Non-Drug Therapies

Non-Drug, Trigger Point, and Alternative Fibromyalgia Treatments

Medications can help reduce your fibromyalgia symptoms, but the side effects sometimes can be a limiting factor. You will also notice that your muscles don’t work like they used to. Not only do they hurt, they can be stiff and restrict your range of motion. The most common areas for muscle pain is in the shoulders, thighs, chest, and back of neck and head—but other areas can be troublesome as well.1 These painful muscles often have rope-like bands in them. If you press along this band you will find nodules that really hurt. These are myofascial trigger points, and they not only cause tremendous pain at the knotted area, they also shoot pain to other muscle regions.2

As mentioned in our Criteria for Diagnosis section, almost all of the 18 diagnostic tender points are actually myofascial trigger points.3 The good news is that there are many therapies that can be applied to ease this type of muscle pain, and for the most part, the side effects are minimal. Various movement therapies and nourishing supplements may reduce the chances that trigger points will develop. So you should consider more than one of the alternative treatment approaches below depending upon the number and severity of your trigger points.

Hands-on Approaches

  • Massage: Patients rate professional massage as their top non-drug therapy for treating the muscle pain of fibromyalgia.4 You will need to find a therapist who can give you a very gentle (low pressure) massage until you know how you will respond.
  • Osteopathic Manipulation: Osteopaths are trained in a variety of hands-on approaches to ease muscle pain. An example is strain-counterstrain (or positional release), which allows the tight muscles to relax and loosen up the knots that cause so much trigger-point pain.5 You can learn to do some of these techniques at home.
  • Neuro-muscular Adjustment: Small muscles near the many tiny joints along the spine could be involved in the development of myofascial trigger points. Gentle manipulation of the spine and nearby muscles may offer relief for low back pain and certain types of headaches, although the mechanism is not fully understood.6
  • Acupuncture: This alternative therapy can reduce pain and fatigue, but the results for fibromyalgia may vary. Make sure you find a licensed practitioner who has experience treating fibromyalgia. Research shows that the additional use of a cupping technique with the acupuncture produces better results.7 You can also do self-acupressure and ease sore muscles with hot water therapies as described in the next section on Self-Help.

Trigger Point Therapies

In addition to the many hands-on therapies listed above, you may benefit from several other approaches designed to treat trigger points, ease muscle pain, and restore function.

  • Trigger Point Injections: A needle with anesthetic (such a lidocaine) is injected into the eye of the trigger point to force it to release the knotted contraction. This procedure should be followed directly by a gentle massage of the area and then on/off application of a cold pack to reduce initial pain. This technique is reserved for stubborn trigger points.2
  • Low Level Laser Therapy: This can be a non-invasive way to apply energy deep into the trigger points of muscles with the goal of getting them to relax.8 Studies show that laser therapy produces mixed results, with some but not all patients benefitting from it. Note: lasers you can purchase inexpensively on the Internet are not effective.
  • Stretch with Heat/Coolant: Muscles with trigger points cannot just be stretched because they will recoil and produce more trigger points. Application of heat relaxes the muscle so they can be gently stretched (never stretch to the point of pain). Coolant topicals work as an anesthetic to enable a light stretch of the muscle as well. Both techniques can often ease muscle tightness and pain.2
  • Manual Therapies: Myofascial release and trigger-point focused therapies are often done by massage and physical therapists. These are two examples of alternative approaches designed to relieve the pain of tight muscles that have trigger points.4
  • Lidoderm Patches and Topicals: Lidoderm patches contain 5 percent lidocaine and require a prescription.9 They can be cut into fourths and applied to painful trigger points. After four days of continuous application, research shows the pain is often greatly reduced. Other topicals may be applied to sooth sore muscles as well.

Movement Therapies

Intense exercise can cause your symptoms to flare, even though you may have been an athlete before developing fibromyalgia. The key to staying fit is to find activities that you enjoy. Keep in mind that frequent rest breaks have been found to tone down the pain caused by vigorous exercise. The point is, don’t overdo it because this will only set you back.

  • Aerobics: Consider starting with a warm water therapy program, especially if your pain levels are really high. It’s easier on the muscles and joints to be in the water, and the warmth is usually soothing. Once you have made progress, you might move to land-based activities two to three times a week. Walk at a pace that you can still carry on a conversation.10 Explore aerobic activities that you enjoy and go at a comfortable self-pace.
  • Tai Chi: This movement form is coordinated with deep breathing and relaxation. You should avoid kicks and aggressive movements that may overstretch your muscles. Stay on two feet until you gain confidence.11
  • Yoga: Gentle stretching movements while focusing on rhythmic breathing can help loosen muscles, improve physical function, ease stiffness and reduce pain. It is important to find a restorative type of yoga class with a teacher who will accommodate your specific needs or limitations.12
  • Isometric Strengthening: Keeping up your strength is important, but not if it drains you of energy. Isometrics involve pressing against a stationary object (or you can use both arms or legs as resistance) for six seconds while breathing to make sure your muscles have oxygen. It does not consume lots of energy, but a 10-minute-a-day program can keep your muscles toned.13

Nutritional Aids

A few small treatment trials show that the nutritional supplements below may be beneficial for reducing your fibromyalgia symptoms, but larger studies are really needed.

  • Magnesium/Malic Acid/B vitamin Complex: Malic acid is a key sugar that is broken down in the muscles to make energy. Both magnesium and the B vitamins (B1 and B6) are needed for this process. One small study showed that this combo of supplements reduced muscle pain in fibromyalgia patients.14
  • Omega 3 Fatty Acids: These oils are often referred to as anti-oxidants. They neutralize chemical byproducts that might otherwise harm your cell membranes and interfere with their ability to function. The best formulas contain roughly 500 mg of EPA and 500 mg of DHA (both omega 3s). DHA makes up about 15 percent of your brain’s gray matter and it is vital for protecting your brain cells. A small study indicates that 2,500 mg of EPA/DHA combined per day helps ease fibromyalgia pain.15 Other larger studies show this supplement reduces triglycerides, protects your cardiovascular system, and works as a mild anti-depressant.
  • Anti-oxidants (Vitamins E and C): These two vitamins work as anti-oxidants to protect your cells and one study in fibromyalgia patients showed that this combination reduced the symptoms.16
  • Melatonin and Valerian: Melatonin is not a powerful hypnotic, but it can regulate your body’s internal clock to improve the quality of your sleep.17 Valerian is an herb that does have sedating properties that may ease you into sleep.18
  • 5-HTP: This molecule is easily absorbed and readily enters the brain where it is converted into serotonin (must be avoid with medications that boost serotonin). Increasing brain serotonin is believed to improve mood, and if taken at night could help some people sleep.19
  • Acetyl L-Carnitine: A small trial in fibromyalgia patients showed that 500 mg of Acetyl L-Carnitine taken three times a day helped ease the pain and fatiguing symptoms of this condition.20


Need Help with a Well-Rounded Treatment Plan?

No single medication or non-drug approach will tame all of your fibromyalgia symptoms. The best solution is to develop a well-rounded treatment plan that addresses your specific needs at any given time. Yet putting together a comprehensive plan requires access to a think tank of treatment ideas. This is just one reason to consider a Membership to Fibromyalgia Network.

Our publications will keep you current on the latest in treatments, with many non-drug approaches illustrated for easy learning. We attend the key medical conferences, interview the experts, and comb through the medical journals, all to package this information into patient-focused articles. A Membership costs less than a doctor’s office co-pay and keeps you in the driver’s seat for directing your care.

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