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All About FibromyalgiaA Guide for Patients and their Families$
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Daniel J. Wallace and Janice Brock Wallace

Print publication date: 2002

Print ISBN-13: 9780195147537

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780195147537.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 13 June 2021

Drugs that are Useful in Selected Fibromyalgia Patients

Drugs that are Useful in Selected Fibromyalgia Patients

22 Drugs that are Useful in Selected Fibromyalgia Patients
All About Fibromyalgia

Daniel J. Wallace

Janice Brock Wallace

Oxford University Press

Doctors often prescribe drugs for fibromyalgia patients with distinct manifestations associated with the disorder such as tension headache, chronic fatigue, or bladder spasms. Few of the preparations discussed in this chapter have been shown to be specifically effective in fibromyalgia, but nearly all of them are widely prescribed by doctors who treat fibromyalgia patients. In an April 1982 bulletin, the Food and Drug Administration specifically allowed physicians to use approved drugs for “off-label” purposes. This chapter reviews our clinical experience with these drugs for fibromyalgia-related manifestations and presents a personalized, critical evaluation of them. One of the most commonly employed interventions in fibromyalgia is the tender point injection. Controlled studies have clearly demonstrated its usefulness in patients with myofascial pain syndrome. When a patient comes to our office and reports that a specific point—for example, in the upper back or neck area—hurts, we try to ascertain how severe this discomfort is in relation to their overall pain. If we are told that at least 30 percent (and preferably more than 50 percent) of their pain at the moment is from a specific tender area, this is an indication for a local injection. Patients who “hurt all over” rarely respond to tender point injections for more than a few days. Once we have decided to give a local injection or injections (usually limiting the number of injections to three per visit, with visits spaced several weeks apart), what preparations are used? The drugs of choice always include a local pain deadener, or anesthetic, usually xylocaine, novocaine, or marcaine. After the painful area is sprayed with a coolant anesthetic such as ethyl chloride or florimethane, the anesthetic in the shots usually works immediately. Sometimes a steroid is added to the anesthetic in the same syringe. Not all doctors use steroids for tender point injections. However, the doses we use are very low, and systemic effects are uncommon.

Keywords:   Aleve, Norfiex, SPECT scan, acetaminophen, barbituates, caffeine, diet pills, female urethral syndrome, growth hormones

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