Fibromyalgia

Lesson 5: Treatments: Traditional Medicine

Treatment for Pain

Most doctors will start by prescribing something to help the pain associated with fibro. Some of the drugs commonly prescribed include COX-2 inhibitors, Hydrocodone, Soma (carisoprodol ), Fentanyl (Duragesic), Ultracet and Ultram. Pain medications have to be prescribed and taken extremely carefully because of the risks involved. Below are some of the most commonly prescribed medications. To learn more about each, simply click on its name.

COX-2 inhibitors are an alternative to the usual non-steroidal anti-inflammatory drugs, and just as effective as the NSAIDs, but without side effects such as ulcers and gastrointestinal bleeding. The most commonly prescribed is Celebrex. Some people hail these as the future of pain relief. However, they may cause other serious problems in some patients. In fact one popular pain medication of this type, Vioxx, was recently recalled because of those side effects.
In fact, the problems with Vioxx have called most of the other COX2 inhibitors under suspicion. If you are taking any drigs in this class, please check with your doctor.
Hydrocodone is a codeine-like drug initially used as a cough suppressant. Medical studies have shown that 5 mg. of hydrocodone are equivalent to 30 g. of codeine. It has opioid properties and the potential for becoming addictive and so its use is strictly regulated. Usually it is sold in ibuprofen or acetaminophen as a prescription-only drug; the name on the bottle may be Vicoprofen. It is useful in cases of severe pain but should not be taken regularly without strict regulation by your physician. Be sure to tell your doctor about any other medications you are taking, including over the counter antihistamines.
Carisoprodol - trade name Soma - is actually a muscle relaxant but is prescribed for pain as well. As a muscle relaxant it can also help to promote better sleep. It is most useful for pain caused by muscle tightness and can be addictive if not taken carefully. Research shows that many patients who use it for more than three months begin to abuse it. It is sometimes sold under the name Vanadom.
Fentanyl, trade name Duragesic is administered through a patch similar to the nicotine patch used to help people quit smoking. The patch is worn for three days, and then replaced with a new one. The first application may take up to 72 hours to become effective. This drug is prescribed only for chronic pain and is a narcotic with addictive potential, although effective if used exactly as prescribed. Some patients, however, report that the patch is not effective for the full 72 hours, and so find that they need another medication for "breakthrough" pain.
Tramadol hydrochloric tablets, trade name Ultram is a synthetic analgesic rather than a non-steroidal anti-inflammatory drug which works directly on the brain to reduce pain, and also to reduce the size of the pain signals sent from one nerve to another. If you have been taking opioid pain medications, Ultram can reintroduce drug dependency It is best used for moderate to moderately severe pain, and appears better suited to post-surgical pain than the chronic pain of fibro.