Hello,
I consulted with "pain experts" at a university associated hospital in Washington, D.C. recently. The doctor suggested a lidocaine infusion for fibromyalgia pain. One study I saw showed that the infusions were no more effective than amitriptylline. Does anyone have any experience with lidocaine infusions for fibro pain? I'm also scheduled for a ketamine infusion next year--the waiting list is a year long.
Thanks for any input
I don't have any experience but it sounds interesting. (The ketamine is REALLY interesting). I don't know the side effects but it might be worth a try.
Did you see this study?
It stated that the critical importance of peripheral impulse input for FM pain and hyperalgesia is also attested by the fact that lidocaine has been effectively utilized for the treatment of FM pain using either local injections (
Hong and Hsueh, 1996b) or intravenous infusions (
McCleane, 2000;
Posner, 1995).
In some placebo controlled studies intravenous lidocaine reduced clinical FM pain by more than 50 % and this effect lasted for up to 7 days (Sorensen et al., 1995).
This study used injections not infusions but it found they were helpful. The key for Staud is that blocking the pain inputs from the periphery can be helpful; i.e. FM is not JUST a central sensitization disorder.
Eur J Pain. 2014 Jul;18(6):803-12. doi: 10.1002/j.1532-2149.2013.00422.x. Epub 2013 Nov 5.Analgesic and anti-hyperalgesic effects of muscle injections with lidocaine or saline in patients with fibromyalgiasyndrome.
Staud R1,
Weyl EE,
Bartley E,
Price DD,
Robinson ME.
Abstract
BACKGROUND:
Patients with musculoskeletal pain syndrome including fibromyalgia (FM) complain of chronic pain from deep tissues including muscles. Previous research suggests the relevance of impulse input from deep tissues for clinical FM pain. We hypothesized that blocking abnormal impulse input with intramuscular lidocaine would decrease primary and secondary hyperalgesia and FM patients' clinical pain.
METHODS:
We enrolled 62 female patients with FM into a double-blind controlled study of three groups who received 100 or 200 mg of lidocaine or saline injections into both trapezius and gluteal muscles. Study variables included pressure and heat hyperalgesia as well as clinical pain. In addition, placebo factors like patients' anxiety and expectation for pain relief were used as predictors of analgesia.
RESULTS:
Primary mechanical hyperalgesia at the shoulders and buttocks decreased significantly more after lidocaine than saline injections (p = 0.004). Similar results were obtained for secondary heat hyperalgesia at the arms (p = 0.04). After muscle injections, clinical FM pain significantly declined by 38% but was not statistically different between lidocaine and saline conditions. Placebo-related analgesic factors (e.g., patients' expectations of pain relief) accounted for 19.9% of the variance of clinical pain after the injections. Injection-related anxiety did not significantly contribute to patient analgesia.
CONCLUSION:
These results suggest that muscle injections can reliably reduce clinical FM pain, and t
hat peripheral impulse input is required for the maintenance of mechanical and heat hyperalgesia of patients with FM. Whereas the effects of muscle injections on hyperalgesia were greater forlidocaine than saline, the effects on clinical pain were similar for both injectates.
