The main symptoms of fibromyalgia usually include muscle pain, stiffness in the morning after waking up, and painful tender points in various parts of the body. Other symptoms would include anxiety, depression, headaches, irritable bowel syndrome (IBS), painful menstrual cramps, tingling sensation in the hands, legs, and feet, and trouble sleeping.
Fibromyalgia pain is usually characterized by widespread pain in the body. Hence, it is quite common for individuals with fibromyalgia to experience aches in certain parts of their bodies. This pain leads most people to consult a doctor since the pain becomes unbearable at some point.
Pain due to fibromyalgia spreads to the entire body, and it can be a sharp, deep, aching, or throbbing pain usually felt in the muscles, ligaments, tendons, and joints. Certain parts of the body are so tender that even with a slight touch or pressure, one can easily feel the pain. In some cases, the pain would come and then go away. However, for some, it seems to radiate throughout the whole body causing a lot of discomfort in performing day-to-day tasks.
People complaining of soreness in the body and muscles also complain of tender points or painful joints. Rather than the joints, it is the tissues that surround the muscles and the joints that hurt the most. These tender areas or points are not something deeply localized. Instead, they are localized and situated under the skin’s surface. The areas with tender points are not uncommon but are at predictable places on various parts of the body. Pressing these tender points for a person suffering from fibromyalgia would be extremely unbearable.
Fibromyalgia pain often comes with morning stiffness. Studies reveal that people who are diagnosed with fibromyalgia also have another complaint that they experience stiffness in the entire body once they wake up in the morning. This stiffness is something that cannot be ignored since it affects the entire body--mostly targeting the joints and muscles of the back, arms, and legs.
There is a need to loosen up these joints and muscles before starting with daily chores. In some cases, people usually mention that morning stiffness lasts for only a few minutes, and then it becomes fine. However, sometimes, morning stiffness can last for 15-20 minutes after waking up. In people with severe fibromyalgia symptoms, the stiffness can last for several hours or even for an entire day.
Treatment for Pain
Today, there are better insights about fibromyalgia, wherein multiple medications are available to get the symptoms associated with the disorder treated. Such treatments include narcolepsy medications, antidepressants, pain relievers, and anticonvulsants. These medications act by altering the brain chemistry, which leads to a reduction in pain, which, in turn, helps in better sleep or improves the quality of sleep along with reducing mental changes and depression.
The main aim of fibromyalgia treatment is to help the patients to function in a better manner so that the disorder cannot greatly affect their daily chores. When it comes to pain being the primary symptom, the doctor can prescribe a pain-relieving medicine such as an anticonvulsant or antidepressant.
Anticonvulsants are basically developed to treat convulsions. They also help in providing relief from any kind of pain. Lyrica, which is an anticonvulsant, was the first medicine approved by the FDA for treating fibromyalgia pain. Antidepressants are also known to provide relief from fibromyalgia pain and improve the quality of sleep. They work by restoring the balance of the hormone serotonin and other chemicals present in the brain involved in pain processing.
Analgesics are nothing but painkiller medicines, which can either be over-the-counter drugs or prescription medications provided by the doctor. For individuals suffering from fibromyalgia, basically, they would be advised to take narcotic medicines to provide relief from severe muscle pain. However, there are still no confirmed studies to show that narcotics (opioids) really work for chronic pain specifically associated with fibromyalgia. This is also one of the reasons why most doctors hesitate to prescribe such type of medicine for a longer duration. Moreover, if it is taken for a longer duration, then users would become physically as well as psychologically dependent on the drug.
There are several types of analgesic drugs, and one of them is acetaminophen (Tylenol), which is widely available without the need for a prescription. Apart from this medicine, there are other opioid analgesics, which are available with a prescription. Other products are a combination of acetaminophen and opioid for additional relief.
Analgesics can be taken by anyone who is suffering from pain including fibromyalgia. However, opioids are only reserved for treating a severe form of pain in an individual such as postsurgical pain, a broken bone, or unbearable pain in the muscles and joints. Opioid medications do not lead to gastrointestinal bleeding, making them a better alternative for individuals who cannot take NSAIDs due to certain kinds of allergies or those who do not respond to NSAID treatment.
Action of Analgesics
Opioids work by binding the receptors on the cells of the brain, spinal cord, and gastrointestinal system. Opioids are often better for relieving severe pain, but they also bring along with them the higher risk of side effects if used for a longer duration, unlike acetaminophen.
Acetaminophen (Tactinal, Actamin, Anacin AF, Tylenol, or Vitapap)
Acetaminophen helps provide relief from pain, which is why it is commonly recognized as a pain reliever or fever reducer. Acetaminophen is known to treat many conditions such as backaches, arthritis, fever, colds, and headaches. This medicine should not be taken by individuals who have a severe form of liver disease.
Before you start taking acetaminophen, let the doctor know if you have certain allergies to medicine, food, substances, or any content of this medicine. People with excessive alcohol intake and those who consume more than three alcoholic beverages in a day should not take this medicine since it can worsen the condition of the liver. Let the doctor know if you are pregnant, planning to get pregnant, or nursing a baby. Moreover, this medicine should not be given to anyone younger than two years of age.
Acetaminophen is available in the following forms:
- Oral solutions
- Oral capsules
- Injectable solution
- Chewable tablets
- Oral suspensions
- Rectal suppositories
- Oral drops solutions and suspensions
Acetaminophen should be taken exactly as prescribed by the doctor or you can check the label of the medicine for further instructions on dosing and usage. Avoid increasing or decreasing the dose of this medicine without the recommendation of the doctor or else it can worsen the condition or lead to side effects.
An acetaminophen overdose can cause liver damage or even lead to death. If the doctor has recommended acetaminophen for a child, then ensure that it is in a pediatric form of acetaminophen. In the case of infants, acetaminophen comes in two dose concentrations and each of the concentrations has its own oral syringe and dropper. These dosing devices are not equal, which is why using the wrong device to dispense the medicine may lead to an overdose of acetaminophen. It is important to note that dosing devices should never be mixed and matched to avoid undesirable situations.
The tablet form of acetaminophen should be chewed properly before it is swallowed. One should not swallow the tablet as a whole, unlike other medicines. It should be kept on the tongue, wherein it would start to dissolve right away. Allow the tablet to dissolve before you start chewing it.
Acetaminophen is also available in granule form. To use the effervescent granules, you would need to dissolve the granules using the recommended amount of water as instructed in the pack. Once the granules are poured into the water, it would immediately start to dissolve. Stir the mixture and drink it right away. Do not store the mixture for later use. Moreover, to ensure that you get the entire dose, add some more water to the glass, swirl the glass, and drink it right away so that the dose is completely taken.
If you experience any of the following symptoms, then immediately stop taking the medicine and consult the doctor:
- Persistent fever after three days of taking the medicine.
- Pain that still persists even after seven days of taking the medicine in the case of adults, and five days in the case of children.
- Signs of rashes on the skin, recurring headaches, and swelling or redness in the body.
- Existing symptoms tend to get worse even after taking the medicine or when new symptoms arise.
This medicine should be stored at room temperature and away from light, heat, and moisture. Be careful not to overdose with this medicine. However, in the case of an overdose, seek medical attention immediately. Some of the symptoms of an overdose include:
- Loss of appetite
- Dark urine color
- Feeling confused
- Skin turning yellow
- Feeling weak and tired
- Pain in the upper stomach
- Excessive sweating
Before taking this medicine, let the doctor know if you have been on any medications whether prescribed or non-prescribed since certain medicines can lead to drug interactions. Avoid consuming alcohol since taking acetaminophen with alcohol can lead to liver problems. In a few cases, the use of acetaminophen can lead to certain allergic reactions, which can turn out to be fatal.
The usual side effects of oral acetaminophen tablets include:
- Breathing difficulties
- Sore throat
- Allergic reactions such as swelling of the face, lips, or tongue
- Trouble while passing urine or changes in the amount of urine
- Loosening of the skin
- Peeling of the skin
- Skin blisters
- Feeling very weak or tired
- Unusual bleeding
- Easily get bruised
There can also be cases of mild headaches, stomach upset or pain, and nausea. Acetaminophen can lead to certain interactions if taken along with alcohol, isoniazid, imatinib, and other drugs that contain acetaminophen.
The Combination of Acetaminophen and Naproxen
Both naproxen and acetaminophen work in different ways when it comes to controlling pain and reducing fever. In most of the cases, it has been seen to work just fine when taken together. However, it is important to first understand how these drugs work along with their side effects. Both of these drugs are used to provide relief from pain and fever. The pain can be due to arthritis, fibromyalgia, body pain, or menstrual cramps. However, both drugs work in a different way when it comes to relieving pain.
Naproxen works by blocking the substance or hormone that leads to inflammation, which often leads to a reduction in pain. On the other hand, acetaminophen does not reduce inflammation but instead helps in reducing pain sensations by blocking the release of the substance that causes such sensations.
Depending on the strength and type, acetaminophen can be taken every four to six hours while naproxen can be taken every eight to twelve hours. Moreover, make sure that if the products are marked as “all-day relief” or “double strength”, they should not be taken very often in a day. Both of these medicines do not interact with each other. However, they can cause drug interactions if used with other medications such as warfarin. These medicines should not be taken for more than 10 days to get relief from pain. Taking them for a longer duration or increasing their dose can lead to the occurrence of side effects.