A fibromyalgia flare (or flare-up) is a temporary increase in the number and/or intensity of symptoms. Worsening pain and fatigue are generally the first two symptoms noticed in a fibro-flare. But other symtpoms like poor sleep, increased cognitive dysfunction and digestive disturbances are often experienced as well.
Some flares only last for a day or two but others may continue for several weeks or even months. It’s those long flares that are the hardest to deal with because it feels like they will never end. When you start to feel discouraged in the midst of a long flare, it’s important to remind yourself that flares are temporary. They will eventually begin to subside.
The best way to prevent FM flares is to identify what causes them and when possible, try to avoid the circumstances that trigger them. Keep in mind that a flare may not occur for up to 48hrs after the event that triggered it.
[From Health Central® - read the 10 causes for fibromyalgia flares here- and be sure to read the comments section too. Good stuff!]
You’ve probably heard of the danger of high heels. But they’re far from the only culprits.
Many common shoe styles are terrible for your muscles and joints. They cause you to change how you walk, how you run, and even how you stand. All leading to muscle imbalances causing that “mystery” back pain.
Back pain from your shoes only gets worse with time. Women take an average of 5,210 steps each day, and men take 7,192 steps daily. Each step is a chance for you to do the right thing for your back – or a chance to reinforce back problems when you’re wearing the wrong shoes.
Take a second look at your feet and the shoes you love to wear, by learning which shoes you should never wear if you have – or want to avoid – back pain.
High heels are guilty of causing back pain in both men and women. While women may recognise that sky-high stilettos are a problem, men may not realize that dress shoes and cowboy boots are the same as high heels as far as their muscles and joints are concerned.
The angle of any heel over an inch high causes you to walk with your back arched and your knees slightly bent. This forces your quadriceps to work overtime, shortens your calf muscles, and puts 200% more stress on your kneecaps as you move.
All that shifted muscle and joint strain rolls up into your spine. While you can try to compensate by stretching your muscles at the end of each day, it’s better to never wear high heels. You may not win any fashion awards, but your back will thank you…
From the MailOnline website – The headline to the article is a little misleading, because what the piece actually says midway through, is that ignoring back problems could be dangerous. The best cure for back pain, it suggests, is to try and stay active and continue with your daily routine, where possible.
‘Going to bed actually makes the condition worse because sedentary muscles lose their strength,’ said Paul Wilson of the Centre for Reviews and Dissemination at York University.
‘The best remedy is to follow a multi-disciplinary programme – a combination of exercise, patient education which involves postural awareness – relaxation routines and behavioural treatment.
‘Sufferers who follow this strategy recover faster, and return to work quicker,’ he said.
Tranquilisers such as valium, which act as muscle relaxants, were also said to help reduce pain, but exercise therapy, involving flexing of the back muscles, made it worse, according to the article.
Manya McMahon of the British Chiropractic Association said she agreed with the report’s findings that the best way to relieve back pain was to carry on with your normal routine rather than staying in bed. But she said ignoring back pain could be dangerous.
‘Sufferers need to visit a doctor, osteopath or chiropractic – or at least someone qualified to diagnose the problem – to ensure there is no underlying problem,’ she said.
‘Back pain can be caused by many problems including life style, postural and even medical conditions. If it’s a medical problem, then it needs to be checked out. Chiropractics feel that taking drugs masks symptoms and does not deal with the cause of the problem,’ she said.
Repeatedly using the same muscle groups causes pain to build up rapidly in muscles, tendons and nerves in the areas concerned, through the repetitive movement and overuse. Notably pain is mostly centred on parts of the upper body, such as the forearm, elbow, wrist, hands, neck and shoulders, and may also cause stiffness and swelling. Ideally rest breaks from the repetitive activity are recommended, although this is seldom a viable option.
There are several types of symptoms associated with repetitive activity:-
bursitis– inflammation and swelling of the fluid-filled sac near the joint of the knee, elbow or shoulder
In a recent repetitive task study in Canada, movement-related pain helped substantiate this escalating pain experience*. The study compared two contrasting groups – those with fibromyalgia and those with lower back pain (LBP) – undertaking a lifting exercise. It documented that fibromyalgia patients reported more intense pain than back pain patients after completing the repetitive task.
“There were no indications that the fear of movement accounted for diagnosis-related differences in repetition-induced pain,” reported the researchers. “Indeed, fear of movement was the same for both the fibromyalgia and back pain patients, so the greater pain in the fibromyalgia group could not be attributed to fear. However, the escalation of pain with repeat movement could offer an explanation for why fibromyalgia patients struggle during the early phases of a fitness program that necessitates using the same muscles over and over again”. The results of the present study show that individuals with fibromyalgia are more susceptible to repetitive-induced activity related pain than individuals with chronic low back pain. The findings are consistent with anecdotal accounts of the difficulties that individuals with fibromyalgia experience in the context of repeated physical activity.”
* Lambin DL, et al. Pain 2011 June;152(6):1424-30.
Original article from The Washington Times Communities :
The National Biotechnology Information Center (NBIC) of the National Institutes of Health (NIH) recently released the findings of research funded by grants from Eli Lilly Pharmaceuticals and Forest Laboratories that claim to have discovered a causative pathology (the science of cause and effect) for fibromyalgia.
The cause of the disease escaped researchers for years. In fact, the condition was considered by many in the field of medicine as psychosomatic (in the mind) because of the variety of symptoms that could not be clinically pinned down and patient reporting was the primary criteria.
Dr. Frank Rice writes of findings at Integrated Tissue Dynamics (see below) that has made a major discovery of the cause of fibromyalgia, making diagnosis more certain and explaining the multitude of varied symptoms and effect.
Research has identified alterations in our core body temperature is a culprit, as our blood acts as a coolant in much the same fashion water does in the radiator of a car. Our major organs and active muscles require a constant temperature of about 98.6°F but sufferers cannot maintain a steady temperature.
If we lose too much heat (hypothermia) or gain too much heat (hyperthermia), our body’s primary thermostat, the hypothalamus, struggles to maintain balance. Our blood is the means by which our body and brain get nutrients, oxygen and takes away waste and blood flow is disrupted.
When we use our muscles, particularly the hands and feet, blood flows between the skin and muscles and must be kept in balance. We have internal thermostat controls distant from the hypothalamus called aterio-venous shunts or AV shunts that act as valves between arterioles or veins that supply the good stuff and venules which carry away waste.
Much as the body as a whole, these must be in synch for homeostasis.
The smallest part of our blood supply system is the capillaries which are tiny vessels that act as temperature regulators (among many other functions) and either conserve or release heat. Capillaries run throughout or bodies and are highly concentrated in our hands and feet. It has long been known that when malfunctioned from injury or another pathological issue, capillary function is diminished causing problems for diabetics.
Now it has been discovered when the AV shunt is defective in function and interferes with capillary function, muscle and skin tissue cannot get proper nutrition or waste drawn away. Additionally, temperature regulation becomes an issue affecting nerve fibres.
One result is a build-up of lactic acid in muscle and deeper tissue affecting the muscular system and causes pain that can seem to ‘travel’ from areas of the body one day to the next and cause fatigue, commonly reported from victims of fibromyalgia.
The sympathetic nervous system which uses the spinal cord for communication and the sensory fibres or nerve fibres that carry signals to the central nervous system, can have their communication disrupted by the results of AV shunt disorder and hypersensitised nerves send pain signals that can ‘travel’ as well.
The American Academy of Pain Medicinefeatured this research on its front cover accompanied by a laudatory editorial from Robert Gerwin of the Johns Hopkins School of Medicine. To date, the research is confined to women, since women seem to suffer from fibromyalgia in greater numbers than men.
According to this research, fibromyalgia has pathology and is not psychosomatic so those who suffer from this ‘syndrome’ can now rest assured it is not all in their minds.
Fibromyalgia is recognised as one of many central pain-related syndromes that are common in the general population. Research advances have led to the conclusion that disturbances within the central nervous system (CNS) represent the most likely cause.
Some researchers have found that daily aerobic and flexibility exercises are an essential component of a successful rehabilitation program. Exercise was first recognized to have therapeutic benefits in the late 20thC. At that time, fibromyalgia patients were randomised to receive 20 weeks of high-intensity exercise or flexibility training. Improvements in fitness, global assessment ratings, and tender-point pain thresholds were greater in the high-intensity exercise group than in the flexibility group. Subsequent clinical trials have confirmed the benefits of aerobic exercise and muscle strengthening on mood and physical functioning.
Patients should begin with gentle warm-up, flexibility exercises and progress to stretching all of the major muscle groups. Low-impact aerobic exercise is necessary at least 3x weekly. Always start at low levels of exercise and progress slowly. The goal is to exercise safely without increased pain. Your target exercise regimen is 4-5x a week for at least 20-30mins each time; this may take the patient months to achieve.
Some patients with fibromyalgia may never be able to achieve this level of exercise; encouragement to exercise at the highest level possible should be the goal without worsening symptoms.
Some researchers believe that aquatic exercise – hydrotherapy – may be the safest and gentlest aerobic conditioning exercise available for this group. Aquatic therapy enables aerobic conditioning and also flexibility, strengthening, and stretching exercise. Aquatic exercise is well tolerated and is especially helpful for some patients.
Certainly this article reproduced here will resonate with those FMS sufferers, like myself, who feel they are sensitive to changes in the weather.
From - http://www.myfibromyalgiadiet.com/2013/09/14/fibromyalgia-and-weather-changes/
Fibromyalgia is an chronic illness with symptoms including widespread pain as well as pain in the tender areas, fatigue, headaches, unrefreshing sleep, waking up stiff and developing cognitive disturbances such as a lack of concentration, clumsiness, dizziness, extreme sensitivity to pain – and a few more.
Some sufferers have reported that they are more sensitive to changes in the weather, to bright lights and hyperacusis (over sensitivity to certain sounds). Amongst all the criteria observed for successful fibromyalgia diagnosis, several record weather sensitivity as a minor criterion for diagnosis.
There are published studies that have associated the pain in fibromyalgia to weather changes. Some studies report that barometric pressure affected fibromyalgic pain positively while others find no association.
There is a definitive association between flare up of rheumatoid arthritis symptoms and weather changes. A wetter and colder climate usually affects arthritis pain adversely. Moreover lower back pain (LBP) worsens with weather and so does osteoarthritis pain due to changes in humidity and temperatures.
However with fibromyalgia sufferers, the belief that the weather affects their pain scores is one of the main factors that affect weather-related pain sensitivity according to one study. In this study patients were given weather parameters like cloudiness, wind speed, barometric pressure, relative humidity, sunlight and temperature and asked to rate their pain scores according to the varying weather conditions. The actual pain scores in the different conditions were examined and the fact that fibromyalgia pain could predict the weather the next day was evaluated for truthfulness. The study found no association between weather changes and fibromyalgia pain on the same or the next day. Furthermore the study revealed that the onset or severity of pain was not indicative of imminent weather change.
The study also found that patients who had been diagnosed with fibromyalgia for less than 10years had significantly greater weather sensitivity for pain and the presence of anxiety and depression lead to an increased reporting of weather sensitive pain.
The importance of self-help groups and support cannot be underestimated - the following is a Press Release from The Royal National Hospital for Rheumatic Diseases NHS Foundation Trust:-
The Royal National Hospital for Rheumatic Diseases NHS Foundation Trust (RNHRD) has joined with other organisations in supporting Fibromyalgia Awareness this September. The Bath based hospital runs a to help people self-manage their condition. Fibromyalgia describes a collection of symptoms which affect the soft tissues, muscles, tendons and ligaments, resulting in widespread and variable pain throughout the body.
Julie Russell, Clinical Specialist Physiotherapist and joint service lead for the Fibromyalgia Service at the RNHRD explains further “As well as the difficulty of the pain itself, the discomfort can lead to poor, unrefreshing sleep which in turn contributes to an ongoing cycle of chronic pain and fatigue, making it hard to carry out even simple, everyday tasks.Fibromyalgia can be a difficult condition to diagnose because the symptoms can be similar to other conditions and no two sufferers will have the same experience. Although there is no simple cure for Fibromyalgia, there are ways of managing your symptoms, and effective treatment can make a huge difference.”
Focusing on raising awareness of Fibromyalgia during September offers an opportunity to find out more about the condition, how it can affect you and what you can do to help yourself if you have the condition. Non sufferers can gain an insight into how the condition can affect quality of life. Fibromyalgia is sometimes described as an ‘invisible disease’ as people can look fine on the outside, but suffer from considerable pain.
Charlotte Cavill who attended a coping skills course at the RNHRD last year says: “The coping skills programme helped me accept that I have a Fibromyalgia and gave me the information that I need to help those around me understand the condition. I have a three year old daughter and work part-time so pacing has helped me to minimise the boom-bust cycle that was making life unbearable.”
Charlotte continues: “I started the course very scared and isolated and thanks to the course now feel confident that I am not alone, can manage the symptoms and know what I can do when I have a flare. This course has given me my life back.”
It is estimated that Fibromyalgia affects nearly 1 in 20 people worldwide. In England and Wales, there could be up to 1.76m adults with the condition.
Anyone can develop the condition, it can occur in people of any age although in most cases it develops between 30 and 60 years of age and it affects more women than men.
The first thing to understand is that other than cases of trauma a slipped/herniated disc does not occur overnight. It may seem like you “threw your back out” all at once, yet it was a process of weakening over time that allowed your disc to suddenly become noticeably problematic. What you may find surprising is many have a herniated disc without pain. It’s when the disc or inner material from a herniated disc press against a nerve that pain results.
Simply put, herniated discs are primarily caused by uneven pressure. Think of driving a car that’s out of alignment. The tyres wear unevenly due to more pressure being present on one edge. Keep driving without fixing the problem and sooner or later you’ll experience a blowout on the worn side.
The effect on spinal discs is similar. Uneven pressure caused by muscle imbalances cause the less-pressured side of the disc to bulge or rupture, squirting the jelly-like interior through the fibrous disc membrane into the spinal column. Imagine squeezing one end of a jam doughnut – the jam would be pushed out the other side.
Relieving the pressure on the herniated disc and correcting the underlying muscle imbalances will either fix the herniated disc or go a long way towards improving the condition.
As you know we love infographics at Nicoll Fibromyalgia Online – here is another one which we found at Real Body Work – http://www.realbodywork.com/articles/Back-pain.html – describing the structures, US-based statistics and causes for lower back pain (LBP).
From NHS Choices – The best way to deal with back pain is to stay active and continue doing regular exercise.
“The advice 20 years ago was to rest, but research has shown that inactivity only makes things worse,” says Dries Hettinga of BackCare, a charity that offers support and information to people with back pain. “When you’re in pain you may want to stay in bed and not move around, but that results in further loss of mobility and will only prolong the pain.”
Staying active means continuing with regular day-to-day activities to avoid becoming sedentary. Examples include walking to the shops rather than taking the car, getting off the bus one stop early, gardening and taking the dog for a walk.
If you experience mild pain, take painkillers available over the counter from your chemist or supermarket. Your pharmacist or GP can advise you on using your medication effectively.
Low-impact exercise ideas:-
Examples include walking, running or jogging, cycling, dancing, swimming, hydrotherapy (exercising in water) and aquarobics.
Hettinga says exercise programmes are most effective if performed regularly and over prolonged periods of time - for at least 150mins a week. You may want to build up to this gradually over several weeks. Hettinga recommends an individually designed exercise programme to give the best results. It is advisable to seek medical advice before starting an exercise routine for back pain.
Read more [http://www.nhs.uk/Livewell/Backpain/Pages/Backexercises.aspx]
From the Barbara Keddy – Fibromyalgia and Sugar Addiction blog
“If only a small fraction of what is already known about the effects of sugar were to be revealed in relation to any other material used as a food additive, that material would promptly be banned” – John Yudkin(b.1910 – d.1995) British physiologist and scientist“.
This is my 79th post on fibromyalgia and/or chronic fatigue and I often wonder what I will write about next. I recently read an interview with Woody Allen who said he walks around and stories come to him. The same seems to apply to me. This time it is about sharing a dark, deep secret.
I am a sugar addict. There! I’ve said it publicly, even though I have known it for many years. I crave it. I like to mainline it with candy. Cookies and cakes…these take too long to give me the sugar high; candy is the fastest hit, especially chocolate. Years ago I read Sugar Blues and thought it did not apply to me. Like all addicts I thought I could stop at any time; I was mistress of my domain. I have rarely met a candy I did not like. I would hide it away from my kids. I would freeze it. I would ask my husband to hide it from me, knowing full well that I would seek it out within minutes of the hiding. Peppermints lined the bottom of my purse. Desk drawers were stuffed with candy wrappers.
But, wait! I did not turn my nose up at ice cream or cakes or cookies! They were a pleasant second choice. Often I would say with pride that I did not take sugar in tea or coffee. That proved that I was not an addict, right? But then, I rarely drink either coffee or tea so who was I fooling? The experts say that I should substitute refined sugar with fruit. But, this doesn’t work very well for me, psychologically.
After menopause, the addiction became much worse and the weight issue became serious. The blood sugar levels began to rise. The fibromyalgia muscle pain increased with the amount of sugar intake. Still, the temporary comfort of the sugar hit was a craving I could not deny. This past winter I decided to go ‘cold turkey’ and lost 20lbs and my blood sugar levels dropped to normal. I even went through the Christmas season without any sweets in my life.
I thought I had finally conquered it! But then, like the alcoholic I tried a little taste of a digestive cookie, then a few weeks later a mint, a wee bit of ice cream; the increase in muscle pain was noticeable, yet I continued on this path. Very moderate exercise which is all we with fibromyaliga can tolerate, is more painful after the sugar indulgence.
Do I read labels? Of course! Yet, I persist on choosing that which has more sugar to feed my addiction. Here is an example: recently a friend gave me a jar of Newman’s Own Mango Salsa. I love salsa passionately and ate it all within a week. Not able to find it locally I bought a brand from my supermarket but it did not give me the same high as the Newman’s Own. I compared labels:
Local Mango and Lime: 1) Sugar 2g, Newman’s Own 3g. 2) Local Mango and Lime : Sodium 135 mg, Newman’s Own 180g. So, did I content myself with the local mango which is the better choice? Of course not! I wrote a note to the management to bring in the higher sugar, carbohydrate and sodium brand of Newman’s Own, which tastes so wonderful. This is but one small example of how even such a tiny difference in sugar content can affect my taste buds! It is no doubt due to emotional eating, which affects so many of us with chronic pain,but the comfort is short lived. I want this sugar fix, but it is not a biological need, rather a brain/mind longing. In the July 2011 edition of the Shambhala Sun magazine, Sasha Loring writes about How to Tame the Wanting Mind with regard to eating issues. It has been most helpful.
What is to be done? I chastise myself regularly. Berating myself does not work; I only feel worse. I have self talk about discipline. I meditate. I do as much light exercise as I can tolerate without a flare up, yet at the end of the day, the addiction rears its ugly head. For the most part of the day I eat a very healthy diet, but when that urge comes upon me, I struggle, then often give in to it.
I know the strategies: eat more fruit, don’t buy high sugar foods, avoid baking, eat only small amounts of high sugar and salt foods. I have lapsed once again. Sugar is in everything it seems, accompanied by its hateful cousin, salt. But, Loring offers expert advice on how to tame this unhealthy wanting.
In all my readings and attempts at dieting I have found that Weight Watchers is the most sensible eating regime to follow. It isn’t a diet per se but a life style change to healthy eating. It requires discipline and making conscientious choices. But, for those of us who are extremely fatigued, particularly at the end of the day, the desire to eat a comfort food is overwhelming and being sensible isn’t high on the priority list.
Fruit, yoghurt, and other healthy choices require motivation and a change of mind. The challenges continue. Today though will be a sugar free day…one day at a time. Hopefully, a pain flare will not arise as I strive once more to forgo the temporary comfort of my addiction. This is now the time to change my brain since I have been advocating this approach for those of us with fibromyalgia for the past 2 years!
It is about truly recognizing that there are other ways of being happy and uplifted and working with the sense of being unfulfilled. Walking when the weather permits, meditating when the craving descends upon me, these among other strategies suggested by Loring are crucial aspects of taming my mind…
I know all the fundamentals. Now to find joy in spite of pain, fatigue and ending the desire to find something outside myself to give me comfort. I am the one I have been looking for! In the words of Judith Viorst “Strength is the capacity to break a chocolate bar into four pieces with your bare hands-and then eat just one of the pieces”.
From – http://womenandfibromyalgia.com/2011/06/03/fibromyalgia-and-the-sugar-addiction/ by Barbara Keddy, BScN, MA, PhD., Professor Emerita, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada who has lived with fibromyalgia for 40+yrs.
Read more of Barbara Keddy’s story – and stories from other fibromyalgia sufferers in her book – click on the thumbnail image to go to Amazon.
The estimated health care costs for back pain total £1.6b per year (NHS & Private).
In addition, the Health and Safety Executive (HSE) estimates that musculoskeletal disorders, which includes back pain costs UK employers between £590m and £624m a year.
Every year, nearly 5m working days are lost as a result of back pain. This means that on any one day 1% of the working population is on sickness leave due to a back problem. Back pain is one of the major reasons for long term sickness in much of the UK.
Back pain is very common; almost half the UK adult population report lower back pain lasting for at least 24hours, at some time in the year. Inactivity and the wrong sort of movement are usually at the root of ‘simple back pain‘. This makes the muscles slacken, and become unable to support the back properly which in turn means it is more vulnerable to damage when certain movements pull too much on one area of your back.
When we sit into a chair, the weight of the upper body causes the pelvis to roll backwards. A good working posture is one that requires the least amount of static muscle work with least muscular effort. The more varied the posture the better. The correct sitting position is the critical first step in minimising the risk of back pain.
The spine is one of the most delicate parts of the human body. As demonstrated in (Fig 1), an incorrect sitting position such as slouching may result in an unhealthy curve of the spine and puts increased pressure on the soft tissues (muscles, discs and so on).
The illustration (Fig 2) shows the use of an upright sitting position, used in combination with a correctly positioned computer screen and keyboard. The lumbar curve is maintained in this way, which helps to reduce the pressure on the structures of the back.
Adjust Your Chair For Maximum Health
An office chair should be adjustable in many ways to support and allow movement to reduce the onset of discomfort. Here are the key points to remember when adjusting the chair to ensure a good working posture is achieved:
Initially sit at the desk, looking squarely at the computer. You are now ready to adjust your chair.
Firstly, adjust the seat height so that your elbows are resting slightly higher than the desk surface (shoulders relaxed). Your thighs should be between 90-95º to the upright body. You may require a footrest if your feet are not comfortably flat on the floor. The top of the display screen should be approximately at eye level (you may need to raise the screen) see Fig. 2.
Secondly, adjust the seat depth – that is the horizontal part of the chair seat – so that you can sit firmly against the back pad with a small gap between the front of the seat pad and the back of your knees.
Next the height of your backrest should be adjusted to match the small of the back. To avoid neck and shoulder tension, shoulders should be relaxed. Additional neck support is generally only required where the person benefits from leaning back to change their posture and requires further support. It is rarely used whilst the person is working; more when they are reclining.
Sitting in your normal working posture, your forearms should rest slightly higher than the working surface, whether the keyboard, the mouse, or paperwork. Armrests are to be used when resting and encourage you to lean back and take the strain off your upper limbs.
Lastly, release the seat and back locking mechanism so the chair can move freely. This free movement encourages your muscles to work and to help your circulation. It greatly helps to reduce discomfort in a sedentary job.
There are a range of ergonomically designed office chairs available these days – with chiropractors and allied health professionals offering their invaluable input into design and comfort. Amazon have a collection of the best – across a range of budgets. Click on the thumbnail here and look at the options available.
Fibromyalgia is a condition that causes lasting, and sometimes debilitating muscle pain and fatigue. No one knows exactly what causes it, but it may be triggered by injuries, emotional trauma, or viral infections. Fibromyalgia is also known as fibrositis or fibromyositis.
Fibromyalgia – the tenderness points
General Description of Fibromyalgia Symptoms
Pain. The main symptom of fibromyalgia is pain. The pain can be in one place or all over the body. The exact locations of the pain are called tender points. Fibromyalgia pain is often described as tender point pain that occurs in local areas. People who are diagnosed with fibromyalgia feel pain in at least 11 of 18 specific tender points. Pain starts in the muscles, usually in the neck and shoulders, and then spreads out from these areas. The joints are not affected, although many patients feel like the pain is starting in their joints. There are no lumps with the pain points, and no signs of inflammation (swelling). The skin also feels more sensitive to the touch.
Widespread stiffness, burning, and aching pain. The pain also “radiates” or spreads, to nearby areas. Most sufferers report feeling some pain all the time, but the intensity of the pain may increase or decrease. Many describe it as “exhausting” The pain can vary with the time of day, changes in the weather, physical activity or inactivity, and stress. The pain is often more intense when sleep is disturbed.
Fatigue and Sleep Disturbances
Fatigue and sleep disturbances are almost universal in patients with fibromyalgia. Restless legs syndrome (RLS) and periodic limb movement disorder (PLMD) are also common. It is not clear whether fibromyalgia leads to poor sleeping patterns or if the sleep disturbances come first.
Many sufferers complain that they can’t get to sleep or stay asleep, and they feel tired when they wake up. Some report that their fatigue is more distressing than their pain, because it interferes with their ability to enjoy life. Some experts believe that if a person does not have sleep problems, the condition may not be fibromyalgia.
Depression and Mood
Up to a third of fibromyalgia sufferers have depression. Disturbances in memory and concentration are also very common. These conditions often go undiagnosed.
The following symptoms may also occur with fibromyalgia:
Digestive problems, including irritable bowel syndrome (IBS) with wind, and alternating diarrhoea and constipation
Painful menstrual periods
Problems with balance
Tension or migraine headaches
Tingling or numbness in the hands and feet
Urinary frequency caused by bladder spasms
Unfortunately in the most common type of fibromyalgia, the causes are unknown. Physical injuries, emotional trauma, or viral infections may trigger the disorder, but no single trigger has been proven to cause primary fibromyalgia.
Many experts believe that fibromyalgia is not a disease, but is rather a chronic pain condition brought on by several abnormal body responses to stress. Areas in the brain that are responsible for the sensation of pain react differently in fibromyalgia patients than the same areas in healthy people.
People with fibromyalgia have decreased activity in opioid receptors in parts of the brain that affect mood and the emotional aspect of pain. This reduced response might explain why fibromyalgia patients are likely to have depression, and are less responsive to opioid painkillers.
Source: Fibromyalgia | University of Maryland Medical Center – http://umm.edu/health/medical/reports/articles/fibromyalgia#ixzz2X3xAlooJ
Click on the thumbnail above to buy My Guide: Manage Fibromyalgia/CFS – by Rebecca Richmond – out 01/07/2013.
Scientists say a single jab could cure back pain for good. An injection of bone marrow into the spine offers hope to millions left in daily agony. And the breakthrough could also boost the economy by saving more than £12b a year lost by patients taking days off sick. Four out of 5 people in UK suffer debilitating back pain at some point in their lives and an estimated 3m every year consult their GP. Possible treatments include painkillers, muscle relaxants, steroid injections, physiotherapy, surgery or simple bed rest. But most are designed just to control symptoms.
Now an experimental study has suggested that bone marrow grafts into the spine could hold out hope of a cure. Dr Donald Meyer, of the Columbia Interventional Pain Centre in Missouri US, said: “Our results are encouraging. Currently, when conservative treatment measures fail, therapeutic options are limited for individuals with back pain due to disc degeneration. Many resort to disc surgery or spinal fusion with mediocre results. Our goal is to help develop a safe, natural method to boost the body’s own capacity to heal disc pain.”
Arthritis Research UK said the study looked promising. “Low back pain, associated with intervertebral disc degeneration, is a painful and debilitating disorder costing the UK economy over £12b a year,” said a spokeswoman. “Although many types of surgery are available for selected patients, current treatments for low back pain remain inadequate, with patients continuing to suffer pain and immobilisation. This study shows that this type of novel treatment using bone marrow grafts may be effective in certain patients.”
Researchers in the US found that the type of bio-cellular grafts increasingly used by surgeons to repair damaged tissue may be useful for treating low back pain. Some though not all patients reported complete relief, the annual meeting of the American Academy of Pain Medicine was told.
The procedure consists of injecting a concentrated form of bone marrow liquid into lumbar discs, which are small cushions of tissue between the bones in the spine that work like shock absorbers. They are prone to wear and tear, and can slip out of place, pressing on nerves.
Back pain accounts for at least 4.9m sick days a year and treatment is estimated to cost the UK NHS £1.5b a year.
Disk Dr. WG30 back treatment and back support belt recommended for lower back pain relief, herniated disc, sciatica, spinal decompression. Back support belt Disk Dr. recommended to wear 6 hours a day, also it can be worn for 12 hours per session, depending on patient’s medical conditions. Click here to go to the Disk Dr website.
Support groups, also called “special interest groups” or SIG, are an integral part of many health organisations and a crucial foundation for those coping with illness.
Support groups allow those who share a common diagnosis to come together, share ideas, coping tips, experiences and most importantly, to exchange emotional support. Most support groups are usually facilitated by leaders who have personal experience in the disease, or condition, and became advocates for others. The primary goal of most groups is to ensure that no one living with the disease or condition that the group serves ever has to feel alone again.
Lack of awareness about fibromyalgia means 1.6m British women in the UK and 400,000 men continue to be marginalised because their condition is not properly recognised.
UK Fibromyalgia is the independent voice of fibromyalgia and it maintains a comprehensive directory of UK-based fibromyalgia support groups. It also serves to inform the public and engage in advocacy; UK Fibromyalgia promotes an Awareness Week in September.
The spine consists of 24 individual bones called vertebrae which are stacked on top of each other.
In between each vertebra there are protective, circular pads of cartilage (connective tissue) called discs. They have a tough, fibrous case that contains a softer, gel-like substance. The discs help to cushion the vertebrae when you move around.
The spinal cord is highly sensitive and passes through the middle of the vertebral column. It contains nerve cells and bundles of nerve fibres that connect all parts of the body to the brain.
What causes a slipped disc?
A slipped disc occurs when the outer case of the disc ruptures (splits), resulting in the gel inside bulging and protruding out of the disc.
The damaged disc can put pressure on the whole spinal cord or on a single nerve root. This means that a slipped disc can cause pain both in the area of the protruding disc and in the area of the body that is controlled by the nerve that the disc is pressing on.
It is not always clear what causes a disc to break down, although age is a common factor in many cases. As you get older, your spinal discs start to lose their water content, making them less flexible and more likely to rupture.
Diagnosing a slipped disc
Your GP will usually be able to diagnose a slipped disc from your symptoms and medical history. They may also carry out a physical examination to test:
sensation in your limbs
Treating a slipped disc
It can take about four to 6 weeks to recover from a slipped disc. Treatment usually involves a combination of physiotherapy, such as massage and exercise, and medication to relieve the pain.
Surgery to release the compressed nerve and remove part of the disc may be considered in severe cases, or if the pain continues for longer than six weeks.
In many cases, a slipped disc will eventually shrink back away from the nerve, and the pain will ease as the disc stops pressing on the affected nerve.
If you have a slipped disc, it is very important to keep active. Initially, moving may be difficult but after resting for a few days you should start to move around. This will help keep your back mobile and speed up your recovery.
Any exercise you do should be gentle and not put a strain on your back. Swimming is ideal because the water supports your weight and little strain is placed on your joints.
Preventing a slipped disc
Taking a few sensible precautions, such as leading a healthy lifestyle, can help prevent back pain and lower your risk of getting a slipped disc. For example, you should:
take exercise regularly.
use a safe technique when lifting any heavy object.
always maintain a good posture when seated and standing.
How common are slipped discs?
Slipped discs are most common in people who are between the ages of 30 and 50. The condition affects twice as many men as women. Slipped discs often occur in the lower back. Although around a third of adults in the UK have lower back pain, less than 1 in 20 people have a slipped disc.
From – http://www.nhs.uk/conditions/slipped-disc/Pages/Introduction.aspx
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Risk factors are distinct characteristics researchers have identified that may increase your chance of getting a certain illness. While researchers have identified some common risk factors for fibromyalgia, there are still many people with the disease who have none of these traits. Also, some women have fibromyalgia with certain diseases, such as osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus (SLE) or other autoimmune diseases. However, others have fibromyalgia without any underlying disease.
Possible risk factors for fibromyalgia include:
Gender (usually female)
Genetic disposition (may be inherited)
Menopause (loss of oestrogen)
Poor physical conditioning
Trauma to the central nervous system (after an injury, accident, illness or emotional stress)
How do I explain my fibromyalgia to family and friends?
There is simply no single theory that explains the cause of fibromyalgia. Neither do we know what causes fibromyalgia to flare up.
Whatever the cause, the unending pain, trigger points and tender points, and insomnia or sleep problems are guaranteed to increase the fatigue and depression you feel. This, in turn, leads to increased anxiety, reduced activity, and greater pain. Disordered sleep, even lack of REM (rapid eye movement) sleep, can reduce your energy levels. If it continues over time, it can lead to a decrease in the body’s ability to repair damaged tissues.
Once your doctor makes a fibromyalgia diagnosis, effective treatment for fibromyalgia can be started. That way, you can manage the symptoms and preserve your quality of life.
Adapted from – http://www.webmd.boots.com/arthritis/fibromyalgia-causes
Researchers are constantly looking at various explanations for the occurrence of fibromyalgia by exploring hormonal disturbances and chemical imbalances that affect nerve signalling. Other experts believe fibromyalgia with its associated deep muscle pain is linked to stress, illness or trauma – that there may be a hereditary cause or maintain there is no explanation at all (idiopathic). However, while there is no clear consensus about what causes fibromyalgia, most researchers believe fibromyalgia results not from a single event but from a combination of many physical and emotional stressors.
What causes fibromyalgia?
It has been speculated that reduced levels of serotonin in the blood leads to lowered pain thresholds or an increased sensitivity to pain. Serotonin is a neurotransmitter in the brain. It’s associated with a calming, anxiety-reducing reaction. Other hormones that have been found to be low in those with fibromyalgia are noradrenaline and dopamine. The lowered pain thresholds may be caused by the reduced effectiveness of the body’s natural endorphin painkillers and the increased presence of a chemical called “substance P.” Substance P amplifies pain signals.
There have been some studies that link fibromyalgia to sudden trauma to the central nervous system (CNS).
Disruption in the transmission of pain messages may also be responsible, as may disturbed sleep patterns.
Who gets fibromyalgia?
It is thought that up to one in 20 people is affected by fibromyalgia. It is far more common in women than in men. Some interesting studies show that women have approximately 7x less serotonin in the brain. That may explain why fibromyalgia syndrome, or FMS, is more prevalent in women.
Does stress cause fibromyalgia?
Some researchers believe that stress or poor physical conditioning are factors in the cause of fibromyalgia. Another theory suggests that muscle “microtrauma” (very slight damage) leads to an ongoing cycle of pain and fatigue. This mechanism, like all the others, is still unproven for fibromyalgia.
Do insomnia or sleep disorders cause fibromyalgia?
Most people with FMS experience insomnia or non-restorative sleep – sleep that is light and not refreshing. Disordered sleep might lead to the lower levels of serotonin, which results in increased pain sensitivity. Researchers have created a lower pain threshold in women by depriving them of sleep, possibly simulating fibromyalgia.
Is depression linked to fibromyalgia?
Some scientists used to believe that because fibromyalgia was accompanied by depression, there may be a link between the two illnesses. Today, mental health issues are no longer thought to cause fibromyalgia. However, long-term pain can cause feelings of anxiety and depression, which may worsen the symptoms.
Is fibromyalgia hereditary?
Like other muscle diseases, fibromyalgia could be the result of a genetic tendency that’s passed on from parents to children. Some researchers believe that a person’s genes may regulate the way his or her body processes painful stimuli and believe that people with fibromyalgia may have a gene or genes that cause them to react intensely to stimuli that most people would not perceive as painful. To date, these genes have not been isolated or identified.
It’s thought that when a person with this genetic tendency is exposed to certain emotional or physical stressors, such as a traumatic crisis or a serious illness, there is a change in the body’s response to stress. This change can result in a higher sensitivity of the entire body to pain.
Adapted from – http://www.webmd.boots.com/arthritis/fibromyalgia-causes
Recent studies have reported positive effects of moderate alcohol consumption on chronic pain and rheumatoid arthritis, but no studies to this date have examined alcohol consumption in patients with fibromyalgia. Arthritis Research and Therapy recently examined the association between alcohol consumption and symptom severity, together with quality of life (QOL) in patients with fibromyalgia. Last week they published their report from research of over 900 patients grouped by level of alcohol consumption – ranging from no alcohol use to heavy consumption (>7 drinks/week).
Their findings suggest that low-to-moderate alcohol consumption (3-7 drinks/week) was associated with lower fibromyalgia symptoms and better QOL compared to non-drinkers whilst acknowledging that the reasons for these results are unclear. Since recent studies have demonstrated that gamma-Aminobutyric Acid (GABA) levels are low in fibromyalgia sufferers, and alcohol is known to be a GABA-agonist, future studies should examine whether alcohol could have a salutary effect on pain and other symptoms in fibromyalgia.
They recommend further investigation to ascertain any mechanism associating alcohol and symptom severity in fibromyalgia. Future studies, they report, may consider assessing the relationship between GABA, alcohol consumption and fibromyalgia symptoms.
Another aspect of fibromyalgia is “dysautonomia” where the autonomic nervous system is off balance. The “autonomic nerve system” refers to the outgoing nerve signals that control so-called “automatic” functions – such as digestion, heart rate – essentially all internal processes.
The autonomic nervous system has two main components – known as the sympathetic and parasympathetic systems. They counterbalance each other to control bodily function.
The sympathetic nervous system (SNS) is one of two elements of the autonomic nervous system: the other being the parasympathetic system. Its general action is to mobilize the body’s nervous system fight-or-flight response. It is, however, constantly active at a basic level to maintain homeostasis – the key process in which the body’s internal environment is kept stable. When the sympathetic system is at a peak, more blood is sent to the muscles and less to the digestive tract, for instance.
In contrast, the parasympathetic nervous system (PNS) generally works to promote maintenance of the body at rest.
Sympathetic and parasympathetic systems typically function in opposition to each other – but are complementary in nature.
Currently doctors take it for granted that most patients will have too much sympathetic activation. Clinicians often advise a patient to meditate, practice relaxed breathing, masticate food more slowly, listen to relaxing music, etc. – activities that enhance parasympathetic tone and calm down our fight-or-flight reactions.
The typical fibromyalgia sufferer is an even more extreme example of autonomic imbalance. Your sympathetic system is flying high and your parasympathetics are overwhelmed.
There’s a new generation of drugs out there for fibromyalgia. They’re not pain relievers like aspirin or ibuprofen – those drugs target the peripheral pain signals coming into the brain from the rest of the body. The newer fibromyalgia drugs are centrally acting – they target the way the brain processes pain. The best treatment for fibromyalgia is highly customized and takes into account the specific symptoms you’re experiencing and, importantly, the psychosocial dimensions of your situation.
Naltrexone, a drug used primarily to treat alcohol dependency and opioid addiction, may be beneficial for people with fibromyalgia, a small study suggests.
The drug belongs to a group of medicines called opioid receptor antagonists and research suggests that small doses may help to reduce pain associated with inflammatory and autoimmune conditions, such as fibromyalgia syndrome (FMS).
Naltrexone is still an experimental therapy in the treatment of FMS and there have been previous studies to gauge its success, so researchers at Stanford University School of Medicine conducted a small clinical trial to assess its efficacy.
The team recruited 31 women with fibromyalgia, all of whom were given 4.5mg per day of naltrexone or a placebo (dummy treatment).
Their daily pain levels were recorded to see whether naltrexone helped to reduce the severity of their presenting symptoms, while other outcomes such as general satisfaction with life, mood, quality of sleep and fatigue levels were also assessed.
Publishing their findings in the journal Arthritis & Rheumatism, the study authors revealed that women using LDN typically benefited from a 28.8% reduction in pain, compared with just an 18% reduction for those on the placebo.
LDN was also associated with improved satisfaction with life and mood, but not with reduced levels of fatigue or improved sleep.
Overall, 32% of naltrexone users experienced a significant reduction in pain as well as a significant reduction in either fatigue or sleep problems and none of the naltrexone users experienced any serious side-effects associated with their treatment.
The study authors concluded: “The preliminary evidence continues to show that LDN has a specific and clinically beneficial impact on fibromyalgia pain.” Furthermore they added that the medication is “widely available, inexpensive, safe and well-tolerated”.
A spokesman for Arthritis Research UK said the results of the study looked promising but that the number of patients involved was a small sample size, and the results would need to be identified in larger study samples.
For years, research has shown a link between smoking and an increased risk for lower back pain and vertebral (spine) disc disease, combined with poorer patient outcomes following surgery. A new study, published at the end of 2012 in the Journal of Bone and Joint Surgery (JBJS), also found that smokers suffering from spinal disorders and related back pain, reported greater discomfort than spinal disorder patients who stopped smoking during an 8-month treatment period.
Nearly all adults will be seen at some time by a health professional for back pain or other painful spinal disorders. As smoking has been identified as a modifiable risk factor for chronic pain disorders, researchers reviewed the smoking history and monitored the reported pain of more than 5,300 patients with axial (back) or radicular (leg) pain from a spinal disorder, treated surgically or non-surgically, over an 8-month timescale.
At the time of entry into care, patients who had never smoked and prior smokers reported significantly less back pain than current smokers and those who had quit smoking during the study period. Current smokers reported significantly greater pain in all Visual Analogue Scale (VAS) pain ratings – worst, current and average weekly pain – when compared with patients who had never smoked.
Other Significant Findings:
Those who quit smoking during the course of care reported greater improvement in reported back pain than those who continued to smoke.
The mean improvement in VAS pain ratings was clinically significant with non-smokers.
The group that continued smoking during treatment had no clinically significant improvement in reported pain.
Using the Oswestry Disability Index (the most commonly used outcome measure for low back pain assessment), greater mean improvement was observed in patients who had never smoked when compared to current smokers.
“We know that nicotine increases pain,” said study author Glenn R. Rechtine, MD, University of Rochester Department of Orthopaedics. “In this study, if you quit smoking during treatment, you got better. If you continued to smoke, there was statistically no improvement, regardless of the treatment you had. Smoking is bad for you. Basically, the likelihood to improve your care – surgical or non-surgical – was dramatically decreased if you are a smoker”.
“This study supports the need for smoking cessation programs for patients with a painful spinal disorder given a strong association between improved patient reported pain and smoking cessation,” said Dr. Rechtine.
Fibromyalgia, a chronic, debilitating, autoimmune syndrome causing severe pain in the muscles and tissues as well as fatigue in over 6m people in the US and nearly 1m in the UK, often causes various other problems, including difficulty with vision. Fibromyalgia affects the nervous system, and therefore, can impact eyesight. It can cause the eyes to become sensitive to both light and touch, and can induce dry eyes, blurred vision, and even blindness.
Sometimes, those who suffer from fibromyalgia become overly sensitive to different sources of light. For instance, some may find it impossible to work under the glare of fluorescent lights or to watch a bright TV or computer screen. Some even find it impossible to watch a live sports game in a brightly illuminated field or to be in bright sunlight without wearing dark glasses.
I am often asked why I prefer to work in dimmed light by my co-workers when they come into the office in the morning. Also I tend to wear a peaked hat on most occasions outdoors. The problem I have found is my light-sensitivity and the reasons are explained here.
If you suffer from chronic pain or fibromyalgia syndrome (FMS) you don’t need a GP to tell you how debilitating it can be. You ache all over, your energy is flat, your mood could be low, and it is likely you have trouble sleeping.
You’re seeking almost any solution to get relief from your aches, give you a little more energy, and just help you feel a bit better about life.
Doctors can get frustrated trying to treat people with FMS. But over the past 20 years the medical world has finally come to acknowledge a group of patients who have difficult-to-explain, generalized pain — what’s now called fibromyalgia. And it’s an area that’s actively being researched.
Naturally, the drug companies are funding lots of the research, and their focus is finding medications to reduce the symptoms. Equally importantly, the basic scientific understanding of the condition – and how it can be treated naturally — continues to grow.
11 Tenderness points
Probably no one understands your condition better than you yourself do. But to help you relate your inner experience to current scientific knowledge, the following is a generalised description of reported symptoms:-
people with FMS have widespread pain that just won’t go away. And the pain isn’t conveniently explained by a specific medical condition or injury.
in addition to the pain, there are many other symptoms that can occur – non-restful sleep, low mood, lack of energy, digestive problems, and much more.
fibromyalgia cannot be described as a homogeneous condition – everyone is different.
the standard definition of FMS requires that you have tenderness at 11 or more (out of 18) sample points on the body. But we know that this definition is over-simplified and arbitrary. Tenderness varies from day to day and even moment to moment. There’s nothing sacred or prescriptive about the number 11. And there’s a lot more to fibromyalgia than just tender points.
there are genetic factors that put you at risk of developing fibromyalgia. If you have a genetic predisposition, FMS can be triggered by a specific event — such as physical trauma, chemical exposure, experience of a traumatic event, extreme emotion, reaction to medication, a viral infection, or other variations.
fibromyalgia overlaps with many other syndromes, such as chronic pain, chronic fatigue syndrome (CFS), multiple chemical sensitivities, IBS, interstitial cystitis, post-traumatic stress, depression, sleep disorders, arthritis, and more.
these conditions are now beginning to be understood as examples of CSS (central sensitivity syndrome). That means that fibromyalgia and these related problems involve an altered state of brain processing. The nervous system becomes overly sensitized to pain signals – the pain starts to take on a life of its own independent of any original source.
what that means is that you can’t point to a specific anatomical spot and say – aha! – there’s the problem! Even though all your body parts seem to be intact, your system isn’t functioning well overall.
Fibromyalgia may be under-diagnosed in men, a new study in the journal Arthritis Care & Research suggests.
The illness is characterised by widespread pain, fatigue, sleep problems, memory and mood issues, and is often difficult to diagnose.
It is more common in women than men, but a new study suggests this fact may be leading doctors to overlook the possibility of Fibromyalgia Syndrome (FMS) when assessing men with these symptoms.Researchers at the Mayo Clinic in Rochester, Minnesota reviewed more than 3,000 patients, aged 21 and over, in a single county in Minnesota, all of whom looked as though they may have FMS.
Of these, around a a third had been formally diagnosed with the condition, equating to only 1.1% of the county’s entire adult population. The researchers then randomly surveyed 830 adults from the county’s general population and found that 5.3% of them (44 adults in all) met the American College of Rheumatology’s criteria for FMS. Yet only 12 of these adults had been diagnosed with the condition.
The study would therefore indicate that 6.4% of adults in the county have Fibromyalgia – far more than official diagnosis figures suggest. Researchers also observed that the discrepancy between the number of people reporting Fibromyalgia symptoms and the number diagnosed with the condition was greatest among men.
3x more women appeared to have Fibromyalgia than had been diagnosed, compared with 20x more men.
Dr Ann Vincent, medical director of Mayo Clinic’s Fibromyalgia and Chronic Fatigue Clinic, observed: “Health care providers may not think of this diagnosis when face to face with a male patient with musculoskeletal pain and fatigue. These findings need to be explored further.”
To review the article from the Mayo Clinic – use the link below - opens in new window
Fibromyalgia often develops after a physical trauma (i.e. an accident, injury, or severe illness) that appears to act as a trigger in predisposed individuals. Such a trauma may affect the central nervous system which in turn produces the condition that we know as Fibromyalgia. In 1997 a team of investigators reported a study of the relationship between cervical spine injuries and the onset of fibromyalgia which found that FM was 13x more likely to occur following a neck injury than an injury to the lower extremities. Studies also show that whiplash of the cervical spine almost always (90-95% of the time) result in damage to the temporomandibular joint (TMJ) and regional fibromyalgia of the head, face and neck.
Patients with fibromyalgia that developed after a trauma will have a “typical history.” The person reports severe pain as their main complaint with the pain commonly in the neck, shoulders and/or back areas. Usually, the person had no previous history of ongoing pain and was in good health until the trauma occurred. Within a short while after the accident, the person developed pain that endured. There may have been a visit to Accident and Emergency, X-rays and evaluations, medications, and other medical treatments, including physiotherapy. Some or these treatments may have helped, but the pain persisted and continued to be described as severe.
When this person is examined by a doctor or clinician, abnormalities such as tender points can be detected. Tender points are areas in the soft tissues, especially the muscles which are very sensitive and painful when pressed. These tender points are in distinct locations of the body. The presence of tender points are the main criteria used to diagnose fibromyalgia; if they are widespread in numerous distinct locations, then fibromyalgia is considered to be generalised.
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Do you understand what causes your fibromyalgia pain and can you explain it to others? According to a study by Robert Ferrari, M.D. and a team of primary care clinicians, these two questions are the source of frustration among most people diagnosed with fibromyalgia.*
“Fibromyalgia patients have long been described as having a disorder that lacks face validity,” writes Ferrari. “The feeling or implication that one’s symptoms, especially pain, is described as ‘medically unexplained’ is of concern to patients, to the point of being offensive.”
Why shouldn’t you be a bit unnerved when your condition is put in the “medically unexplained” category? It implies your condition is poorly defined, despite more than 20 years of active research on its causes
“Patients have indicated exactly this: while the diagnosis may confer some legitimacy, it does not improve their understanding of their own illness, nor help them explain their illness to others,” Ferrari explains in his article. Based on this perception, he compared a group of 104 fibromyalgia patients to a group of 272 “other” chronic pain conditions. This latter group had either rheumatoid arthritis, whiplash-associated disorder, osteoarthritis, tendinitis, bursitis, or back pain.
Ferrari found people with fibromyalgia were four times more likely to have trouble understanding and explaining their pain to others than people in the group of “other” disorders. Admittedly, the diagnosis of fibromyalgia has been controversial and patients are stigmatized for having such a wide range of symptoms. However, many patients in the “other” group had ill-defined or difficult-to-describe conditions as well.
“Whiplash is a highly controversial disorder,” notes Ferrari, “and rheumatoid arthritis patients have only ‘autoimmune’ and ‘inflammation’ to rely on for explanation.” Despite the complexity of these terms, rheumatoid arthritis patients feel confident understanding their pain and explaining it to others. Ferrari found patients with tendinitis, bursitis, and back pain often view their pain as a form of arthritis, which is what they told others. While this belief is incorrect, it undoubtedly makes life easier.
“It is not accuracy and proper explanation that matters in one’s sense of understanding,” claims Ferrari. “Perhaps people with fibromyalgia have too many symptoms and too much information about their likely causes, which makes it more difficult to put into a few words, like “arthritis” and “inflammation.” For whatever reason, people tend to automatically understand these two words mean serious pain.
Attempts to explain your fibromyalgia in terms of everything that is going wrong in the nervous system and the muscles could be overwhelming. After all, scientists are still trying to iron out the details of what causes fibromyalgia pain and other symptoms. Although describing your condition in terms of current research findings may be more accurate, it could also be an added burden you don’t need. Maybe if you just said you had widespread arthritis (even though you know this is not the case), life would be easier.
Knowledge is power for helping you adapt and understand why certain treatments may reduce your fibromyalgia symptoms. But when it comes to everyone else, view the explanation of your fibromyalgia on a need-to-know basis, with less information being the easiest for most people to grasp.
It is an approach and strategy I have used for nearly 20 years.
* From - Ferrari R. Quantitative assessment of the “inexplicability” of fibromyalgia patients: a pilot study of the fibromyalgia narrative of “medically unexplained” pain [published online ahead of print]. Clin Rheumatol. July 22, 2012.
It is essential that you consult your health professional or physiotherapist before commencing any extension exercises.
An understandable response to experiencing back pain is to take it easy and relax – either staying in bed or at least stopping any activity that is at all strenuous. Whilst this approach seems to make sense and is often recommended in the short term, when continued for more than a day or two it can actually undermine healing. Instead, active forms of back exercises are almost always necessary to rehabilitate the spine and help alleviate back pain.
Recommended by osteopaths and physiotherapists (which is where I came across this book) Robin McKenzie has written an easy to follow guide called “Treat Your Own Back” which includes useful background information and rehabilitative exercises.
Speak to your health professional first; it only takes one bad movement to cause damage to your discs.