Alternative therapies offer longer and more effective relief from fibromyalgia pain than conventional treatments such as narcotic drugs, according to a national expert.

Fibromyalgia, which affects about 5.8 million Americans, is a common and chronic disorder characterized by widespread pain, diffuse tenderness, and fatigue.

The disorder can be difficult to diagnose and treat because the pain messages originate in the central nervous system (the brain and spinal cord), not in the parts of the body where patients experience it, according to Daniel Clauw, M.D., a University of Michigan professor.

This makes drug therapy generally less effective because medications such opioids and other narcotic painkillers do nothing to reduce pain signals from the brain. The drugs actually can make the condition worse, Dr. Clauw said at the recent American Pain Society Annual Scientific Meeting.

He says medications that work better for fibromyalgia include gabapentinoids (Neurontin and Lyrica), antidepressants (Elavil, Pamelor, Lexapro, Zoloft, and Prozac).

However, non-drug therapies, such as cognitive-behavioral therapy, stress reduction and exercise often work even better, said Dr. Clauw. “Sometimes the magnitude of treatment response for simple and inexpensive nondrug therapies exceeds that for pharmaceuticals,” he added.