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I have fibromyalgia and have been doctoring for quite a

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while. Another fibro patient has...
I have fibromyalgia and have been doctoring for quite a while. Another fibro patient
has just begun taking low doses of prednazone. Have you heard of this? ( Please forgive the spelling.)
Submitted: 8 years ago.Category: Health
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Answered in 23 minutes by:
6/15/2010
Health Professional: Anthony Bray, MD, Doctor replied 8 years ago
Anthony Bray, MD
Category: Health
Satisfied Customers: 10,341
Experience: 14 years as clinician in the field of Family Practice
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Hello!

With fibromyalgia the finding is an increase in muscle pain and tenderness (not joints by the way...if joint pain then this would indicate a different diagnosis...but joint pain problems such as osteoarthritis can certainly co-exist with fibromyalgia).

The cause of fibromyalgia is believed to be related to an increase in the central nervous system processing of pain. It has been my observation that fibromyalgia patients also tend to have sleep disturbance problems which seems to worsen symptoms.

Tramadol is one of the medicine commonly used to help with the pain of fibromyalgia. Other medicines that may be used in combination with this include Lyrica, Neurontin and Cymbalta. These medicines are thought to help reduce the pain of fibromyalgia by reducing the CNS processing of pain. They are very helpful in some patients but less so in others.

I have had pretty good success with sleep meds and especially Ambien to help patients get to sleep. This step seems to help significantly in many fibromyalgia patients.

The anti-inflammatory meds are often tried but rarely seem to do much good in fibromyalgia patients. It is common practice to try an anti-inflammatory (a nonsteroidal anti-inflammatory or NSAID) as a first line with patients that complain of muscle type pain (or joint or nonspecific combinations). Prednisone is stronger as an anti-inflammatory but has more potential adverse side effects and is avoided to the extent possible because of the side effects. Prednisone would not be expected to have much benefit with fibromyalgia but if it did show benefit then an alternate diagnosis such as polymyalgia rheumatica would the need to be considered. (Response to prednisone would be greater in the more inflammatory related conditions but inflammation does not appear to be a major factor in fibromyalgia). In lab tests fibromyalgia may have a slight elevation in C-reactive protein but no elevation in sed rate. (These two tests are nonspecific tests for inflammation).

Prednisone would be very helpful in rheumatoid arthritis, polymyalgia rheumatica and psoriatic arthritis but not in fibromyalgia.

I hope this information helps. further questions are welcome if you have others. If my answer has been helpful and to your satisfaction then please remember to press the "ACCEPT" button. Thank You and Best Regards,

Anthony Bray MD

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