Fibromyalgia pain⁵ is a call to action!
The only conventional medical treatment that has been proven to be very useful, is exercise. This exercise however, has to be done according to a strict protocol.
This protocol is also appropriate for anyone who is just starting an exercise program to get fit.
We are concerned here with the amount rather than the exact type of “aerobic” exercise.
Exactly the same principles apply to resistance exercises (such as pumping iron.)
The type of exercise will vary with the details of your condition, and may need to be prescribed by an exercise physiologist.
You start with a time exercising, that you can even do on one of your bad days, even though this may be a ridiculously tiny amount.
You exercise for this amount of time every day, including on bad days.
It is equally important not to do more exercise than that, on a good day.
People who are disabled, naturally feel very frustrated. They can’t do what they used to be able to do. If they have a good day, they are likely to “go for it” and end up getting very sore or fatigued. If you do this, it can set you back badly.
I can vouch for this from personal experience. Some years ago, I foolishly disregarded the program laid out for me at a gymnasium, thought I could start much more quickly, and paid dearly for it. I was really surprised how many days I was sore for.
In a fortnight or so, once it is clear there’s no problem, the exercise program is increased a little.
This is increased after that as often as you feel fit enough to do so.
This exercise regime is appropriate for everyone in just about every circumstance, not only for fibromyalgia pain . People with severe heart or lung disease even, respond favorably. In these people the benefit can be quite useful. It can be enough for them to no longer need surgery (partial pneumonectomy - bullus removal, in emphysema.)
Consider getting a top of the range mini trampoline, or an air walker.
If you're pretty disabled, you will be starting with very brief workouts. These can be one step away from your bed.
Conventional medicine has very little to offer otherwise, apart from pain relief.
Adjuvant drugs used including amitriptyline, duloxetine hydrochloride, gabapentin and naltrexone are sometimes of limited use.
Pregabalin benefis 1 person for 7 treated⁴.
Dr. Daniel J. Clauw, MD, obviously a very good doctor, has given his management regime in an interview²
In fibromyalgia chronic pain is debilitating, quite apart from the metabolic disturbance responsible for the condition in the first place.
Adequate pain relief is a must, even if it involves conventional medicine and opiod drugs temporarily. NSAID drugs are another thing, even over the counter versions. These are even more likely to aggravate while they relieve.
In order to overcome the attitudes developed because of disability, and the belief patterns developed because of failed treatments, some self analysis using an affirmation - response exercise may be helpful.
This is self administered, contemplative work. You may operate better when interacting with other people, who can act as a sounding board, accountability partner, reality check etc.
Reiki is wonderful in this work, operating at a totally different level. It provides fuel for the spiritual part of our being, leaves it up top us how we use it.
These range from providing symptomatic relief to attempting to manage the underlying biochemical and physiological disturbances.
Fibromyalgia and chronic fatigue are allied conditions.
Chronic fatigue syndrome (cfs) as usually defined, is simply a small segment of this continuum (with a relatively sudden onset, predominantly of fatigue, following a probable viral infection, with Epstein-Barr virus, Ross River virus etc in Australia³, others elsewhere.)
None of these labels make a scrap of difference to management.
As with inflammation , for causes of fatigue and fibromyalgia pain, start by looking at your bowel function and flora.
A lactulose/mannitol test of your intestinal permeability, may show leaky gut.
A hydrogen breath test after a rice load, may show small bowel bacterial overgrowth.
Comprehensive digestive stool analysis may show up a lot of other possibilities, including large bowel.
Check your detoxification metabolism by specialized pathology, again through laboratories such as Great Smokies (now Genova.)
Even without checking this, it is reasonable to try a supplement called glutathione. This is the principal antioxidant manufactured in our cells, and is one of the molecules attached to toxins to get rid of them from our body.
It has not been available until now, in a form which is well absorbed when taken by mouth. This has all changed with the introduction of LivOn labs "Lypo-Spheric" GSH.
Correction of deficiency of vitamin D can help⁷.
Acupuncture is worth trying, as part of the whole management.
Laser treatment ditto⁶.
Nutrient supplements can be used to alter neurotransmitters involved in acute and chronic pain.
Magnesium has been shown to reduce need for pain relief after operations¹. It blocks NMDA receptors, concerned with pain. It is low in fibromyalgia.
Zinc is also a crucial nutrient to assess in fibromyalgia pain, due to its involvement in digestion of our food and production of proteins and neurotransmitters...
low levels of breakdown products of noradrenaline and serotonin have been found in the cerebrospinal fluid which surrounds the brain, in people with fibromyalgia. Drugs, herbs and nutrients to increase the levels of these neurotransmitters, are used
Lots of other nutrients have been found useful in some people. A good list and sources is on the ukfibromyalgia site.
From fibromyalgia pain to home pain page
Parkinsonism as a cause of general aches and pains.
Chronic pain syndrome page
Cancer pain - general comments on management
Chronic pain advocacy, resources
Backache? - think thyroid gland malfunction
Primer on patient doctor communication problems
Understanding that this condition is a disturbance of function, potentially completely reversible.
Honesty with oneself re level of motivation and preparedness to seek help.
Recognize any social predicaments, including relationship, economic, domestic and work related.
Be prepared to look at anything, as well as having healthy skepticism.
Learn about analgesic drug use. It is easier to prevent pain than relieve it, so analgesics are taken regularly rather than only once it has become intolerable. Maybe 30 to 50% reduction in pain is the best one should aim for, as larger doses of analgesics produce more side effects.
In plain English, that is the causes and modes of development of the syndrome. The word syndrome means a collection of symptoms and physical attributes, which occur together often so they are thought to be connected in some way.
One such theory involves the following steps...
• genetic characteristics
• early childhood trauma (emotional or chemical)
• post traumatic stress disorder or specific intolerance, of some degree
• later events or exposures "pressing the buttons" and causing stress
• release of Corticotropin releasing hormone
• release of somatostatin
• reduction of growth hormone
• reduction of liver insulin-like growth factor
• reduced healing of muscle microtrauma
• muscle pain
1. Lysakowski et al Anasth Analg 2007 104(6) pp 1532-9
4. Tzellos TG et al, Gabapentin and pregabalin in the treatment of fibromyalgia: a systematic review and a meta-analysis. J Clin Pharm Ther. 2010 35(6):639-56.
5. This is widespread pain, accompanied by widespread tenderness to pressure. Push with a finger pad just enough to start to squeeze the blood out of the skin under the fingernail.
Abnormal tiredness and unrefreshing sleep and emotional disturbance are part of the deal as well.
It is best not to rely on self diagnosis, as lots of other conditions can either co-exist with FMS or mimic it.
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"Leaky gut" refers to damaged bowel wall, allowing germ products into
circulation (leak is into the body.) The damage also results in faulty
absorption of nutrients into the body, which causes uneven absorption of
the amino acids needed to build our proteins and make our
N methyl D aspartate (NMDA) is a neurotransmitter - one of the substances which modify how nerve cells talk to each other.