Lyrica and fibromyalgia: Why does a medicine for nerve pain help a muscle disease?

by James Hubbard, M.D., M.P.H.

I’m starting to wonder if we’re on the right path with fibromyalgia. Is it truly the type of disorder we think it is? Here are some clues I’ve come up with. What do you think, Sherlocks?

I recently wrote about a JAMA study that showed how well the antidepressant amitriptyline worked for fibromyalgia symptoms, though we don’t know why. That got me to thinking. We also don’t know why another drug, Lyrica, helps.

Lyrica (pregabalin) is FDA-approved to treat fibromyagia symptoms.  But it also treats things like:

  • neurological-related problems, such as seizures
  • postherpetic neuralgia, the nerve pain that can continue after a bout of shingles (caused by a virus infecting a nerve)
  • the nerve pain associated with diabetes called diabetic neuropathy.

As you can see, Lyrica normally treats neurological-related problems and pain originating from nerves. But we think fibromyalgia pain originates from muscles. The word actually means fibrous tissue (muscle) pain (myalgia).  So what gives?

Maybe we’re barking up the wrong tree.  Since we’re not sure what causes fibromyalgia, could it be primarily a neurological (brain and nerve) disease?  After all, a recent study showed abnormalities in the brain in fibromyalgia patients.

Someday, perhaps you’ll be seeing a neurologist instead of a rheumatologist for treatment.

What do you think?  Sound reasonable?

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14 Responses to “Lyrica and fibromyalgia: Why does a medicine for nerve pain help a muscle disease?”

  1. cathy Says:

    Interesting. I know a couple of people with fibro. I’ll have to pass this information along to them

    cathys last blog post..Friday Link Love

  2. Mark Salinas Says:

    Fantastic information…passing along as well!

  3. James Hubbard, M.D., M.P.H. Says:

    thanks Cathy and Mark. Please do.

  4. Bill Says:

    I was told I had fibromyalgia by a rheumatologist. The doctor prescribed Lyrica, which helped some, and also diagnosed me, following a sleep study, with sleep apnea. Using a CPAP machine and taking Lyrica made my life bearable, but still miserable. One of the most uncomfortable symptoms of my condition was the peripheral neuropathy that affected my neck, head, arms, hands, legs, and feet. Lyrica eased my discomfort, but never to the point where I could sleep without taking Ambien CR.

    Then I remembered something that had happened to me when I was about 17 years old when my legs hurt so bad I could hardly stand to touch them or walk. I went to our family doctor and he gave me a B12 shot. My legs were better within several days.

    To make a long story short, I was desperate for relief, and given my uncomfortable situation with the fibromyalgia, I figured I had nothing to lose. I went online and found a recommended B12 replacement therapy dosage. Then I went to the pharmacy and bought what I needed.

    Within three days of taking the B12, I felt better than I had in two years. I came off the CPAP machine, stopped snoring, my brain fog began to lift, my memory and thinking processes began to clear up, and the neuropathy diminished to the point where I could actually sit in a chair and watch a movie and then , when it was finished, go lay down in bed and fall asleep in less than a minute and sleep all night.

    Is fibromyalgia a neurological disease? I don’t know. What does B12 affect?

  5. James Hubbard Says:

    I am glad you are doing so well.

    B12 does, in fact, help nerves. It is mostly used to treat B12 deficiency anemia (pernicious anemia). It has been used to relieve the nerve pain associated with carpal tunnel syndrome with mixed results.

    I am not sure how it would help sleep apnea. Have you been exercising more? Lost weight?

    At any rate thanks for sharing your experience.

  6. Bill Says:

    Dr. Hubbard,

    To answer your questions, no, I have not been exercising more, nor have I lost weight, but I sleep like a baby and my wife says she never hears me snore anymore. My nights used to be miserable to the point where I dreaded going to bed.

    I take 1000 mcg. of B12 a day and one NeuroBion tablet. I was actually told about the NeuroBion by a nurse who told me her mother has terrible neuropathy in her legs and that on the NeuroBion, she is fine, but if she stops taking it for a few days, the pain in her legs returns. The NeuroBion formula doesn’t seem like anything special, but I do notice a difference if I don’t take it for a while.

    I can only say that I had gone from being an active workaholic to a near invalid in just a couple of years, and that everything the doctors had tried at best only served to mildly alleviate my symptoms. I have a large, decorative tin container that holds all the prescription bottles for the various medications the doctors had prescribed that and I keep it as a reminder of where I once was. In addition, I have a diary that I kept as my condition steadily got worse.

    As for the cause of my improvement, I can only say what I know — I started taking B12 and all of my symptoms either subsided or disappeared. For whatever reason, I’m thankful.

    Thanks for allowing me to share this experience.

    Best wishes for all you do.

  7. James Hubbard Says:

    Great for you Bill,

    Anyone else out there care to share your experience?

  8. Chronic Disease ” Not so easy to Diagnose | The Health Care Blog Says:

    [...] James Hubbard’s My Family Doctor Blog » Blog Archive » Lyrica and … [...]

  9. Fibrosmart Says:

    Thank God for a doctor that thinks outside the box! I too have wondered why a drug to treat neuropathy works for fibromyalgia. I personally have had bodywide pain, not just in tender points or muscles but pain when I get a blood pressure test or get my hair washed at the salon.
    My fibromyalgia started after being pregnant during which I had gestational diabetes. Even though I didn’t have diabetes after being pregnant my blood sugar problems continued, first with hypoglycemia, then either too high or too low, it seemed my metabolism never returned to normal.
    I do certainly agree that fibromyalgia seems to be more of a nerve dysfunction than a muscle or joint dysfunction. I have questioned hundreds of fibro patients about their symptoms and 99% have either hypoglycemia, diabetes or pre diabetes. The other 1% have numbness in their hands and feet but haven’t yet been diagnosed with any blood sugar problems. I think it is a metabolic disorder personally, brought on by insulin resistance. I believe it is the excess sugar (glucose) and inability to process it that leads to the damage in the nerves, disrupted endocrine system, liver, pancreas, adrenals and brain, and finally the muscles. All of this leading to system breakdown that affects the digestive and immune system from which all other problems like bacteria, Epstein Barr, yeast, mold, toxins become opportunistic.
    I also believe that trans fats play a role, women my age with fibromyalgia are the first generation that grew up eating primarily trans fats and hydrogenated soy oil. Trans fats are being studied for their role in insulin resistance.
    This is just my personal opinion but I greatly admire any doctor who is willing to question established thought.

  10. kathy Says:

    if you live in milwaukee can you tell me your doctor name i am looking for a doctor in milwaukee i have fibromyalgia to and i am in so much pain everday and so far nothing has help please get back with me thank you

  11. britt Says:

    I too had gestational diabetes, and also a disc protusion in L5/S1. Rheumatologist has suggested Lyrica or Endep but reading about them I am sceptical. I was however seeing a neurological chiropratoctor up until 8 months ago which gave me great relief. Stopped only because of financial pressures. He deals with neuroplasticity and treated me for what he called a soft brain lesion. I had all sort of subtle neurological issues symptoms, including vertigo, and a general one sided dominance which exhibited itself as a feeling of spinning when stationary and inability to touch fingers with eyes closed etc etc. To answer your question Dr Hubbard, yes it is absolutely brain related. Needless to say I am going to see my chiropractor again. Do I think its diabetes related. yes, I do not have diabeted currently but do monitor my levels. When I feel a low blood sugar attack it invariably coincides with a bad period of fibromyalgia.

  12. Dr. Dopps Says:

    As a Chiropractor I have been witness to some of remarkable recoveries. Admittedly , chiropractic isn’t a miracle cure and may not help everybody. I does offer the answer for recovery for many. Try It you might just pleasantly surprised. If you live in wichita Ks or the surrounding area, Call us at Dopps Chiropractic In Wichita Ks

  13. John Gatesby Says:

    Fibromyalgia is one of those autonomic disorders which are perceived to be not curable, as of now. As you stated very correctly, we could indeed be barking at the wrong tree, unless we could pinpoint on the correct cause, it will be tough finding the correct treatment.

  14. Alan Donoho Says:

    I was really coming up with a different conclusion, but I entirely understand your points.

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