Treatment list
Shortest summary/appetizer
- mind: pacing, diaries for symptom tracking etc., simplifying, relaxation, sleep hygiene etc.,
- physio: e.g. osteopathy, chiropractic; esp. self-treatments, e.g. Asian, stretches, TENS, praps cryotherapy.
- diet: healthy, e.g. Mediterranean, or eliminating various things.
- environmental changes in bedroom and weather protection.
- Med/supp/herbs: Esp. supps, check if anything is low (for FM esp. D3 and B12), try magnesium types (for FM esp. malate) and esp. the amino acids (check Trudy Scott’s amino acid questionnaire.)
Full list
Systematically here, alphabetically: first try above. 2021-07-17: Numbering reduced again.
Therapist-types named for each treatment field (if you can, get 2nd/3rd opinions).
If your doc/therapists/physiotherapist doesn’t know fibro & doesn’t want to get educated by himself
- show info material like brochures (e.g. FMA UK, internet pages),
- learn to accurately describe your symptoms,
- search for experts or knowledgable or acknowledging docs on the web, incl. some forum resources,
- ask support groups for good docs,
- phone around for a new good doc, asking at the desk how many fibromites they treat.
Scientific evidence is almost only possible for meds and their many harmful side effects, so almost everything else here is “complementary”, wikipedia often writes “pseudoscientific” or like most studies concludes that more high-quality research is necessary.
This meta-review (2021) for instance cdnt “prove” anything helps for fibro except that CBT (psychotherapy), CNS depressants & antidepressants can help pain & Quality of Life, at least in the short & medium term, of which CNSd are all highly addictive.
A. MIND (1. pacing, 2. understanding, 3. therapy, 4. relaxation, 5. sleep, 6. fog help, 7. & body)
Psychologist, psychiatrist, psychotherapist, counsellor, pastor, helpdesk, outreach clinic, holistic/functional medicine doctors
A.1 Pacing: Stopping in time, resting, fatigue,
- finding, learning & keeping under (or not too far/long over) the invisibly moving sweet spots & limits of each activity,
- not overdoing it; not trying to keep up with us before fibro or with others,
- incl. socializing, incl. evenings, incl. work stress, amount, type or altogether.
- symptom tracking incl. pain tracking using pain resources, various diaries, keeping track of what you’ve done and how you’re feeling before, during & after, adapting with abbreviations to your need, cf. JayCS’s Fibro Blog
- Dilemma 1: Sometimes (when we can do something with little or no pain) we feel like carrying on doing it to feel ‘normal’, which is good for our mental hygiene and to get our body back into better shape at least once in a while. The art is finding how to do it in a way that the consequences are limited.
- Dilemma 2: The repercussions of overdoing it often come delayed, not during or immediately. after an activity. That makes it harder to spot the sweet spots, making diaries, analysis and the suggestions of others (people around us as well as fibromites) necessary.
- A good not-to-do-list (© 2013 Toni Bernhard)
A.2 Understanding/Being understood: Memes & other support, e.g. forums, support groups = mental hygiene (German: "Psychohygiene"), information, research, accurate symptom description.
Memes
Emotionally…
Educating ourselves, e.g.
books,
videos,
online resources
Educating others (docs, partners, friends, bosses, colleagues, acquaintances ), e.g.
memes,
better symptom descriptions,
brochures & similar summaries
A.3 psychotherapy, e.g. CBT (& b. CPT), psychoanalysis, Gestalt therapy, Trauma therapy (CPT) for PTSD, pain management, Anxiety therapy, depression, with or better without using meds, cf. T.E.1, counselling.
A.4 Relaxation techniques
Alexander Technique
Autogenous/autogenic training
Calming music
Calming nature sounds
Deep Breathing exercise
Knitting, crocheting etc.
Meditation
Progressive muscle relaxation (Jacobsen)
Reading
Self-hypnosis
Sun (if OK)
Yoga Nidra (‘yogic sleep’)
A.5 Sleep hygiene
A.6 Reminders (for brain fog)
A.7 Body psychotherapy → B.1 & B.2
B. PHYSICAL (1. Exercise, 2. Manual, 3. Meridians 4. Breath 5. Cold/Heat, 6. Electro, 7. Water, 8. Devices, 9. Positioning, 10. Sports, 11. Non-touch)
*TCM doctor (Chinese trained if possible): acupuncturist, Chinese herbs/teas, holistic/functional medicine doctor,
Physical therapist = physiotherapist, incl. massage therapist, acupressurist, acupuncturist, chiropractor, osteopath, Rolfers, teachers of the various types of yoga, tai chi, qi gong.
“Physios are better with fascia issues (than osteopaths). Sports physios in particular.” (??))
“Good physiotherapists are more important than good docs, unless you want mainly meds.”
Studies: seems to help
B.1 Physical therapy exercises
B.1.1 by Body parts
Legs
Back
Arms
Hands
Jaw
Neck
…
B.1.2 All over
Aqua jogging, as one form of water/“Hydrotherapy” (aqua fit, aqua therapy…) (cf. hot/cold)
Body Psychotherapy (influenced by Reich & Jung, many schools/branches)
Feldenkrais Method
Hakomi Method (somatic/body psychotherapy, mindfulness)
Pilates
Qi Gong / Qigong
Somatic experiencing (Peter A. Levine, for PTSD)
Stretching, cf. Yin Yoga gentle, dynamically, short Twist-Stretching
Tai Chi
Yin yoga stretches
Yoga, (“Hatha” yoga with asanas/poses), Styles, restorative/chair/senior, background
B.2 Manual / Massages and Bodywork
Body Realignment by Jan Trewartha (incorporates aspects of Fascial Release, Orthobionomy and Positional Release)
Bowen Technique pro & con
Connective tissue massage
Dry needling (trigger point dry needling)
Manual therapy = manipulation (muscles, joints)
Myofascial release MFR, self-myofascial release) Foam roller video
Myofascial trigger point massage, = MTrPs, cf. PRT
Osteopathy (incl. Counterstrain, Positional Release Technik PRT/Jones Technik - gentler!, craniosacral therapy = CST, visceral therapy, parietal therapy)
Postural Integration (form of body psychotherapy, cf. Gestalt therapy)
Reflexology (incl. foot reflexology, ear reflexology like ear-acupressure and ear-acupuncture)
Rolfing
Scar and Bonework (Sharon Wheeler)
Shiatsu (Japanese form of massage)
Trager approach
B.3 Meridian system (Asian): Acupuncture, acupressure
Acupuncture (best only few needles though!)
Ear-acupuncture
Acupressure (therapist)
Acupressure points / palpation points (self help, see devices)
Ear-acupressure (Penzel)
B.4 Breath
Pranayama yoga breathing exercises (… Yoga),
Wim Hof’s breathing-exercise, Wim Hof Method, WHM (Yoga-influenced)
B.5 Cold / Heat (sometimes moist)
Cold/heat overview
B.5.1 Whole body
B.5.1.1 Cold showering or ice baths inspired by Wim Hof, cf. WHM/breath-holding exercise) vs. warm showers (or baths, e.g. with magnesium = Epsom salts; mudbaths) or alternating (e.g. after sauna) (form of hydrotherapy)
B.5.1.2 Whole body cryotherapy (cold barrel, cold chamber, cold sauna) or heat chamber.
Cold down to -150°C (-240°F) for 3 mins.
B.5.1.3 heated mattress pad
B.5.1.4 blankets,
B.5.1.5 sauna
B.5.1.6 Sun! 
(if you’re OK with it)
B.5.1.7 Acupressure or acupuncture to stimulate temperature tolerance
B.5.2 Parts of the body
B.5.2.1 Hand grain baths (15’, canola, alternatively rice, spelt, wheat) cold or hot.
B.5.2.2 Topical/localized cryo therapy: = Partial body cryotherapy = PBC or heat (e.g. using an air hose)
B.5.2.3 Smaller Cold pads / ice packs or heat pads, hot water bottle, grain cushions (e.g. spelt, cherry, wheat), or gel pads for either, wherever necessary, bag of frozen peas.
B.6 Electrotherapy
Careful: Triggers focal seizures (that’d be me)
Cranial electrotherapy stimulation (CES, e.g. “Alpha-Stim” (R)"
Electroacupuncture
Microcurrent unit (gentler than a TENS unit), Microcurrent electrical neuromuscular stimulator
TENS unit (pads) or TENS pen.
TMS, Transcranial magnetic stimulation (= brain magnetic stimulation)) and transcranial direct current stimulation (tDCS)
Bioresonance diagnosis/therapy
B.7 Water therapy, hydrotherapy
moving in certain ways in water (e.g. “aquajogging”, “aquafit” “aqua therapy”) cf. B.1.2
using hot or cold water etc. cf. B.4
B.8 Mechanical devices
B.8.1 Acupressure devices
Acuball, for muscles & joints, e.g. for TMJ (cf. B.7. acupressure),
Acupressure mat (‘Acumat’)
Energy roller
Foot roller (“krupa chakra”)
Power mat (pyramid mat)
Spine roller
Teishein needle for percussion pressure
Cupping
Foam roller for B.2 MFR
Footwear change for skeletal problems
Gum shield, mouth guard, tooth guard: for grinding teeth, bruxism
Insoles change for skeletal problems
Kinesio tape/taping
Nose strips for better breathing, more oxygen
Traction
B.9 Changing positions regularly
Arms up
Feet up = legs up
Lying down; finding new lying positions (pillows etc.)
Standing working station (bar stool, bar table)
B.10 Sports (incl. for stress...)
Cycling, bike
Swimming
Walks
Weight training
Workout. For Muscles, tendons, fasciae, joints, breathing, overall.[/details]
B.11 Non-touch (pseudo-scientific)
Breathwork respiration techniques
Energy healing (New Age)
Reiki
Therapeutic touch (non-contact therapeutic touch, NCTT)
C. BIOLOGICAL (1. Diets, 2. essential oils, 3. oxygen/ozone)
holistic/functional medicine doctor, nutritionist, alternative practitioner, allergologist…
C.1 Diets
sorted by symptoms: put there
For FMS: Fructose & fructans free
For Gut / IBSD/C: Fructose free, elimination diet. BTW: Belt etc. loose around the waist.
For stomach - hyperacidic: elmination diet, e.g. nothing acidic, i.e. sour, spicy, onion-like.
For Bladder: … pumpkin seeds
For Cardiovascular: Mediterranean diet
Quick overview of diets here under “I do still have questions about the ketogenic diet”
C.1.1 dairy free (but perhaps meat)
C.1.2 fructose/fructans free (for FMS)
C.1.3 gluten free,
C.1.4 grain free,
C.1.5 nightshade free,
C.1.6 sugar free
C.1.7 vegan (no dairy, no meat etc.)
C.1.8 vegetarian (no meat etc., but dairy)
C.1.9 dairy free plus grain free
C.1.10 low carb/Atkins, incl.:
C.1.11 Keto diet / ketogenic diet (high fat, low carb, low protein) and
C.1.12 low FODMAP (fermentable oligo-, d i-, mono-saccharides and p olyols, i.e. all short-chain carbs), incl. fructans (see fructose free above),
C.1.13 candida diet (= low on simple carbs)
C.1.14 low histamine
C.1.15 low oxalate
C.1.16 low salicylate
C.1.17 paleo diet (palaeolithic, caveman, stone-age, = no dairy, grains, sugar, legumes…), incl.:
C.1.18 AIP diet (Autoimmune protocol) / anti-inflammatory: paleo minus nightshades, nuts, seeds, sweeteners and egg; no wheat/gluten, milk
C.1.19 plant paradox (lectin free) for leaky gut
C.1.20 virgin diet (no gluten, dairy, soy, eggs, corn, peanuts and sugar)
C.1.21 Mediterranean diet: unsaturated fats (e.g. omega 3: flaxseed oil) fats & complex carbs
C.1.22 pegan, a vegan form of paleo, for fibro (‘nutrition docs’ on German TV/youtube)
C.1.23 elimination diet using diary for food sensitivities contributing to IBS & stomach hyperacidity or pain, or the whole30 elimination diet.
C.1.24 Hay diet (“separate” proteins & carbs in one meal), seperate plant & dairy protein) for IBS
C.1.25 organic foods
C.1.26 whole foods (i.e. non-processed)
C.1.27 fasting, e.g. intermittent fasting
C.1.28 healthy: Unsaturated fats rather than saturated fats, complex carbs rather than simple carbs (e.g. sugar), Omega 3: flaxseed oil. 5 smaller meals, or if blood fats are high 3, not too late in the evening.
C.2 Essential Oils / Aromatherapy
capsules or topically or scents
Lavender
Swiss pine
“Morphine bomb”: majoram, lemongrass, frankincense
C.3 Oxygen
HBOT = hyperbaric oxygen therapy 2
Nose strips for better breathing, more oxygen (cf. mechanical devices)
ozone/oxygen-autohemotherapy (ozone/oxygen-injections)
D. ENVIRONMENTAL (1. Inside: air, bed, heating, light, noise; 2. outside: weather, aids)
forums, web pages, empathetic doctor, counsellor, friends, family, partner
D.1 Inside
D.1.1 Air rooms: Windows at the best time of the day to regulate heat & cold, rather than all day?
D.1.2 Bed
pillow(s), pillow-wedge
mattress
soft topper on mattress
lambskin under painful parts of the body (e.g. thighs), best under topper or sheet,
mattress pad heated
cushion, hard small spelt, or folded towel under hunchback
blanket weighted blanket or thicker continental quilt.
night clothes change
blanket change
D.1.3 Heating: moisten air, but not too much, see Better sleep - 30 wakers & stoppers
D.1.4 Light: blackout curtains or blinds, eyemask
D.1.5 Noise: ear plugs - many different types, noise cancelling earphones, talk with neighbours
D.2 Outside
D.2.1 Weather protection
Cold protection: Longjohns, “rain legs” for cycling, more socks, more clothes, layered onion-like, thick warm insoles.
Rain protection: “Rain legs” - plastic thigh shield for cycling.
Sun protection: amount, shielded…
Wind protection: Hoodie, windbreaker/windcheater.
Wind protection: windbreak, shelterbelt, shielded, blanket on balcony.
D.2.2 Aids for sitting
Chair cushion to go (restaurant, bench)
Chairs foldable to go: esp. camp chair (light).
D.2.3 Aids for walking
Bicycle
Walker/rollator
E. BIOCHEMICAL (1. Meds, 2. supps, 3. herbs)
E.1 MEDS: 1. Pain, 2. Depression, 3. Sleep/pain 4. Others
Doctors (change them if necessary, get 2nd and 3rd opinions if you’re dissatisfied and can afford to do so), GP / PCP / principal; pain doctor, rheumatologist (orthopedists), neurologist…
Life-belts when we aren’t able to cope/pace or treat, but suppress & fog over underlying issues.
E.1.1 Pain (Analgesics, Painkillers)
Cannabinoids
CBD without THC, e.g. as CBD oil: sleep & pain
MMJ = Medical Marijuana / Medical Cannabis, CBD with THC
Anti-convulsant: GABA-derivates:
gabapentin (‘Neurontin’, partial seizures, neuropathic pain, neuralgia)
pregabalin (‘Lyrica’…, for neuropathic pain, fibromyalgia, RLS, generalized anxiety disorder
phenibut (‘Anvifen’, ‘Fenibut’, ‘Noofen’, for anxiety, insomnia)
baclofen (‘Lioresal’ for muscle spasticity)
mirogabalin (‘Tarlige’ for neuralgia, neuropathic pain)
Hyaluronic acid injections (hyaluronan)
(knees, skin, eyes) (for me in the lumbar spine ‘sunburn’ in face, excrutiating pain in spine)
Local anaesthetic
Lidocaine (lignocaine) infusions, ‘Xylocaine’
Lidocaine injections with procaine or lidocaine etc. = “neural therapy” (Huneke) (= complementary medicine),
Metamizole ('Novalgin')
NMDA receptor antagonist
Dextromethorphan (DXM)
Ketamine
Methoxetamine) (MXE)
Nitrous_oxide
Phencyclidine (PCP),
NMDA receptor antagonist and Opioids at the same time
Dextropropoxyphene,
Ketobemidone
Levorphanol
Methadone
Pethidine
Tramadol (‘Ultram’… )
NSAIDs (Nonsteroidal anti-inflammatory drugs), incl. COX-2-inh.
Aspirin (acetylsalicylic acid, ASA, developed out of willow bark)
cf. combinations like co-codaprin = aspirin/codeine
COX-2-inhibitors:
Celecoxib
Etoricoxib
Diclofenac (‘Voltaren’)
Ibuprofen (‘Advil’, ‘Brufen’, ‘Motrin’, ‘Nurofen’…)
Meloxicam (‘Mobic’…)
Naproxen (‘Aleve’)
Opioids, incl. Opiates (directly derived von opium)
Embeda CR 20-0.8 (combination of opioid (morphine) and opioid antagonist (naltrexone))
Morphine (‘Oramorph’, ‘Sevredol’, …, extended-release: ‘Avinza’, ‘Dolcontin’, ‘Filnarine’, ‘Kadian’, ‘Morphagesic’, ‘MS Contin’, ‘MST Continus’, ‘MXL’, ‘Zomorph’.
Tilidine
Low Dose Opioid Antagonists
Low-Dose Naltrexone, LDN (ardent supporters)
Paracetamol (acetaminophen) (pain & fever)
SNRI (Serotonin–norepinephrine reuptake inhibitors)
Milnacipran (‘Ixel’, ‘Savella’, ‘Dalcipran’, ‘Toledomin’) (pain, depression)
Venlafaxine (‘Effexor’) (depression, anxiety, pain)
Sumatriptan ('Imitrex', migraines)
Paracetamol = acetaminophen 'Tylenol'
(add for gut: omeprazole) when paracetamol or NSAIDs aren’t enough:
Combinations
Co-Codamol = Codeine / paracetamol(=acetaminophen) (‘Emtec’, ‘Zapain’)
Co-Dydramol = Dihydrocodeine (dihydrocodeine tartrate) / paracetamol
cf. similar combination co-codaprin = aspirin/codeine
E.1.2 Depression (Antidepressants)
SSRIs, selective serotonin reuptake inhibitors
Citalopram (‘Celexa’…)
Fluoxetine (‘Prozac’, ‘Sarafem’) (depression, anxiety, OCD…)
Paroxetine (‘Paxil’, ‘Seroxat’)
E.1.3 Sleep/pain/depression/anxiety (tricylic antidepressants)
amitriptyline (‘Endep’)
nortryptyline (‘Pamelor’)
E.1.4 Sleep (sedatives, hypnotics) & anxiety/spasms (tranquilizers): CNS depressants, very addictive
Benzodiazepines incl.
- Diazepam (‘Valium’)
- Clonazepam (‘Klonopin’)
- Alprazolam (‘Xanax’)
- Triazolam (‘Halcion’)
- Estazolam (‘Prosom’)
Non-Benzodiazepine Sedative Hypnotics incl.:
- Zolpidem (‘Ambien’)
- Eszopiclone (‘Lunesta’)
- Zaleplon (‘Sonata’)
- Zopiclone (‘Imovane’)
Barbiturates incl.:
- Mephobarbital (‘Mebaral’)
- Phenobarbital (‘Luminal’)
- Pentobarbital sodium (‘Nembutal’)
E.1.5 Others
Guaifenesin (‘Mucinex’…, coughing = expectorant) Guaifenesin protocol: Anti vs. Pro (ardent supporters)
BCG vaccine (tuberculosis), cf. C.A.2, C.B.1. Recently Discovered Vaccine Treats Fibromyalgia Patient - Fibromyalgia Resources
E.2 SUPPS: 1. Amino acids, 2. Minerals, 3. Enzymes, 4. Hormones, 5. Vitamins, 6. Fatty Acids, 7. Kuklinski Protocol 8. D-Ribose
functional medicine doc, holistic medicine doc, alternative medicine doc, ‘environmental doc’…, some half-conventional docs etc., alternative health practicioner, nutritionist, orthomecular medicine doc
E.2.1 Amino acids
GABA = Gamma-Aminobutyric Acid & perhaps picamilon
Glutamine (not glutamic acid, despite Verla branding theirs “Glutamin”)"] German link
Glutamic acid: Is turned into glutamine, so less effective than that.
Glycine
Theanine: sleep.
(L-)Tryptophan
Tyrosine
N-Acetyl Cysteine (NAC)
5-Hydroxytryptophan (5-HTP)
Glutathione: antioxidant compound made up of the amino acids Glutamic Acid, Cysteine, and Glycine.
E.2.2 Minerals
Calcium
Magnesium types:
Epsom salt-baths = magnesium sulfate for neck & back pain cf. warm baths, B.5
Magnesium taurate for TMJ
Magnesium glycinate vs. malate combination product calming & more bioavailable & slightly less IBSD-ey vs. more ATP/energy.
Potassium
Selene
Zinc
E.2.3 Proteolytic enzymes (for Myofascial and Fibro)
E.2.4 Hormones
Melatonin: sleep (for 5 HTP & (L-)Tryptophan cf. E.2.1. amino acids)
Has Anyone Seen the Research on Melatonin? - #16 by JayCS
Shd praps analyze again whether 5-HTP helped in the winter break, as not working in the Easter break did not help:
JayCS’s Fibro Blog - #174 by JayCS
Progesterone
E.2.5 Vitamins
Vitamin B1
Vitamin B2
Vitamin B3
Vitamin B6
Vitamin B12 - basic, often one of the most nec.
Vitamin C (protect)
Vitamin D3: often very necessary
Vitamin E: 8 types.
Co-Enzyme Q10 = ubiquinone-10
E.2.6 Fatty acids
Omega 3: flaxseed oil, cf. diets
Oil pulling
E.2.7 Kuklinski Protocol
A vitamin & mineral protocol in 5 phases of 2-3 weeks each, mainly: 1. vitamin B12 injections / 2. potassium, zinc, selene / 3. vitamins B1 + B2, C, E / 4. flaxseed oil / 5. Q10)
? E.2.8 D-Ribose
a simple sugar: for pain, cramping, stiffness, CFS, FMS, mitochondria/ATP ( → C:A.6) heart,
E.3 HERBS: 1. Pain, 2. Sleep, 3. Fatigue...
functional medicine doc, holistic medicine doc, alternative medicine doc, ‘environmental doc’…, some half-conventional docs etc., alternative practitioner
E.3.1 Pain
Arnica as oil or complex cream (‘Traumeel’) for pain in muscles and tendons (‘joints’)
Celafen cream (with Celadrin), cf. wp.
Rhus toxicodendron for (rheumatic) pain
Willow bark: pain (developed to aspirin)
E.3.2 Sleep (Anxiety, Restlessness
Ashwagandha
Hops
Passiflora = passion flower
Valeriana
E.3.3 Fatigue etc.
Golden root (depression, fatigue, BP)
Turmeric, raw peeled: fatigue (Curcumin)
E.3.4 TCM herbs as hot teas.
E.3.5 Homeopathy (Hahnemann), incl. Bach flower remedies, Schüßler/Schuessler salts (placebo or more?)
Version 2021-08-11 = 11th August