The 4 R’s of Fibromyalgia Treatment

In this video from the Frida Center for Fibromyalgia, Dr. Ginevra Liptan talks about the symptoms of the fibromyalgia and her four R’s approach to treatment for the condition.

Nancy talks about how switching to a gluten-free diet helped her keep her fibromyalgia symptoms at bay.

The first step is “rest,” important for anyone who suffers from a chronic illness but something that many fibromyalgia patients struggle to get enough of. The second is “repair,” through digestion and nutrition. The third step is “rebalance,” reducing the inflammation and addressing hormone imbalance. The final step in Dr. Liptan’s treatment program is “reduce,” using targeted medicine to reduce fatigue and other symptoms.

Find out how another fibromyalgia patient copes with her flare-ups.  

Fibromyalgia News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.


  1. Carole B says:

    Hi. I an suffering so much with the fibromyalgia. Nothing works for the paine. Sometime I just don’t want to leve anymore. I need something for the paine. The cannabis patches are they available for Canada ? Thsnk you

    • Tim Bossie says:

      We are so sorry to hear that you have such a struggle Carole. While there are patches on the market through mail order companies, the patches mentioned on our site have not been approved for public use and are not available as of yet. We are hopeful that soon many women like yourself will get adequate relief from the constant pain.

      • Rose M. Flynn says:

        What about Servella? I’m allergic to Lyrica and Garbapentin do you think that will work for me because I can’t bare the pain I’m in 24/7? Please be sure to send me a reply I really need answers from those who have knowledge on Fibromyalgia doctors have me suffering in an unthinkable way

        • Tim Bossie says:

          Hi Rose, Savella is an approved fibro med that has shown good results in clinical trials. Many experienced a 30% reduction in pain over those who took a placebo. However, like any other medication it is not without side effects. If you have tried everything else (Lyrica, Cymbalta) without success, you might want to talk to your doctor about it.

    • Judith Bradley says:

      I am having the same struggles. Plus wide spread
      spinal stenosis. Just does not seem worth it at times. Searching for the most appropriate specialist. I am so sorry for your desperation. I understand.

  2. Roberta King says:

    would like to know after you have done every test, taken a lot meds that just made everything in my life a blur, how do I get the doctors to help you… I don’t want to take meds and live my life in a fog I want to live my life… I work everyday as a motel manager, but I do all the housekeeping, bookkeeping, front desk, maintenance etc… so I don’t rest much I don’t relax have no time. I have asked to be referred to the pain clinic in my area but still have no referral… also have also asked to be referred to the hospital in Toronto for women they run tests and give you advice on what my next move could be and still nothing… most times it feels like he doesn’t believe a word I say and just tries to up my medication… I have since stop taking everything and have been living with the pain, no rest, hardly any sleep… please tell me how I get my doctor to listen and help me… thank you

    • Tim Bossie says:

      Roberta, sometimes the best way to get people to listen and help is to be a consistent pain in their rear. Ask questions, tell of your symptoms and keep asking for those referrals.

  3. I’ve found no medicines to be of any long term benefit to fibromyalgia only for short term flare ups. Natural nutrition, daily mindfulness yoga, meditation, vitamins and supplementation, reduction of chemicals in beauty products and household products and a positive approach are the only successful approaches to reducing symptoms and living as normal a life as possible

    • Ruth says:

      I have had Fibromyalgia for over 50 years, long before it had a name. I saw many, many doctors trying to get help and a diagnosis. Interestingly, I have been taking a prescription medicine for some time called Tramadol. It is related to the opiates, but I have never had to increase the dosage in the years I have been taking it. It reduces my pain and allows me to function normally most of the time. I do have a flare-up now and then, but not very often.

  4. Mason says:

    Thank you for sharing your knowledge; I think more Dr’s should study and know the steps to keep the reactions affiliated with Fybromyalgia from flaring up.

    I was diagnosed in 2007, I still cannot understand how I attracted this painful life, I have been in pain for as far back as 2010, the kind of pain that stays. It has worsened over the years, I am lost in knowing what Dr to see,

    I have had 2 neurologist that told me pain meds are not the answer; but never gave me the steps other than to take meds (which do work, but instead they take them away).

    I was very athletic as a child teen and in College. I do not understand why I cannot find a Dr that can help me.
    I am 55 of age, I’ve birthed and raised two children as a single parent . No one is here to help me deal with this dreadful pain.

    Thanks for listening

    I wake in pain
    I work in pain
    I walk in pain.

    • Tim Bossie says:

      Mason, I am truly sorry for the pain you have to live with alone. Fibro is hard enough to deal with, but to have nobody around makes it exponentially harder. I do hope that you are able to work with your doctor to find some relief from your pain.

    • Sandra says:

      Your story really resonates with me! I am 56 been diagnosed since 35. I take EVERY evidence-based medication there is which is only moderately effective. Like you the pain has worsened over many years. I was forced to leave a career I LOVED because of the pain and am now on Disability. I will say that I recently started Medical Marijuana and am finding it helpful. Not a cure but some help for sure.
      I would recommend if possible for you to get a referral to a Rheumatologist as they usually are skilled at managing Fibro. My Rheumatologist told me she believed that the stress of divorce and raising kids as a single Mom were what triggered Fibro……I am not sure I agree?? I know MANY girls who were or are divorced who do not end up with Fibro…..maybe there is something about the brain that makes me, you, all off us susceptible to this kind of stress response?
      I pray for more research answers and ultimately as cure.
      Keep pushing for what you need…..with Chronic Pain you need to advocate for you own health a lot of the time……don’t give up!!!

    • Carol says:

      The Mayo Clinic in Rochester MN has a Fibro Clinic that is wonderful! They run you through some blood tests to rule out things such as arthritis, lupus or vitamin deficiencies before they diagnose you with Fibromyalgia. Once diagnosed you are allowed into the three day clinic. They give you tools and help you understand what is happening. Then they follow up with ways to help you feel better. Medicine is not always the answer. They have many other things to offer. I went through this several years ago and it has changed my life.

  5. Sandy Geib says:

    Most doctors just want to give you medicine that doesn’t work. I am 70 and have always have been active. I don’t believe the doctors know what Fibromyalgia is. I finally found a product on line that is an all natural vitamin and herbal formula that is working for me from Fibromyalgia Treatment Group. ( Another thing I take from this group is Fibrolief Energy Optimizer which I never want to give up. It helps so much for the those of us who suffer from chronic fatigue. I also take Nerve Renew from Nerve Renew ( I also take a Turmeric capsule every day. These natural products don’t take it away, but so far they are helping me cope with fibro. In addition I walk every a.m. and p.m. for a total of 3-5 miles (depends on how my body and mind is working on any given day), but I push myself to do it. Don’t always want to, but I keep telling myself that I always feel better. One more thing that was suggested to me by a friend of a friend that suffers from Fibro and she gets a massage once a month. I started doing this and I will keep doing massages. Has helped so much.

  6. Lind Dempster says:

    I know the feeling. It is frustrating. Luckily my Dr is awesome. We have found that short doses of the steroid prednisalone really helps. OMG after just two treatments I really feel le myself again. I only e ear take them when the pain is unbearable and I lock up. I just have to be carefull not to do too much I feel that good. My next door nabour quietly a asked me one day while I was having a round…. “What are you on?” She thaught I may have crossed the line and was on speed. I laughed for ages.

  7. Kim says:

    I don’t believe this 4xR’s will work any better than any other previous treatments that have claimed great results then failed. I think this is just another dr jumping on the bandwagon to sell books. I have had FMS for almost 30yrs and your claims that it all starts with stress is just too simplistic.

    • Tim Bossie says:

      Completely understand where you are coming from. However, these types of posts are to give people some tools to help cope with their pain. Yes, it can be a bit simplistic in nature, but some people can gain a benefit from these practices as well as many others. The key is to get as much information as you can to find what works for you.

  8. Genelle says:

    Hi I am a 47 year old woman with fibromyalgia. I have had it a few years it just seems to get worse. My dr.has tried all the meds with me and I live in pain everyday. I am besides myself and don’t know what else to do. Any advice? ??

  9. Paula Bromil says:

    I have had fibro for almost 30 years. Raised 2 children on my own after my husband died of cancer at 40. I remarried and my husband worked night and day, weekends and holidays for 25 years. We also moved away from our support system. Our lives revolved around his job, his exhaustion and subsequent PTSD. I deteriorated, first in depression, then in aches and pains and now hardly able to walk. Many flare-ups later, I have realized that the stress was a very large factor for me. I try to avoid all stress, do laugh therapy, eat well and exercize often. I am still working hard to deal with flare-ups from allergies, weather effects, overdoing and pushing my body to do more. At 67, it is a chore to slow down but recognize that I still have to move to deal with this. I am on a muscle relaxant, gabapentin at night as well as arthritis tylenol when I go out. You convince yourself that things could be worse, but some days you just crash and quiet the mind to deal with this crazy condition. I have seen a rheumatologist who had nothing “new” to offer. I hope and pray that sometime soon, researchers are able to pinpoint the cause and effect. as well as treat this disability. I also have 3 friends who have developed this condition.

  10. Lynn Santosuosso says:

    I am a US Army combat veteran of the first Gulf War. I was exposed to neurological chemical weapons and other environmental hazards. I suffer from Gulf War Illness and one of those aspects of the illness is fibromyalgia and chronic fatigue, however, it has taken 25 years for the VA to admit to this aspect of my illness. Knowing how to treat fibromyalgia is another issue. The VA is not always the best informed, educated and forthright. When I sent a message to my PCP at the VA the other day and they informed her of my increase in flareups and pain she asked me what I wanted for medication. To that I said, if I knew I had to prescribe my own medication then I would’ve gone to medical school! That was pretty much out of frustration and probably not the most appropriate thing to say… This past year has been extremely difficult for me with increased symptoms of pain and chronic fatigue. I’ve changed my work schedule to a four day work week so I have enough time off to get as much rest as possible but it’s still difficult keeping up a home by myself and trying to take care of everything else in between. I feel sometime that I don’t want to go on living like this… The frustration level is overwhelming. I don’t know how much longer I will be able to continue working either, the future is very frightening!

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