Fibromyalgia is a common chronic condition whose main symptoms are specific tender points on various parts of the body, widespread musculoskeletal discomfort, morning stiffness, fatigue, and disturbed sleep. The cause of the condition is unknown, but it occurs most often in women aged 30 to 50. Other symptoms commonly believed to be associated with fibromyalgia are irritable bowel syndrome, urinary frequency, anxiety, headache, and numbness or tingling.

Apart from tender points on the body, physical exams and lab tests for people with fibromyalgia are usually normal. Because of this, some physicians are inclined to believe that the condition is "all in the patient's head." One researcher has noted that many of the symptoms of fibromyalgia, including certain tender points, are common in the general population, and goes so far as to question whether it is a real condition.1

However, the current consensus is that fibromyalgia is real, and the American College of Rheumatologists has given it an official medical definition. It involves the presence of widespread chronic pain and the existence of pain in at least 11 of 18 specific points on the body when pressure is applied. Although the cause of fibromyalgia is not known, it may be related to poor sleeping with incomplete muscular relaxation.

Antidepressants have been shown to help chronic pain from many causes 2and have been found to be effective in reducing fibromyalgia symptoms, even when given in doses too low to treat depression.3 Other conventional treatment for fibromyalgia may include antidepressants, anti-inflammatory drugs, muscle relaxants, sleeping pills, and anti-anxiety medications.

Various forms of exercise,4,5,43,53,54especially aerobic exercise, have been shown to be helpful for symptoms associated with fibromyalgia, most notably global well-being and physical functioning.52

There are three natural treatments that might be helpful for fibromyalgia, although the evidence is not yet strong: SAMe, 5-HTP, and capsaicin.

SAMe

SAMe, short for S-adenosylmethionine, is a chemical derived from a combination of methionine, an amino acid, and adenosine triphosphate (ATP), the main molecule for energy in the body. More well known as a treatment for depression and also osteoarthritis, preliminary research suggests that SAMe may be helpful for fibromyalgia as well.

Four double-blind trialshave studied the use of SAMe for fibromyalgia,6-9 three of them finding it to be helpful. Unfortunately, most of these studies gave SAMe either intravenously or as an injection into the muscles, sometimes in combination with oral doses. When you inject a medication, the effects can be quite different than when you take it orally. For that reason, these studies are of questionable relevance.

However, the one double-blind study that used only oral SAMe did find positive results.10 In this trial, 44 people with fibromyalgia took 800 mg of SAMe or placebo for 6 weeks. Compared to the group taking placebo, those taking SAMe had improvements in disease activity, pain at rest, fatigue, and morning stiffness, and in one measurement of mood. In other respects, such as the amount of tenderness in their tender points, the group taking SAMe did no better than those taking the placebo.

It is not clear whether SAMe is helping fibromyalgia through antidepressant effects or some other mechanism.

For more information, including dosage and safety issues, see the full SAMe article.

5-HTP

5-HTP, short for 5-hydroxytryptophan, is most commonly used as a treatment for depression. It is thought to work by increasing the amount of serotonin in the brain. However, evidence that it helps fibromyalgia is still preliminary.

One double-blind study of 50 people with fibromyalgia found that those taking 300 mg of 5-HTP for 30 days reported significant decreases in the number of tender points and the amount of pain they experienced, compared to those taking placebo.11 They also noted improvements in sleep patterns, morning stiffness, anxiety, and fatigue. Interestingly, the people taking placebo also noted significant improvements in pain and sleep, although less marked than those experienced with 5-HTP. More studies are needed to determine how much 5-HTP really helps.

For more information, including dosage and safety issues, see the full 5-HTP article.

Capsaicin

Capsaicin, the "hot" in cayenne peppers, is widely used as a treatment for various painful conditions, such as shingles and arthritis. One double-blind study of 45 people found that it may be beneficial for fibromyalgia as well.15 In this study, participants used either the capsaicin cream or a placebo 4 times a day for 4 weeks, rubbing it into the tender points on one side of their body. Those who used the real treatment reported less tenderness in their tender points than those using the placebo. Interestingly, the points on their untreated sides were also less tender. There was no difference between those using capsaicin or placebo in the amount of overall pain or sleep quality. It must be noted, however, that it is hard to believe the study was really double-blind, since it is impossible to hide the burning sensation caused by capsaicin!

For more information, including dosage and safety issues, see the full Cayenne Pepper article.