6 Best Fibromyalgia Pain Killers

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Of primary concern for sufferers of fibromyalgia, of course, is the issue of pain killers and which are going to be most effective for your pain. There are different symptoms of the syndrome, but pain is the most pertinent condition. Effective pain relief can come from over-the-counter, prescription drugs or a combination. We present the 6 of the best fibromyalgia pain killers.

6 Fibromyalgia painkillers


Advil is a brand of ibuprofen, first developed in 1962.  It is a type of non-steroidal anti-inflammatory drug or NSAID. There are different brands of ibuprofen, but Advil is one of the best known. Similar to Tylenol, Advil is used for pain or fever relief. However, unlike Tylenol, Advil also soothes inflammation, making it one of the most effective fibromyalgia painkillers.

NSAIDs are among the most common pain relief medicines in the world. Over 30 million Americans use them every day to soothe headaches, sprains, arthritis symptoms, and other aches and pains. And, because of the anti-inflammatory abilities that NSAIDs have, they can also lower fever and reduce swelling.

NSAID drugs work by inhibiting cyclooxygenase-1 (COX-1), the chemical responsible for production and release of prostaglandins, which are, in turn, responsible for pain and fever. They also inhibit cyclooxygenase-2 (COX-2), which is responsible for inflammatory response.

These drugs are very effective for relief of pain caused by inflammation. Unfortunately, while the causes of fibromyalgia are still a bit of a mystery, it is known that it is not caused by inflammation. While these drugs have been prescribed often for fibromyalgia pain, they haven’t actually been all that effective on their own. However, NSAIDs have seen success in combination with other pain relievers.


Plain old Aspirin is also a NSAID like Advil, and it’s also one of our favorite fibromyalgia painkillers. The chemical name of Aspirin is acetylsalicylic acid or ASA for short. The use of willow and other salicylate-rich plants has an ancient history, being used by the ancient Sumerians. More recently, ASA in its pure form was distilled in 1899 by a scientist working for Bayer. There are also other brands available such as Bufferin, Entrophen and house brands. Like Advil, because it has anti-inflammatory properties, it can provide fever and pain relief. However, unlike either Tylenol or Advil, Aspirin also works to thin the blood and is therefore often used to prevent stroke and heart disease.

As part of the NSAID class of drugs, Aspirin inhibits COX-1 and COX-2 to provide relief from pain, fever, and inflammation. While most NSAIDs also inhibit platelets in the blood, Aspirin does so irreversibly for eight to ten days, the full lifespan of the platelet. It is this which gives it the ability to act as a blood-thinner, but can also make you more prone to bleeding.

Aspirin is generally safe, but children under 18 years of age should avoid it. While the side effect that might cause Reye’s syndrome is rare and only occurs in very specific circumstances, it is also very serious. Since there are other types of painkillers available, it is easier for children to simply avoid the drug altogether. It should also be noted that while there are products called “baby aspirin” or “low-dose ASA.” In spite of the names, these should also be avoided for children. These products are actually blood-thinners for adults to take to prevent heart disease and stroke.6 fibromyalgia painkillers


The generic name of Tylenol is acetaminophen and it’s also on our list of fibromyalgia painkillers. This drug was discovered and marketed in 1956. It is called acetaminophen in the US, Canada and Japan, and paracetamol elsewhere. Unlike Advil and Aspirin, Tylenol is not in the NSAID category. Because it works on the nervous system instead of inflammation, it is more effective than NSAIDs for fibromyalgia pain.

Tylenol is used for pain or fever relief, but it has no anti-inflammatory action. Therefore, it won’t affect any underlying inflammation that can cause pain. Conversely, it can have a greater effect on pain like fibromyalgia where the pain is brought on by conditions in the nervous system rather than inflammation.

Tylenol is a safe drug to take for pain during pregnancy or lactation. That is because though it can be detected in breast milk, no adverse effects on either mothers or infants have been reported. Therefore, it is considered to be the first choice painkiller in pregnancy and lactation.

Acetaminophen is generally considered a very safe drug because it has few interactions with other drugs. It has also been around for a long time, so healthcare professionals are very familiar with it.  However, this can lead to a significant risk of overdose with the drug. First, because of the way it is perceived, it can mean that people are not as cautious with it as they really need to be. Because fibromyalgia pain is ongoing, it seems likely that, in an attempt to relieve pain, a person might be tempted to take more of the drug than is recommended.

Also, acetaminophen overdose can be quite serious. The symptoms of overdose include nausea, diarrhea, abdominal pain and jaundice. It also has several symptoms that may easily blend with symptoms that a patient is already suffering because of fibromyalgia and can, therefore, be easily missed.

Finally, it can be very easy to overdose on acetaminophen accidentally. This is because the drug is often included in other kinds of drugs. For example, you might be taking Tylenol for your fibromyalgia pain, and then catch a cold. Cold medication often also includes acetaminophen.

Acetaminophen is also sold in combination with opioid and other drugs.

Like ibuprofen and ASA, there are generics and other brands which have acetaminophen as the main active ingredient. They are virtually the same thing as Tylenol, and so it’s up to you which brand you want to use. If cost is an issue, you may want to buy the house brand acetaminophen, which is generally cheaper than the brand name Tylenol.


Unfortunately, there has been a long history of fibromyalgia being treated as a psychosomatic condition, so naturally, you might be suspicious if your doctor prescribes an antidepressant as one of the fibromyalgia painkillers. However, there has been a great deal of success in treating pain through tricyclic antidepressants like Amitriptyline.

It is believed that this is because the mechanism for fibromyalgia pain is chemically based on the neurotransmitters that carry pain signals to the brain. Many of these same neurotransmitters are involved in depression, which helps explain why antidepressants can help with fibromyalgia pain.

Unlike Tylenol, Aspirin, and Advil, Amitriptyline is not available over-the-counter. It is only available through a prescription. The drug can also help with sleep issues that come with fibromyalgia. So it can not only help with pain, but help you get more and better sleep.

It’s also not much of a surprise if the chronic pain of fibromyalgia might have made you depressed. Because there is generally a linkage between physical and emotional health, it will be helpful if it’s possible to elevate your mood. So in another way, an antidepressant can help with fibromyalgia suffering.


Lyrica is an oral medication that is classified as an anti-seizure or anti-convulsant drug. Lyrica is the trade name of the drug Pregabalin and it’s one of the more effective fibromyalgia painkillers. It was the first drug approved by the FDA for treatment of fibromyalgia. Like Amitriptyline, Lyrica is not an over-the-counter drug and must be prescribed.

Lyrica binds to a part of the nerves and it is thought that this reduces the ability for nerves to send pain messages to each other; it slows down impulses in the brain that cause seizures and affects chemicals in the brain that send pain signals across the nervous system.

Again, like Amitriptyline, the anticonvulsants work on the nervous system to relieve pain. The drug will reduce the number of pain signals that are sent to the brain. Fibromyalgia is believed to be caused, at least in part, by nerves being effectively “hyperactive” and so sending too many signals. What anticonvulsants do is calm the nerves and cause them to send fewer signals. This helps them prevent seizures in other conditions and also helps relieve pain in fibromyalgia.


There is little doubt that opioids do the job, and they will almost definitely be one of the most effective fibromyalgia painkillers. However, they also carry a very significant risk of creating dependence. For this reason, while there is very little question that opioids are effective, it is generally seen as a measure to be taken only after other treatments have been tried.

However, because antidepressants and anticonvulsants can take several days to take effect, opioids are sometimes prescribed in conjunction with other drugs. Also, where other options aren’t effective at relieving pain, long-acting opioids are often prescribed to stay on top of the pain while other solutions are explored.

While there are drugs with a higher success rate than others, it is also important to note that what works for one person may not work for another. One single drug won’t work for everyone. Conversely, a drug that may work for you won’t necessarily work for other people. To a certain extent, it will require some investigating and some trial and error.



  • Leslie Snipes

    Nice spin but it’s definitely spin. Amytriptyline comes with very significant risks and use of it for Fibro is OFF label. Pregabalin also comes with significant risks, including a risk of dependence. NO patient should be forced to try these drugs as a prerequisite to opioids. Those come with a risk of dependence? Yeah, so does the use of insulin for diabetes. Pain kills and it kills in a slow and miserable and draining method. When one needs a medication to improve their quality of life, it is absurd to require them to take additional risks from other drugs as a knee jerk prerequisite.

    • Gayle

      Of cours there becomes a dependency for the opioids. The dependency is to be able to have some kind of quality of life. And yes after taking them for years there is withdrawl if you stop. I find my self hurting and in the beginnings of withdrawl at times before I think oh dummie you haven’t had Ned’s for over 6 hs. Dependency and addiction is 2 different things. I’m 60 and raising a 5 year old grand son. If not for my meds I would be in a nursing home and my grand son would be in foster care. What makes me angry as hell are the people that abuse the meds because it makes it harder and harder for us that need them to get them. And of course the looks at the Er if you have to go like when I broke my tib-fib after hip replacement. Also had 2 back surgeries and neck surgery all on top of the Fibro. I was a Paramedic for 15 years all before the hydraulic stretchers and thing that make that job somewhat easier these days. tired of being judged by uppity people that wouldn’t know pain if it smacked them in the face. I explain how I feel everyday to people like this. ” My best day is your worst day with the flu ,”

      • Christine de la Garza

        Gale I couldn’t of said all of this any better than you did ! Thank you and Bravo to keeping it real with this miserable debilitating disease ! ! ! Blessings of comfort sent to each & everyone of us.

  • lisa

    Willing to try anything.

  • Marlo Mackenzie

    Well said Leslie!

  • sally

    So Leslie, what would you suggest, especially when one has been under chronic pain management for 8 years for 3 ruptured discs, a lipomatosis, arthritis since age 10, bilat torn Achilles tendons, bilat torn meniscus and arthritis, fibromyalgia for 11 years plus, and have been on every med there is, and still live in pain 24/7.

    What exactly do you suggest? Tylenol?

  • Mary Howe

    I’m rather disappointed not to see tramadol on this list. While it is categorized as an opioid, it is an atypical opioid and has worked very well for all but the most severe of my fibro flares. It’s also easier to get because it’s only schedule 4 and most doctors that won’t prescribe stronger pain medications will prescribe tramadol.

  • Lizzie

    Hey there Sally. You might re-read Leslie’s comment. I believe she is advocating for you, not against you. I agree with Marlo…Well said Leslie!

  • Treshea Johnson

    Thank you for your courage to say that Leslie. I am now in pain management and they have completely destroyed the tremendous progress my Family Practice Physician had achieved. I am grateful that we can at least still choose. Thank you to this blogger and the time and attention you take to describe to my illness

  • Julie D Castañeda

    I’m actually not using any of these. My doctor has me on Duloxetine 60mg daily, Topiramate 100mg daily, and Tramadol 50 mg as needed for flairs. I’m doing pretty well with these. I’ve made some dietary changes to minimized inflammation, cut out processed sugars, etc. I still have days with migraines and horrible pain, but I found a wonderful rheumatologist who has help me manage fairly well…. .better than I have for years. I have 3 bulging discs, fibromyalgia for 5+ years, and a lifetime history of migraines.