Brief Answer:
Check on the diagnosis

Detailed Answer:
Good evening. Whenever answering patients as to what they can do for chronic pain syndromes to get relief I cannot emphasize how IMPORTANT and really USEFUL a suggestion it is to FIRST and FOREMOST make sure the diagnosis you have been given is THE BEST possible diagnosis. May seem obvious but unfortunately, FIBROMYALGIA is sometimes mistaken for other things that could possibly be more treatable or even reversible....but the patient has to take the initiative to get the diagnosis VERIFIED by someone who has a reputation in the field.

The specialists who most physicians would consider EXPERT in making such a diagnosis would be the RHEUMATOLOGISTS so I would consider taking myself to a rheumatologist of repute and see how in sync with some of what you're describing as your diagnosis they might be especially if the medication doesn't seem to be working.

The next thing I would recommend is to be sure that your doctor has sent you for a metabolic check of serum levels and concentrations of things such as thyroid hormones (TSH, FT4, FT3, TT3), Vitamin B12, serum folate, ESR, CRP, Vitamin D, and then, liver and renal function tests. If there are any significant deviations from normal values (or if in the case of Vit. B12 you are <400 or Vitamin D<40-60) then, you should have replacement therapies instituted either by improving ingestion of certain foods, vitmamin/mineral supplements, or hormonal replacement therapies.

There are a number of other medications that can be tried for FM if that indeed is the diagnosis. For example, have you been tried and some of the more basic drugs such as GABAPENTIN, NORTRIPTYLINE, TOPAMAX, MIRAPEX, SAVELLA, CYMBALTA? Also, EXERCISE therapy and especially AQUATHERAPY have been shown to have positive benefits in FM patients as have BIOFEEDBACK therapy and ACUPUNCTURE. I used to do trigger point injections but I've found over the years that the variability of success in the same patients from one time to the next was so vast that I'm not sure that the intervention was really any better than chance and with steroids having potential downsides due to side effects, etc. I don't use steroids anymore to inject FM patients.

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