Firbromyalgia and HGH- continued

Treatments For Fibromyalgia

Because symptoms change over time, treatment is progressive and should be individually tailored to the patient.

Exercise Therapy

Once the patient gets over the initial pain hurdle, one of the most beneficial treatments is exercise.

Exercise increases endorphins, the body's natural painkillers and sleep-deepening substances, and stimulates the secretion of human growth hormone, serotonin, and blood flow to the muscles.

A physiatrist, a physician who specializes in physical medicine and rehabilitation, should recommend and design a program tailored to the patient's condition. For example, the patient may begin with just 3 to 5 minutes of exercise per day, with slow increases to avoid inducing pain.

Swimming or exercising in water is often recommended because it puts less strain on the joints. The patient's muscles may have atrophied from prolonged inactivity. Collaborating with a physiatrist should give the patient the support needed to build up stamina.

Pharmacological Therapy

Some drugs may also help. Low dose antidepressants may help by increasing deep sleep.

A combination of a selective serotonin re-uptake inhibitor in the morning and a tricyclic antidepressant at night may be beneficial.

Some patients benefit from zolpidem (Ambien) and alprazolam (Xanax) used as short-term sleeping aids.

Muscle relaxants may help treat muscle spasm and control pain, and NSAIDs such as celecoxib (Celebrex) and rofecoxib (Vioxx) may also ease aches and pain.

Local anesthetics or corticosteroid injections at painful tender points are other options.

Because of the risk of opoid dependence, chronic opoid analgesic therapy is a last resort in patients whose pain is moderate to severe despite other therapies.

Other Therapies

Nonpharmacologic treatments include cognitive therapy and psychotherapy, which can help patients understand and deal with the pain and life changes brought about by fibromyalgia.

Massage therapy can help with general muscle aches and pains, and stretching can help limber up inactive joints.

Acupuncture can be combined with other therapies for pain relief.

Lisa Wells, RN

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