New Fibromyalgia Treatments in 2024
Scientists researching new fibromyalgia treatments in 2023 made developments in a number of key areas, some of which are available for you to try right now as we welcome in 2024.
Find out what new treatments are out there, and what to keep your eyes open for.
As always, if any of the content in this article interests you, or if you have any concerns about your health, your symptoms, or your treatment plan, please speak to your doctor. Our content is for educational information only, and is not medical advice.
What is fibromyalgia?
We know that fibromyalgia is a chronic condition, affecting around 2% of the global population. The most common symptoms are widespread pain and tenderness, fatigue, and challenges with sleep, mood and memory. But there are many, many more fibromyalgia symptoms that people can experience.
Clinicians and researchers have looked for different diagnostic markers, such as measuring a person’s grip strength or brain chemicals, but so far they have not found a consistent link. This means that, for now, a fibromyalgia diagnosis remains a diagnosis formed by ruling out other conditions.
Medications for fibromyalgia
Medications for chronic pain form part of many people’s pain-management journey, with greater and lesser success. So what’s new?
Duloxetine – often sold under the brand name Cymbalta – is a medication that has been around for a number of years now, and was originally used to treat depression and anxiety disorders. However, the use of Cymbalta for fibromyalgia and central sensitization is on the rise. Research studies show that duloxetine can reduce, or significantly reduce people's pain1, and improve overall quality of life2.
The medication is a serotonin–norepinephrine reuptake inhibitor (SNRI), which means that it helps to regulate the levels of serotonin and norepinephrine in the brain. This in turn impacts sleep, mood, memory and pain.
Another medication that is increasingly being used to treat fibromyalgia is milnacipran (under the names Ixel, Savella, Dalcipran and Toledomin) – another SNRI. In most studies, duloxetine provides people with fibro with greater pain relief, although milnacipran3 is often more helpful for fatigue. If you are interested in using medication to help your symptoms, chat with your doctor about your symptoms and your medical history to determine what might be right for you.
Low dose naltrexone (LDN) has also been gaining recognition as a treatment for fibro. In low doses, LDN can provide pain-relief and an anti-inflammatory effect, and with few side effects.
Although not new, the other medicines that still show promise for people with fibro are pregabalin for pain and amitriptyline for sleep, fatigue, and health-related quality of life2.
Gut health in fibromyalgia
Gut microbiome & fibro
We all have trillions of tiny microbes living in our gastrointestinal tracts. While that might sound crazy, these microorganisms make up the gut’s microbiome and that is essential.
The gut microbiome is responsible for helping us to break down food, create vitamins, manage inflammation (approximately 70% of our immune defenses are stationed in our gut!), and even regulate our mood.
Research has shown there is a link between chronic pain conditions, such as fibromyalgia, with low grade intestinal inflammation and an imbalance in the bacterial composition and activity in the gut, known as dysbiosis4.
In addition, lots of people with fibro experience gut symptoms, such as irritable bowel syndrome, as part of their fibromyalgia experience. And both of these can be linked to the gut microbiota5,6.
Emerging research shows that altering the gut bacteria of both mice and people can either induce or relieve fibromyalgia symptoms7! This work by Sharon Edrich is currently in review, and we will be inviting Sharon to speak to the MoreGoodDays® community. Follow us on Facebook or Instagram, or get in touch to be notified when details are released.
Gut bacteria can be altered in a few different ways.
The most ‘out there’ option is by something called fecal transplant8, which sounds very off-putting! This is usually done by a colonoscopy, although the donor material can also be introduced via a long tube through the nose, or sometimes by a pill or an enema9,10.
Studies show that fecal transplant from a healthy donor, can help to reduce symptoms in people with conditions such as IBS, colitis (an inflammatory bowel disease) and fibromyalgia11,12.
Nutrition, prebiotics & probiotics for treating fibromyalgia
If you don’t quite fancy a transplant, you can try getting your food to work for you, through increasing your intake of probiotics and prebiotics and increasingly your vitamin D13 through eating foods such as eggs and getting 30 minutes of sunlight each day.
Probiotics are foods such as yogurt with active cultures, and fermented foods, such as sauerkraut, kimchi, and kefir. These contain friendly bacteria and yeasts. You can also get probiotics supplements, but these are not always suitable for people with severely compromised immune systems, certain medications, or who just had surgery – so make sure you chat with your doctor or pharmacist and find an option that’s a good fit for you14.
Prebiotics can also be important for our gut health. Prebiotics are a type of fiber that our bodies can’t digest, but it feeds the probiotics and keeps them strong and able to continue their good work. These include garlic, onions, asparagus, bananas, whole grains, greens, soybeans and artichokes15.
While these foods are generally helpful to increase beneficial bacteria in your body, not everyone can tolerate these foods because they are higher in FODMAPs.
If you’d like to know more about the role of nutrition in fibromyalgia and chronic pain, including the role of antioxidants and anti-inflammatory foods, check out the MoreGoodDays® program – we have a 4-week course dedicated to the role of food in reducing pain, fatigue and other symptoms. Download the app from the Apple App Store or Google Play for Android to get started today.
Regenerative medicines
Autoantibodies
In research that is slightly similar to the fecal transplant, in a 2021 study, scientists injected different mice with the antibodies from people with fibromyalgia and people without fibromyalgia.
The mice injected with antibodies from people who do not have fibromyalgia were unaffected, but those mice who received antibodies from people with fibro started showing fibro-like symptoms, until the antibodies had cleared from their system16.
This is very exciting, and lends weight to the argument that fibromyalgia could be an autoimmune disorder – at least in some people. Although for many people this explanation does not ring true, antibody treatment – a type of regenerative medicine, in this case conducted either by transplant from healthy donors or by identification and removal of fibro-associated antibodies – could be a game changer for some people17.
Cell & gene therapy
Regenerative medicines are any treatments that use regenerative molecules such as stem cells to repair damaged tissue back to an earlier (healthier) state. This sort of treatment will only work in cases where there is structural damage to the body, but could help to relieve fibro pain for some people, particularly those with a comorbid condition, such as osteoarthritis.
One method is to begin with a sonographer (a person who conducts ultrasound scans) looking for damage, such as small tears in muscles or tendons, which might show up in someone who lives with osteoarthritis-induced chronic pain. A clinician can then inject exosomes – small cellular containers into the affected area. These exosomes signal for proteins and factors that promote growth, immune responses and so on, to enter into the damaged area. These then tell the body to start healing this area18.
These regenerative treatments have had promising results and are likely to continue growing in prominence.
Other treatments for fibro
Last, but not least, emerging research into transcranial magnetic stimulation (TMS) has been showing some positive results for helping reduce fibro symptoms in studies19.
TMS is a noninvasive form of brain stimulation, in which clinicians apply magnetic fields to specific areas of the brain. To do this, an electric coil is placed around the person's head, and then the magnetic field is turned on and off. The clinician will move the coil until they find the post that makes your fingers twitch! For the patient, this might be a bit weird, you might feel a tapping on your head or hear a clicking sound, but you shouldn't experience any discomfort. You also don't need any form of anesthesia and can drive or take yourself home by your usual mode of transport after the appointment20.
TMS has already been shown to assist people who live with depression, with around 50-60% of people who receive TMS reporting a reduction in their symptoms21.
TMS is generally well-tolerated, which means that most people experience no side effects, or mild side effects only. However, it might not be suitable for people who have had seizures, epilepsy, serious head traumas or other serious neurological conditions.
The whole approach
As with all fibromyalgia treatments, things work differently for different people, so chat with your healthcare team to discuss what might be suitable for you. We'll be keeping up to date with other new and emerging treatments and keep you informed of the latest developments.
Studies show that the most effective treatment for fibromyalgia is a multidisciplinary approach. That might include things such as medications, gut health and nutrition, as well as psychology therapy and movement. Get in touch with us for more information about our pain-management program and follow us on Facebook and Instagram for more information about living well with fibromyalgia.
