Travel for Healing: How Medical Tourism Helps Manage Fibromyalgia

Fibromyalgia treatment

Fibromyalgia is a long-term disorder that is marked by painful sensations in all parts of the body, exhaustion, sleepsomnia, and cognitive impairment (sometimes referred to as fibro fog). Although no lasting cure exists, treatment is directed at reducing the symptoms, enhancing the quality of life, and recovering everyday functionality.

The following is a summary of the treatment options of fibromyalgia:

Lifestyle & Self-Care

• Exercise: Low impact aerobic (walking, swimming, cycling, yoga, tai chi) enhances pain and function.
• Sleep hygiene: Sleep routine, reduced caffeine, and pre-sleep routine.
• Stress management: Mindfulness, meditation, deep breathing or cognitive behavioral therapy (CBT).
• Diet: Anti-inflammatory foods (fruits, vegetables, foods rich in omega-3, whole grains); excessive sugar, caffeine and processed food should be avoided.

Medications

Pain relievers:

• Over-the-counter (acetaminophen, NSAIDs) - less than useful, but possibly beneficial to some patients.
• Prescription (tramadol can be taken with caution).

Antidepressants (in order to decrease pain, fatigue, sleep, etc.):

• Duloxetine (Cymbalta)
• Milnacipran (Savella)

Anti-seizure medication (calm nerve overactivity):

• Pregabalin (Lyrica)
• Gabapentin (Neurontin)
• Sleep aids (but only when required and under medical supervision).

Therapies

• Physical therapy: Enhances posture, flexibility and pain.
• Occupational therapy: Assistance to change daily routines to make them less demanding.
• Counselling (CBT or psychotherapy): To deal with stress, anxiety or depression related to fibromyalgia.

Complementary Therapeutic Treatments

• Acupuncture- can be used to enhance sleep and pain.
• Massage therapy- relaxes muscles and alleviates stress.
• Chiropractic treatment- can aid in the alignment of the musculoskeletal system.
• Supplements (consent of a doctor): magnesium, vitamin D, omega-3 fatty acids, CoQ10.

Patient Education & Support

• Learning to cope with fibromyalgia can decrease worry about the symptoms.
• Emotional relief and coping strategies are offered by support groups (online or local).

Fibromyalgia symptoms and causes

Fibromyalgia is a persistent discomfort condition that influences the manner in which the brain and the spinal cord transmit the signals of pain, resulting in widespread pain, and other systemic signs.

Fibromyalgia symptoms:

Pain-related

• Musculoskeletal pain (dull, aching, burning, or throbbing) that is persistent (or has not yet healed), present 3 months or longer.
• Painful areas of the body (neck, shoulders, chest, hips, knees, elbows).
• Hypersensitivity to pain (central sensitization).

Fatigue & Sleep Problems

• Constant fatigue even after getting enough sleep.
• Non -restorative sleep (not waking up refreshed).
• Some patients will have restless legs syndrome or sleep apnea.

Cognitive & Mental Symptoms

• Fibro fog: loss of memory, attention, and concentration.
• Anxiety and depression (typical comorbidities).
• Stress sensitivity.

Other Physical Symptoms

• Headaches or migraines.
• Irritable bowel syndrome (IBS) -Abdominal pain, bloating, constipation, or diarrhea.
• Bladder problems (urinary urgency, frequency).
• Pain/ numbness of legs and hands.
• Light, sound, temperature or touch sensitivity.

Fibromyalgia Causes and Risk Factors

Its cause is not completely known yet but it is believed to be a combination of genetic, neurological and environmental factors.

Abnormalities of the nervous system

• Overall activation of pain pathways of sensation leads to pain sensitivity (central sensitization).
• Disproportion in the brain chemicals (serotonin, dopamine, norepinephrine) that control mood and pain.

Genetic Factors

• Families run in families- some genetic mutations can be risk factor.

Triggers & Risk Factors

• Physical trauma or injury (e.g. accidents, surgery).
• Infection (e.g. viral diseases can precipitate it).
• Stress or psychological trauma.
• Sleep disturbances (cause and effect relationship).
• Gender: It affects females more often (2-3 times more frequently than it affects male sexes).
• Age: It is typically diagnosed with middle age although it may happen at any age.
• Other systemic conditions: Arthritis, lupus or other autoimmune diseases.

Best hospital for fibromyalgia treatment

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket

Fibromyalgia diagnosis and management

The fibromyalgia does not have one test. It is diagnosed through clinical examination and elimination of other causes (such as thyroid disorders, arthritis, lupus or chronic fatigue syndrome).

Diagnostic Criteria (American College of Rheumatology - ACR)

• Widespread Pain Index (WPI): Number of painful areas (019).
• Symptom Severity (SS) Scale: Fatigue, sleeping difficulties, cognitive problems, and other symptoms (0 -12).

Diagnosis is considered if:

• WPI ≥ 7 and SS ≥ 5, OR WPI 3–6 and SS ≥ 9.
• The symptoms have existed at a similar level at least 3 months.
• The pain is not due to any other disorder.

Physical Exam

• Examining the presence of pain and tenderness (formerly known as tender point exam, currently reduced in importance).

Exclusion Tests

Blood tests may be ordered by doctors to exclude other diseases:

• Thyroid tests (hypothyroidism).
• CBC (anemia).
• ESR/CRP (inflammation, autoimmune disease).
• B12 levels (deficiencies), vitamin D.

Management of Fibromyalgia

No cure exists, so treatment aims at alleviating symptoms and enhancing the functionality. Multidisciplinary approach is the best.

Lifestyle & Self-Care

• Regular exercise: low impact aerobics, yoga, tai chi, swimming or walking.
• Sleep Hygie: regular sleep, pre-sleep relaxation.
• Stress management: meditation, deep breathing, or counselling.
• Balanced diet: Anti-inflammatory foods; no processed foods, too much sugar, caffeine.

Medications

• Analgesia: Acetaminophen, restricted NSAIDs; tramadol (in selected cases).
• Antidepressants: Duloxetine (Cymbalta), milnacipran (Savella) - relieves pain and fatigue.
• Anti-seizure medications: Pregabalin (Lyrica), gabapentin (Neurontin) - soothes nervousness.
• Aids to sleep: Only in case of necessity, and with strict supervision.

Therapies

• Physical therapy: Therapy enhances posture, movement, and pain.
• Occupational therapy: Modifies activities of day-to-day life to lessen the strain.
• Cognitive Behavioral Therapy (CBT): Aids in dealing with stress, anxiety, and depression.

Complementary and Alternative Approaches

• Acupuncture, massage and Chiropractic therapy can be useful.
• Supplements (under the doctor's recommendation): vitamin D, magnesium, omega-3 fatty acids, CoQ10.

Patient Support & Education

• Knowledge of the condition alleviates anxiety and disappointments.
• Emotional and coping strategies are offered by support groups (local or online).

Advanced fibromyalgia therapy

Neuromodulation & Brain-Targeted Therapies

Magnetic Stimulation of the brain (Transcranial Magnetic Stimulation):

• Magnetic-field stimulation of the brain in a non-invasive manner.
• Helps diminish the perception of pain and elevate mood.

Transcranial Direct Current Stimulation(tDCS):

• The electrical currents used to control brain activity by passing through the scalp are low.
• Initial research indicates decreased pain and increased cognitive ability.

Infusion Therapies and Injection Therapies

Ketamine Infusion Therapy:

• Low doses of intravenous ketamine may be used in the treatment of severe and treatment-resistant pain.
• Short-term relief; applied to special facilities.

Lidocaine Infusion:

• IV lidocaine can suppress the general pain to a certain degree.

Trigger Point Injections:

• Local anaesthetic or steroids in painful knots of the muscles.

Sophisticated Pharmacological Solutions

Low-Dose Naltrexone (LDN):

• Studies on the microglial cell to decrease central sensitization.
• New treatment with good prospects of pain and fatigue.

Cannabinoids (Medical Cannabis, CBD oil):

• May relieve pain, sleep and anxiety to a certain group of patients.
• In research; it is not always legal.

Regenerative & Biologic Therapies

Stem Cell Therapy (experimental):

• Studies are in progress to investigate its possible use in reducing inflammation and re-setting the pain pathways.

Platelet-Rich Plasma (PRP):

• Evidence in fibromyalgia; more widespread in local musculoskeletal pain.

Digital/Technology Assisted Therapies

Virtual Reality (VR) Therapy:

• Immersive distraction therapy decreases pain and stress.

Biofeedback & Neurofeedback:

• Assists patients to manage stress reactions, which helps to decrease pain flare-ups.

Mobile health applications and telemedicine:

• Monitor symptoms, enhance compliance to exercise, CBT, and mindfulness.

Integrative Medicine (Programs)

Combination of multidisciplinary pain rehabilitation programs comprising:

• Exercise physiology
• Cognitive behavioral therapy (CBT)
• Nutritional guidance
• Mind-body (yoga, tai chi, mindfulness-based stress reduction - MBSR) interventions.
• Located in high-tech pain clinics and fibromyalgia centers.

Fibromyalgia pain relief treatment

The treatment of fibromyalgia pain relief is based on the reduction of pain, improvement of sleep, and quality of life. Due to the prevalence of pain and the change in pain processing in the nervous system, a multi approach approach is suitable.

Medications for Pain Relief

Over-the-counter options:

• Acetaminophen → can be used in mild pains.
• NSAIDs (ibuprofen, naproxen) → may not always benefit, but may be useful in conjunction with arthritis.

Prescription pain medication:

• Tramadol (selective moderate pain).
• Long-term: opioids (because of dependence and ineffective long-term outcome).

Narcotics:

• Pregabalin (Lyrica) and Gabapentin (Neurontin) → decrease the sensitivity of nerves.

Antidepressants (dual effect: mood + analgesic):

• Duloxetine (Cymbalta)
• Milnacipran (Savella)

Non-Medication Pain Relief

Exercise therapy

• Light, nonstrenuous (walking, yoga, tai chi, swimming).
• Pain and stiffness are alleviated with time.

Heat & cold therapy

• Warm baths, heating pads → loosen hard muscles.
• Ice packs → in the case of acute flare pain.

Physical therapy

• Stretching, positioning and light strengthening.

Massage therapy

• Relaxes the muscles, increases blood flow, decreases pain.

Mind-Body Approaches

• Cognitive Behavioral Therapy (CBT) → decreases pain associated with stress.
• Mindfulness and meditation → This technique assists the brain in coping with chronic pain.
• Biofeedback → conditions the body to react to stress and pain.

More Important: Advanced Pain Relief (when the pain does not respond)

• Low dose naltrexone (LDN) - experimental, decreases pain sensitization.
• Ketamine infusions - short term relief in severe cases.
• Transcranial Magnetic Stimulation (TMS) - decreases the sensitivity to pain.
• Acupuncture- could potentially enhance pain and sleep.

Daily Self-care in pain control

• Keep a regular sleeping pattern → lack of sleep increases the pain.
• Mixed anti-inflammatory food (fruits, vegetables, omega-3 foods, whole grains).
• Keep yourself hydrated, do not consume processed food, alcohol and too much sugar.
• Pacing efforts → do not overdo it, as this will result in a flare-up.

Fibromyalgia treatment in India with GetWellGo

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

• Complete transparency
• Fair costs.
• 24 hour availability.
• Medical E-visas
• Online consultation from recognized Indian experts.
• Assistance in selecting India's top hospitals for Fibromyalgia treatment.
• Expert doctor with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food