HOW DO INFUSIONS WORK IN ALLEVIATING THE SYMPTOMS OF FIBROMYALGIA
Infusions are often part of a multidisciplinary approach in the management of Fibromyalgia. Some of the common infusions in vogue today and their proposed mechanism of action are follows
- Myer’s Cocktail cocktail – Originally introduced by Dr John Myers, a physician from Baltimore who started treating patients suffering with widespread pain and fatigue with intravenous infusions consisting of combinations of calcium, magnesium, B Vitamins and Vitamin C.
The Myers cocktail contains a variety of nutrients:
- 5 milliliters (mL) magnesium chloride hexahydrate
- 3 mL calcium gluconate
- 1 mL hydroxocobalamin
- 1 mL pyridoxine hydrochloride
- 1 mL dexpanthenol
- 1 mL B-complex (thiamine, riboflavin, niacinamide) vitamins
- 5 mL vitamin C
Proposed Mechanism of action
Though the exact mechanism of action remains unclear, groups of patients receiving Myer’s Cocktails have experienced reduction in pain and fatigue.
B Vitamins are essential for maintaining the health of nerve cells and hence probably stabilisation of the nerve cells by the influx of B Vitamins maybe helpful in reducing the pain. The fatigue of FM has been compared to the fatigue experienced after rigorous excercise, which can build up lactic acid in the oxygen deprived muscles. The Magnesium and Calcium help in dilating the blood vessels so that they can carry more oxygen and help muscles relax.Many clinicians like to give weekly intravenous infusions of Myer’s Cocktail to their patients.
Lidocaine Infusions- Some patients of Fibromyalgia, treated with Lidocaine infusions have shown marked improvement in the symptoms. Lidocaine infusions were initially started to manage neuropathic pain. Lidocaine infusions are thought to bring about pain relief via blockage of the sodium channels. It thus attenuates peripheral pain receptors and central hyperexcitability by causing blockage of the sodium channels. Lidocaine also possesses anti inflammatory properties. Lidocaine infusions have nowadays become a common tool in combating hyperalgesia and mechanical allodynia.
Ketamine works by blocking the NMDA receptors. In doing so, it can reboot the pain receptors which have been altered in patients of FM. In the long term ketamine may also help in decreasing Neuro inflammation which might play a role in neuropathic pain.
Intravenous infusions are coupled with a MULTIDISCIPLINARY APPROACH involving pain physicians, physical therapists, clinical nutritionists, clinical pyschologists ,pharmacological as well as non pharmacological interventions for the optimal management of this complex yet highly debilitating entity.