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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Fibromylgia Pain

Yes I have been on Fentinal patch for R A and fibromylgia pain.I am om 75 % strength. I am in extream pain, especially from the Fibromylgia. I am on as well Methotrexate 50 mg. I am told I must be on methotrexate if I get Rotexan , which will be about every 6 Months.. My joints are swolen especially my hands The pain is sevear and the Dr. says there is not much more he can do for me. My Rhumatologist sugest I go to a pain clinic. I am also a Diabetic #2 ., on one pill a day One half in the morning and evening.Asso Im on Cimbalta for the reason to sleep better. I have had all of this for 30 yrs. Do you think anything can be done for the pain my body throughout is very week, and is this from the Fibro my lgia.. What do you think. Thank you Beth
Fri, 14 Aug 2020
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Addiction Medicine Specialist 's  Response
Hi,

Several points. Fibromyalgia implies there is not an actual problem going on. If someone is stabbed repeatedly and goes 'ouch' that is not fibromyalgia. Similarly, large stones falling on someone, pieces ripped off, severe inflammatory diseases requiring methotrexate, are all NOT fibromyalgia. Likewise, having a nerve inflammation treated with chemotherapy like methotrexate that is certainly dangerous and likely strongly carcinogenic is not ever EVER done. Not. Ever.

So, I certainly cannot comment on your situation at all. Fibromyalgia is either a rather poor term which by being defined as having pain when ju jitsu pressure submit points are hit and not being entirely happy 100% of the time would include absolutely all of us. If it were a real condition of pain wiring dysfunction it would be like what I and 5% of those from my part of the world have where opiate receptors do not function.

Fentanyl and opiates are at best utterly worthless for this. Rewiring the pain perception by non-opiate means is the standard practice. This might include any medicine that damps down nerves. Any anti-epileptic, any Lidocaine like drug, most arrhythmia medicines. Also, down regulation by constant small pain by doing moderate to high amounts of exercise daily will help. But, as mentioned, I cannot comment on your situation at all.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Matt Wachsman, Addiction Medicine Specialist
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Suggest Treatment For Fibromylgia Pain

Hi, Several points. Fibromyalgia implies there is not an actual problem going on. If someone is stabbed repeatedly and goes ouch that is not fibromyalgia. Similarly, large stones falling on someone, pieces ripped off, severe inflammatory diseases requiring methotrexate, are all NOT fibromyalgia. Likewise, having a nerve inflammation treated with chemotherapy like methotrexate that is certainly dangerous and likely strongly carcinogenic is not ever EVER done. Not. Ever. So, I certainly cannot comment on your situation at all. Fibromyalgia is either a rather poor term which by being defined as having pain when ju jitsu pressure submit points are hit and not being entirely happy 100% of the time would include absolutely all of us. If it were a real condition of pain wiring dysfunction it would be like what I and 5% of those from my part of the world have where opiate receptors do not function. Fentanyl and opiates are at best utterly worthless for this. Rewiring the pain perception by non-opiate means is the standard practice. This might include any medicine that damps down nerves. Any anti-epileptic, any Lidocaine like drug, most arrhythmia medicines. Also, down regulation by constant small pain by doing moderate to high amounts of exercise daily will help. But, as mentioned, I cannot comment on your situation at all. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist