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Suffering with fibromyalgia, anxiety and depression. What treatment should be done?

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Both sides. Are. So. Sore. And. Always. Have. A. Feeling. Bladder. Is. Full . I. Suffer. With. Fibromyalgia have. Had. Numerous. Tests. Results. Are. Negative. I. Suffer. With. Anxiety. And. Depression. I have. Lost. All my confidence. And. Can't do. Any. Manual. Work. Owing. To. Feelings. In my sides. And. My. Whole. Body. Burns. With. Inflammation. + I. Had. Operation. On. Prostate. Last. Yr. they. Paired. It. Like. Slicing. An XXXXXXX +. An. Operation. In neck. Of. My. Bladder. Everything. Was. Great. For2months. And. Then. Went. Back. Where. I. Was. At. Before had. Adcortyl. Injections. Which. Helped. A. Little. While. Am. Taking. Zamadol. 50mg+lyrica. 300mg. Both. Twice. A day . My. Doctor. Refused. To. Gave. Me. A. Pain. Patch. To. See if. It. Would. Help. I found. When. I. Got. Relief. From. My. Sides. My. Bladder. Feeling. Went. Away.
Posted Thu, 15 Nov 2012 in Anxiety and Stress
Answered by Dr. Jonas Sundarakumar 7 hours later
Hello and welcome to Healthcare Magic. Thanks for your query.

I understand that you are going through a difficult time due to your health problems. Fibromyalgia is indeed a very distressing condition causing chronic pain and suffering. In addition, you also seem to be battling anxiety and depression, which would make things even more difficult for you to cope up with.

Your soreness / pain appear to be due to the fibromyalgia. Now, fibromyalgia is a chronic pain syndrome, where pain often persists for years together. Unfortunately, due to the chronic and widespread nature of the pain, treatment strategies have only partial success. Moreover, the pathology of fibromyalgia has still not been understood fully and it has been proposed that a combination of multiple factors may be responsible - such as genetic, physical and psychological factors. Typically, all medical tests turn out negative, but still the pain symptoms continue to persist.

The best approach in these cases, is a wholistic approach - where we don't focus on just prescribing pain killers alone, but rather try to help the person on the whole manage and cope up with this chronic condition. One of the major causes for pain in this condition is thought to be "a heightened perception of pain and a lower threshold for pain tolerance" in such individuals. This in turn, is thought to be due to certain neuro-chemical imbalances in the brain. This is why psychiatric disorders like anxiety and depression (which also involve similar neuro-chemical imbalances) are commonly present in persons with fibromyalgia.

Now, treatment for the chronic pain can be in the form of medication as well as psychological techniques. Other than pain killers / steroid injections, there are other effective medication also. Certain specific anti-depressants like Duloxetine, Milnacipran, etc. may not only ease the pain, but also tacke your depressive symptoms, fatigue and promote sleep. Certain centrally-acting medication like Gabapentin have also been found to be effective. Certain central muscle relaxants like Baclofen are also used. In addition, there are several effective and proven psychological techniques, which can help you handle the pain as well as the stress due to the pain. It is also important that you take treatment to handle your anxiety and depresive symptoms as that could be worsening your problem. So, I would advise you to discuss these above mentioned treatment options with your doctor.

Best wishes,

Dr. Jonas Sundarakumar
Consultant Psychiatrist
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