Treating One Area Can Reduce Overall Fibromyalgia Pain

by Kristin Thorson, Fibromyalgia Network Editor
Posted: October 25, 2010

Can treating your most troublesome shoulder muscle lead to a significant drop in your overall fibromyalgia pain? Yes, according to a study published online this month in the European Journal of Pain, and the same results were found for treatment of just one painful joint.1

Research during the past year shows that fibromyalgia patients have many muscles with tight, rope-like bands containing firm knots called myofascial trigger points.2,3 These trigger point areas hurt even when a person with fibromyalgia is resting. And when pressed, they also radiate pain to other muscles.

Osteoarthritis or trauma to a joint is another source of discomfort, besides trigger points, that may occur in people with fibromyalgia. One population-based study in Sweden found that joint pain was seven times more common in fibromyalgia patients than the rest of the nearly 45,000 individuals who were screened for health conditions.4

Based on the high incidence of trigger points and joint pain, Maria A. Giamberardino, Ph.D., and her team at Chieti University in Italy, designed a study to find out if effectively treating one nagging trigger point or painful joint would effect the overall impact on the body-wide pain of fibromyalgia. Only one area, a trigger point in the shoulder or a bothersome joint, was relieved of pain using regional techniques applied to the selected area. 

A series of two to four injections with anesthetic was used to treat a trigger point in one group of fibromyalgia patients. For the group of patients whose focus was pain in one joint, a combination of two anti-inflammatory medications were applied topically to the area with the aid of a tiny electrical current to help the drugs penetrate the tissues. Treatment effects after 30 days were compared to fibromyalgia patients with similar local pains that received placebo therapies.

Treating either the trigger point or the joint in the two groups of fibromyalgia patients led to a substantial reduction in pain at the local area addressed. In addition, the patients who received treatment, compared to those in the placebo group, reaped a 20 to 30% reduction in body-wide discomfort. This was assessed by an examiner who was unaware of which group (trigger point, joint pain or placebo) the patients belonged to.

“Local treatment of the peripheral muscle/joint sources not only relieves local symptoms but also significantly improves the widespread fibromyalgia symptoms,” write Giamberardino and coworkers. More specifically, they state that diffuse pain and tenderness throughout the body was greatly improved by addressing just one area.

Giamberardino suggests that the first step in treating fibromyalgia might be to target trigger points, painful joints, and other similar conditions that hurt. She points out that this could lead to a lower dose of oral drugs, minimizing the side effects that they tend to cause for patients.

Alternatively, she notes the addition of local treatments plus orally-administered medications that work systemically “could lead to better symptom control at the same doses, with obvious advantages for the patients. This is particularly important for a syndrome like fibromyalgia where management options available so far are still of limited effectiveness in a large percentage of cases.”

Three medications are currently FDA-approved for treating fibromyalgia pain (Lyrica, Cymbalta and Savella), but they only provide mild pain relief for roughly one-third of patients.5 This study shows that treatment of regional areas that hurt (such as trigger points or joints) with a variety of topical and nondrug therapies may be well worth the effort to achieve better control over fibromyalgia symptoms. There are also many self-help approaches that you may find beneficial.

1. Affaitati G, et al. Eur J Pain [Epub ahead of print] Oct.1, 2010.
2. Ge HY, et al. PAIN 147(1-3):233-40, 2009.
3. Ge HY, et al. J Pain 11:644-51, 2010.
4. Kato K, et al. Arch Intern Med 166:1649-54, 2006.
5. Hauser W, et al. J Pain 11:505-21, 2010.

12 Responses to Treating One Area Can Reduce Overall Fibromyalgia Pain

  1. Elizabeth Williamson says:

    I have been taking Zoloft for the past 15 years for my fibromyalgia. It never seems to be mentioned now. Are there better edications available?

  2. Jean Brown says:

    when my pain in my shoulders and neck are really bad, I have taken a muscle relaxer which within 15 minutes reduces the pain tremendously,and the next day it hurts less and even my achy legs are better. And for a few days feel almost normal!

  3. Cynthia says:

    Recommend tramadol 50mg taken with 0,1,or2 Tylenol 8hr-arthritis depending on the day. Tramadol is not addictive I have been taking twice a day for three years and never taken more or needed more…just like anti depressants if you decide to stop taking need to wean with dr aware
    Vitamin d And omega 3 are a must

    • pati says:

      Tramadol is addicting in the way it has a mild mood enhancer and opioid. If you stop taking it you will feel very depressed in a day and worse day 2, you may even feel like you are getting a cold or just cry for no reason. I have been taking it for about a year an when i tried to stop i started within a day to get really sad an just cry. When i took the med i felt like a completely different person.

  4. Lola Vanslette says:

    I have never heard of Zoloft for Fibromyalgia, only for chronic depression. I do take Cyclobenzaprine as a muscle relaxant 3 times a day. It seems to help, but I also take 800mg Ibuprofen and 2 extra-strength Tylenol for osteoarthritis, as needed. Is there anything anyone can do about bone-spurs in a joint? Very painful.

  5. Lindsey says:

    I recieved a series of lidacaine (anesthetic) injections in my upper back and lower back down spine once a week for 8 weeks and my symptoms and I mean all of them have been cut in half. I’m 8 weeks now since last injection and am so happy to be med free and the pain is manageable by exercise.

  6. laurie says:

    My dr. gave me an Rx for Tramadol and said use as needed. It never did a thing for me. Should I take it 2x a day with the vitamin d and omega 3? I would definitely try that if it worked for you. (I know you are not a dr.) thanks.

  7. sara says:

    I’m willing to try anything once for my pain to go away or be tolerable.

  8. Barb says:

    Diagnosed with fm in 1987, tried anti depressants, muscle relaxants, TP injections to no avail. I stopped working 13 years ago, changed my diet, no grains, dairy, sugar. As well large amounts of greens including sea vegetables in green juices & smoothies. I force myself to exercise, walk with nordic poles. As well I take Asana HP omega 3 therapeutic dose. went from 8 prescriptions to 1.

  9. Susan says:

    From personal experience: Be sure to drink a lot of water with the consumption of the greens, as they contain high levels of oxalate which can lead to kidney stones in some people.

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