Why Anti-inflammatories Don’t Work For Fibromyalgia?



Anti-inflammatory drugs are usually the very first medication doctors prescribe to fibromyalgia patients to help alleviate their pain. It is also what many fibromyalgia patients would turn to during early years of their condition. However, it wouldn’t take long for many to realize that this class of drugs are not effective for fibromyalgia.

What are anti-inflammatory drugs?

Most over the counter painkillers such as Ibuprofen (Advil), Naproxen (Aleve) fall under the class of non-steroidal anti-inflammatories (NSAIDs) analgesics. As the name suggest, NSAIDs drugs reduce pain caused by inflammation which can result from an infection, an injury or an illness.

What exactly is inflammation?

Inflammation is often misunderstood or misused. Most people use the word inflammation and infection interchangeably causing a misconception of the meaning of an inflammation. While infection is the cause of an attack of foreign substance such as bacteria or virus on body cells, inflammation, on the other hand, is a defensive process initiated by our body in response to harmful stimuli and our body’s attempt to heal itself. Inflammation can cause swelling, redness, hotness and pain.

Under normal circumstances, inflammation is a benign, however, it can become malignant when our body is not able to control it, leading to chronic inflammation which are seen in illness like asthma, chronic sinusitis, rheumatoid arthritis, Crohn’s disease etc.

So why exactly do anti-inflammatories not work for fibromyalgia?

Now back to answering the question, why don’t anti-inflammatories work for fibromyalgia? The answer is simple and many of you probably should have guessed by now. Yes, that’s because despite all the pain associated with it, fibromyalgia is not considered as an inflammatory illness.

Having said that, blood test of most fibromyalgia patients do reveal a presence of slightly raised inflammation levels as compared to healthy individuals but the elevation is not sufficient to qualify as chronic inflammation. Some experts believe that inflammation occurring just beneath the skin in the fascia could be responsible for the inflammation levels seen in fibromyalgia patients. However, this remains a debatable theory.

To date, researchers have reached a common consensus that fibromyalgia pain is neurological, and not inflammatory. Many experts explain that the elevated pain in fibromyalgia is somewhat due to a dysfunctional brain and central nervous system resulting in central sensitization in patients.

This explains why anticonvulsant drugs like Pregabalin (Lyrica), Neurontin (Gabapentin) or antidepressants like Duloxetine (Cymbalta), Milnacipran (Savella) are more effective for reducing symptoms in fibromyalgia patients.


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