Which medication offers relief to my mother's fibromyalgia?

Q. I am not clear with the diagnosis of my mother's condition. Please clarify.

Answered by
Dr. Anshul Varshney
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 17, 2015 and last reviewed on: Jul 10, 2023

Hi doctor,

Five years ago my mother was diagnosed with fibromyalgia. I think she also has rheumatoid arthritis. For the past five years, she was managing the pain with anti-inflammatory medicine, Lyrica, Mythycobal, Voltaren injections, herbal creams, etc. You can see the veins in her hands popping out. I also realized that the pain has got worse now. For about 12 months the doctor put her only on Prednisolone 5 mg per day and painkiller when necessary. She was fine till last month but the pain increased in her hands now. In the daytime she is fine and the pain starts mildly in the evening. When she lies down in the bed she gets electrical tingling in her legs by which her sleep gets disturbed. She has undergone several tests last week and I attached them for your reference. She did not consult a rheumatologist yet. What medication can I give to reduce the inflammation and cure her? Her ESR, CPR, and ANA are quite high. The pain in her hands and the tingling in her legs at night are agonizing her life. Kindly provide your expert advice.



Welcome to icliniq.com.

First of all your mother does not have rheumatoid arthritis or fibromyalgia. From her reports (attachment removed to protect patient identity) I found that she has connective tissue disorder and the most possible diagnosis would be systemic lupus erythematosus (SLE). The joint pain, high ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), positive ANA (antinuclear antibody), and response to Prednisolone favor the diagnosis of connective tissue disorder. She definitely does not have functional pain which occurs in fibromyalgia. Her pain and suffering are very true. Now to help you better I need some more details: Since how long is she suffering from all these? Is there any frequent reddening of eyes? Does she suffer from oral ulcers or any rash over the nose or cheek after sun exposure? Did she have any past history of heart and lung issues? I would also like to know if her anti-ds DNA (anti-double-stranded DNA) test has been performed.

Thank you.

Hi doctor,

She has been suffering from this condition for the last five years. In the first two years, the pain hit her ankle, then moved to the neck, the wrist, and so forth. It started when my dad was kind of paralyzed and she took complete care of him. She does not suffer from any frequent reddening of her eyes. She denies oral ulcers and rash on sun exposure. There is no relevant past medical history of note. The anti-ds DNA test has not been done yet.



Welcome back to icliniq.com.

Please check her anti-ds DNA test in a short period and the laboratories, which perform ANA may also perform anti-ds DNA. She needs Prednisolone for disease activity control. Though it has various side effects, it is essential. She should also be started on Hydroxychloroquine Sulfate (HCQS). This drug helps in the long term. Now for acute pain, she would require an anti-inflammatory painkiller like Etoricoxib. During the winter or during the acute painful attacks she might require treatment with a single shot of intramuscular Methylprednisolone that gives pain relief for two to three weeks. So in short she needs steroids at present. In fact, at big centers, we also use monoclonal antibodies like Rituximab, which is costly but helps a lot in controlling the disease activity. So at present, she should see a doctor, an internal medicine specialist (MD in medicine) and share my opinion.

Thank you.

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