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My sister takes a pill called Amitriptyline for fibromyalgia. It helps her sleep and reduces her pain. I tried one of her pills for my chronic elbow tendonitis. I slept better, felt more rested, and could use my computer for the first time without pain. Would my doctor prescribe this for me if I don't have fibromyalgia?

More and more jobs require repetitive motions like typing, scanning product labels, or grasping tools. As a result, arm pain is becoming a more common complaint. Wrist or elbow tendonitis and/or carpal tunnel syndrome are the most common diagnoses. Treatment for persistent pain associated with repetitive motion tends to be conservative with antiinflammatories, physical therapy, and sometimes, steroid injections. Amitriptylene, an antidepressant used to treat chronic low back pain, headaches, and muscle pain from conditions like fibromyalgia might be of some benefit. A recent study from Harvard University Medical School compared the use of low-dose (25 mg) Amitriptyline with a placebo (sugar pill). They found that the Amitriptyline didn't seem to effect pain levels as much as it helped patients feel better (mood) and therefore able to do more. When they stopped taking the drug, their function declined once again. That's called a reversal of positive treatment effects and points to Amitriptyline being more effective than a placebo. Taking a pill like Amitriptyline one time and gaining benefit from it may in itself be a placebo effect (you think it's going to help, so it does). This medication has not been fully tested in treating chronic or persistent musculoskeletal pain from repetitive overuse. If you have not been treated with some of the other conservative approaches, you may want to start there. Ask your doctor to help you find ways to reduce your pain and improve your function. Of course, ask about the use of Amitriptyline as well and see what's best for your symptoms, diagnosis, and particular clinical picture.

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