgia and other pathologies.

10. Eating should be done slowly, chewing thoroughly and getting satisfaction from the process.

Food Sensitivity

If you’ve adopted these nutritional guidelines and want to learn more about which foods will potentially worsen your symptoms, the second step is to refine your diet based on your food type.

Individuals with fibromyalgia have been reported to show fewer symptoms when one or more food allergy trigger foods are removed from the dietary protocol.

Typical foods that cause problems of this nature include corn, wheat, soybeans, dairy products, citrus fruits and sugar.The most irritating are pasteurized milk, soy and gluten.

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Other factors to be aware of

• Inadequate sleep is often a problem in fibromyalgia.
• Exercise can relieve pain in fibromyalgia. In addition, the psychoemotional state of patients improves.
• Vitamin D deficiency can worsen fibromyalgia.* published by econet.ru.

* Articles of Econet.ru are intended for informational and educational purposes only and do not replace professional medical advice, diagnosis or treatment. Always consult your doctor for any questions you may have about your health condition.

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P.S. And remember, just by changing our consumption – together we are changing the world! © econet

Source: https://econet.ru/

Symptoms and treatment of fibramyalgia

Fibromyalgia is a complex of symptoms that is manifested by chronic, widespread muscle pain and the presence of tender points in certain anatomical areas. This disease is accompanied by sleep disorders, fatigue, increased anxiety, memory impairment, depressive disorders.Fibromyalgia is more common in middle-aged and older women.

The causes of this disease are not fully understood. Studies by different authors indicate that gender, hereditary predisposition, age, physical or psychological stress, exposure to viruses can influence.

There is, unfortunately, no special laboratory test for fibromyalgia, radiation methods are also likely to be powerless. The main symptom is pain in soft tissues or increased sensitivity when there are no other reasons (inflammation, trauma) for their appearance.

Provoking factors:

• physical fatigue;
• cold and humidity;
• hormonal imbalance;
• emotional experiences;
• long-term overvoltage;
• long-term stay of the body in a motionless state.

Characteristics of pain syndrome

Fibromyalgia is characterized by diffuse, persistent pain for more than 3 months.Often, due to its debilitating nature, patients refer to it as “toothache.” The condition is aggravated as a result of overwork, physical overload, emotional stress, a long stay in one position. And the most important characteristic is that pain constantly accompanies a person throughout the day.

Fibromyalgia Treatment

To develop a treatment plan, you need to contact a neurologist or rheumatologist. As a rule, treatment requires an integrated approach, and combines several techniques, including massage in its various manifestations: classic manual, electrostatic, shock wave therapy.

Artus Clinic applies only the best methods to improve the quality of life and health of its patients. The center uses physiotherapy equipment from leading European manufacturers such as Great Britain, Germany and the USA.

Physiotherapy in the Artus clinic will help relieve acute pain syndrome, relax muscle tissue in fibromyalgia.

You can make an appointment at any time convenient for you or consult on the issue of the disease by phone: 8 (843) 252-42-00, 252-43-00.

Diagnosis and Treatment of Fibromyalgia | # 05/12

Fibromyalgia is a complex disorder with widespread musculoskeletal pain, depression, sleep disturbance, morning stiffness, and fatigue. The disease is also characterized by the presence of painful areas on the body – the so-called “pain points”. Women are more susceptible to developing this disease than men. Among all forms of chronic pain syndromes, fibromyalgia is the leader in terms of the prevalence of depression, the degree of maladjustment of patients suffering from this disease, i.e.That is, according to the degree of decline in their quality of life. Fibromyalgia is a disease that comes to the attention of not only rheumatologists, neurologists, pain specialists, but also general practitioners. According to statistics, fibromyalgia affects 2–4% of the population. However, despite its prevalence, the diagnosis of fibromyalgia in the world, in particular in Russia, is extremely rare. This is due to the unusual manifestations of the disease, insufficient awareness of doctors and the lack of clear diagnostic criteria.

History

Although the term “fibromyalgia” was introduced relatively recently, this condition has long been described in the scientific literature. In 1904, William Gowers coined the term fibrositis. In the second half of the twentieth century, some doctors believed that fibrositis was a typical cause of muscle pain, others believed that fibrositis was a consequence of “stress” or “psychogenic rheumatism”, and the rheumatology community did not consider this pathology at all. The modern concept of fibromyalgia was created by Smythe and Moldofsky in the mid 70s of the last century.They introduced a new term “fibromyalgia”. The authors identified the presence of local hypersensitivity, the so-called tender points, as a characteristic symptom of fibromyalgia. In addition, they found that patients with fibromyalgia often have sleep disturbances. The next step in the study of fibromyalgia was the development of the American College of Rheumatology (ACR) diagnostic criteria for fibromyalgia, which were published in 1990 [3].Significant progress in the study of fibromyalgia was made after researchers concluded that the condition was not caused by peripheral tissue damage or inflammation. Therefore, all efforts were directed to the study of the central mechanisms of pathogenesis.

Etiology and pathogenesis

One of the most important mechanisms of the formation of chronic pain in fibromyalgia is the phenomenon of central sensitization (CS). It is characterized by the fact that after prolonged peripheral nociceptive stimulation, a certain level of excitation remains in the central sensory neurons of the dorsal horn, which maintains pain even in the absence of further peripheral pathology.However, numerous studies have demonstrated that CS can develop in disorders of the central nervous system without peripheral damage. An example is fibromyalgia. That pain may be the result of changes in the central nervous system and a “real” neurobiological phenomenon that contributes to the formation of pain seems unlikely to many. Often, patients with fibromyalgia who do not show peripheral changes are considered by doctors as simulants or patients with hysteria. Some doctors, in situations where they cannot find the organic cause of pain, choose to use diagnostic labels such as psychosomatic and somatoform disorders.

However, today it has been convincingly shown that CS, as well as a violation of the descending (noradrenergic and serotonergic) inhibitory control of pain, occur in fibromyalgia not as a result of peripheral changes in muscles, fascia, ligaments or connective tissue, but as a result of neurodynamic disorders in the central nervous system in individuals with a genetic predisposition to exposure to a large number of stressful (physical and mental) events (Table 1).

Research on fibromyalgia over the past two decades has shown that pain threshold is related to the degree of distress.Many psychological factors, such as hypervigilance, suspiciousness, catastrophization, and the external locus of pain control, can play an important role in the severity of fibromyalgia symptoms. Special studies have shown that serotonergic and noradrenergic activity is reduced in patients with fibromyalgia. It was also found that in patients with fibromyalgia, there is a decrease in serum serotonin and its precursor L-tryptophan and a decrease in the main metabolite of serotonin in the cerebrospinal fluid, 5-hydroxyindole acetate.Supporting these findings is the fact that drugs that simultaneously increase serotonin and norepinephrine levels (tricyclic antidepressants, duloxetine, milnacipram, and tramadol) are effective in treating fibromyalgia. Neurobiological evidence that fibromyalgia is a condition with increased pain sensitivity (CS) and impaired perception processes is confirmed by the results of hardware diagnostic methods: single-photon emission computed tomography and functional magnetic resonance imaging [1, 2].

Clinical presentation and diagnosis

In 1990, the American College of Rheumatology developed guidelines for the diagnosis of fibromyalgia (ACR criteria) (Table 2) [3]. Although these criteria are not intended to be used in a clinical setting, but only in research, they nevertheless provide more than 85 percent accuracy in the differential diagnosis of patients with fibromyalgia from similar diseases.

The main symptom of fibromyalgia is chronic diffuse pain, not caused by any pathology of the musculoskeletal system, which bothers the patient for at least three months.The pain is diffuse, spreading throughout the body above and below the waist. Typically, patients describe their condition as “I feel like I have pain everywhere” or “I feel constantly cold”. Patients usually describe pain that spreads to all muscles, but sometimes they also report pain and swelling in the joints. In addition, patients often complain of paresthesias, numbness, tingling, burning, creeping sensation on the skin, especially in the legs and arms.

In patients with fibromyalgia, physical examination reveals only tenderness or tenderness at specific points in the body.Exploring painful spots requires experience. The doctor should know exactly where to palpate and with what force. According to the ACR criteria, 9 pairs of painful points in fibromyalgia were identified (Fig.).

The pressure produced at these points should be 4 kg / cm – the pressure at which the researcher’s nail beds turn white. When performing palpation of 18 painful points, it is recommended to apply uniform pressure on the paired points and, with the same effort, palpate other parts of the body to compare sensitivity.In patients with fibromyalgia, tender points have increased sensitivity compared to other parts of the body. Painful points reflect areas of increased sensitivity to pain stimuli, and are not the result of local inflammation or tissue damage.

The presence of a positive reaction in more than 11 of 18 painful points was determined by the diagnostic criterion based on the analysis of statistical data from large populations of patients. However, not all patients with fibromyalgia will necessarily have increased sensitivity at more than 11 points.Again, the ACR criteria for fibromyalgia are for research purposes and not for specific patient diagnoses. Nevertheless, the examination of painful points is considered an important part of the study of the functioning of the musculoskeletal system in patients with generalized pain syndrome. Palpation of soft tissues and joints allows you to identify areas of increased sensitivity. This examination excludes synovitis or myositis and is very important in the diagnosis of fibromyalgia.

As can be seen from the ACR criteria, fibromyalgia is more than just pain. This condition includes a whole range of disturbing symptoms for the patient. Along with chronic diffuse pain, fatigue is another common symptom of fibromyalgia. This symptom is most pronounced upon awakening, but also occurs in the afternoon. Slight physical activity can dramatically increase pain and fatigue, although prolonged rest and inactivity can also exacerbate symptoms.

Fibromyalgia patients feel stiff in the morning and feel sleepy, even if they slept for 8-10 hours. Such patients usually do not sleep well, often wake up and find it difficult to fall asleep. Usually patients say: “It does not matter how long I slept, but I feel like I was run over by a truck.”

Behavioral and psychological factors play a role in the development of the clinical picture of fibromyalgia. It has been found that the prevalence of psychiatric comorbidities in patients with fibromyalgia can reach from 30% to 60%, and the incidence of mental disorders is even higher.Depression and anxiety disorders are the most common conditions. In addition, most patients have cognitive impairment. For example, sufferers usually describe their problems with concentration or attention as “head fog”.

The FiRST (Fibromyalgia Rapid Screening Tool) questionnaire has recently been proposed for screening for fibromyalgia (Table 3). The advantages of the questionnaire are its brevity and ease of filling out. Its high sensitivity (90.5%) and specificity (85.7%) should be emphasized.It is important to note that the questionnaire is intended for screening and cannot be used for diagnosis alone. Patients who scored 5 or more points on the FiRST questionnaire should be carefully examined for a reliable diagnosis of fibromyalgia.

Fibromyalgia Treatment

Non-drug treatment

A specially conducted analysis of various non-drug methods of treating fibromyalgia showed that two methods have significant efficacy – cognitive behavioral therapy and physical education (tab.4) [4]. With both treatments, there was a persistent improvement in fibromyalgia symptoms for one year or more.

Drug treatment

Antidepressants

Among the drugs, tricyclic antidepressants (TCAs) were among the first to treat pain in fibromyalgia. It has been shown that amitriptyline is able to relieve the intensity of pain, strengthen sleep and reduce fatigue in patients with fibromyalgia [5].At the same time, antidepressants from the group of selective serotonin reuptake inhibitors (SSRIs) (fluoxetine, sertraline, citalopram, paroxetine) showed low efficacy in randomized, placebo-controlled studies in fibromyalgia [5].

Serotonin and norepinephrine reuptake inhibitors (SNRIs) (venlafaxine, duloxetine, milnacipran) were found to be more effective than SSRIs. These drugs, as well as TCAs, inhibit the reuptake of serotonin and norepinephrine, however, unlike TCAs, they practically do not affect other receptors.This selectivity leads to fewer side effects and better tolerance. Evidence for venlafaxine suggests its successful use in the treatment of neuropathic pain and fibromyalgia [6].

In studies using duloxetine, there was a more pronounced decrease in the overall score on the Fibromyalgia Impact Questionnaire (FIQ) fibromyalgia scale [7] and a 30% reduction in pain in 54% of those taking the drug compared with 33% of those in the placebo group [8, 9]. Duloxetine is approved by the US Food and Drug Administration (FDA) as an SNRI for the treatment of major depressive disorder, neuropathic pain in diabetes mellitus and fibromyalgia.

Milnacipran, which is widely used as an antidepressant, is FDA approved for the treatment of fibromyalgia. In a 12-week randomized clinical trial (RCT), 125 patients with fibromyalgia received either milnacipran once or twice daily (at doses up to 200 mg / day) or placebo [10]. Only 37% of patients with fibromyalgia achieved a 50% reduction in pain with a double dose, 22% with a single dose, and 14% with a placebo. In a 27-week study of milnacipran in 888 patients with fibromyalgia, the pain intensity decreased by at least 30% in 56% of cases, compared with 40% in the placebo group [11].Side effects were usually mild and nausea and headache were most common.

Despite the fact that many chronic pain syndromes, including fibromyalgia, are accompanied by depression, some studies have shown that the analgesic activity of antidepressants does not depend on their effect on the emotional status of patients [7-11].

A recent meta-analysis of 18 RCTs confirmed that antidepressants can reduce pain in fibromyalgia, reduce depression, fatigue, restore sleep and improve quality of life [5].

Anticonvulsants

Pregabalin

Pregabalin, an alpha-2-delta calcium channel ligand, is approved for the treatment of neuropathic pain and was the first drug approved by the FDA for the treatment of fibromyalgia.

Pregabalin (Lyrica) is the first and so far the only drug in Russia officially registered for the treatment of fibromyalgia. Pregabalin binds to the alpha-2-delta site of voltage-gated calcium channels in the central nervous system.Due to a decrease in the influx of calcium into neurons, the release of substance P, glutamate and norepinephrine decreases, providing the analgesic and anxiolytic effect of pregabalin. The activity of this drug is limited to neurons and does not affect vascular calcium channels.

In a large RCT of 528 patients with fibromyalgia, pregabalin showed significant reductions in pain score, improved sleep quality, decreased fatigue, and improved overall well-being [12]. Study participants received a placebo or one dose of pregabalin (150, 300, or 450 mg / day) for 8 weeks.All patients taking the drug showed improvement within 2 weeks, which persisted until the end of the study. A follow-up 6-month, placebo-controlled study enrolled 566 fibromyalgia patients who completed the 6-week open-label study and responded to treatment (responders) [13]. Monotherapy was carried out with pregabalin 300, 450 or 600 mg / day (twice a day). As a result, it was shown that the response to treatment with pregabalin is prolonged in time.The time to decrease in therapeutic response was significantly shorter in placebo-treated subjects than in pregabalin-treated subjects. With prolonged therapy, pregabalin led to a later deterioration in parameters such as sleep disturbance, fatigue and general well-being of the patient. Two other large RCTs, where treatment lasted 13-14 weeks, showed that pregabalin monotherapy was effective in reducing pain intensity in fibromyalgia at doses of 300, 450, and 600 mg / day [14, 15]. The efficacy of pregabalin in the treatment of fibromyalgia was evaluated in a meta-analysis of the results of six RCTs in which more than 2000 patients with fibromyalgia participated [16, 17].It was shown that pregabalin caused a decrease in pain in fibromyalgia, improved sleep and improved quality of life, but did not affect the severity of depressive mood. In addition, patients with fibromyalgia treated with pregabalin experienced reductions in fatigue and anxiety.

Gabapentin

Gabapentin, whose pharmacological properties are similar to pregabalin, was used in a 12-week RCT in 150 patients with fibromyalgia [18]. There was a significant decrease in the mean pain intensity score in the gabapentin group than in the placebo group.In addition, gabapentin significantly improved the FIQ fibromyalgia severity score, the Patient Global Impression of Change (PGIC) score and the sleep quality score. Compared with placebo, gabapentin significantly increased the incidence of sedation, lightheadedness, and dizziness.

Tramadol

Tramadol is a centrally acting analgesic that binds to mu-opioid receptors and inhibits the reuptake of norepinephrine and serotonin.The combination of paracetamol (acetaminophen) with tramadol in a ratio of 8: 1 showed synergism of both drugs in preclinical pain patterns. During a 13-week multicenter RCT, tramadol / paracetamol at doses of 37.5 mg / 325 mg relieved fibromyalgia pain more effectively than placebo [21]. All adverse events reported in this study (transient and non-serious adverse events) were well-known complications of tramadol: dizziness (vertigo), nausea, vomiting, constipation, drowsiness, headache and weakness.

Benzodiazepines

The effectiveness of benzodiazepines in the treatment of fibromyalgia is not fully understood. Many studies have produced conflicting results. For example, benzodiazepines, including alprazolam (0.5–3.0 mg at bedtime), did not show an advantage over placebo for the treatment of pain in fibromyalgia, but clonazepam was quite effective in relieving temporomandibular joint pain, which is often observed in fibromyalgia [22, 23]. In addition, this drug has been effective in relieving restless legs syndrome, which is a common cause of restless and intermittent sleep in patients with fibromyalgia.

Local anesthetics

Systemic use of lidocaine was used to treat patients with fibromyalgia: single and course infusions of lidocaine at doses of 5–7 mg / kg led to a rather noticeable reduction in pain in patients with fibromyalgia [24]. In a recent RCT in patients with fibromyalgia, 50 mg of lidocaine was injected into a painful point in the trapezius muscle. As a result, not only a local reduction in pain at the injection site was observed, but also a general analgesic effect [25].This study demonstrated the important role of peripheral tissues in the development of hyperalgesia in fibromyalgia and proved the clinical use of local anesthetic injections for pain relief in fibromyalgia.

Conclusion

Thus, today there are four main directions in the treatment of fibromyalgia (Table 5): 1) reduction of peripheral pain, in particular, muscle pain; 2) prevention of central sensitization; 3) normalization of sleep disorders; 4) treatment of concomitant pathology, in particular depression.The first approach is more focused on the management of acute pain in fibromyalgia and includes the use of physiotherapy, muscle relaxants, muscle injections, and analgesics. Central sensitization is successfully controlled by cognitive behavioral therapy, sleep correction, antidepressants and anticonvulsants. Sleep disturbances are corrected by stress reduction, aerobic exercise, and gamma-aminobutyric acid (GABA) agonists. Medication and behavioral therapy for secondary pain affect (anxiety, depression, fear) are among the most promising treatment strategies for fibromyalgia.Although any combination of these approaches can be very beneficial for patients with fibromyalgia, only comparative studies can provide reliable data on the effectiveness of a particular treatment. All specialists emphasize the need for an integrated multimodal approach in the treatment of fibromyalgia, including both pharmacological and non-drug methods.

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A. B. Danilov, Doctor of Medical Sciences, Professor

GBOU VPO First MGMU im.I.M.Sechenov Ministry of Health and Social Development of Russia, Moscow

Contact information about the author for correspondence: [email protected]

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