Fibromyalgia

Read this important information about this debilitating disease that affects millions.

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Fibromyalgia is a syndrome involving debilitating pain, sleep disturbance, jaw pain, irritable bowel, headaches, difficulty with concentration, anxiety and/or depression, and fatigue. In the United States, this condition affects nearly 4 million people, or 2% of the population; twice the number as those with rheumatoid arthritis. The primary symptom, pain, which often migrates through the entire body, usually occurs between the shoulder blades, on the forearms and outer thighs, and throughout the neck and back.

Fibromyalgia (FM) was called Fibrositis until 1991 when the American College of Rheumatology officially recognized this unique collection of symptoms and classified the condition

as Fibromyalgia. Prior to FM, the syndrome was confused with mononucleosis, arthritis, Lyme Disease, and Chronic Fatigue Syndrome. Many sufferers describe years of seeking medical help, only to be brushed aside. They were told by their physicians “it’s all in your head” or “there’s nothing we can do; you’ll have to learn to live with it”. They continued to feel invalidated, afraid, and alone.

FM often affects women who describe themselves as Type A, perfectionistic, over-achievers. They also appear to have difficulty with stress management and assertiveness. These personality traits may create the breeding ground for FM.

Many with Fibromyalgia describe an initial stressful situation or physical injury which triggered the FM, like a car accident or work stress. The injury may have begun as a minor sleep problem or a painful joint, but instead of getting better, it progressed into Fibromyalgia. I personally believe FM is the accumulation of stressful situations in a person’s life which can no longer be handled by the mind, so the stress overflows into the person’s body, sleep, and mood. Some researchers believe FM is a form of Post Traumatic Stress Disorder. The fact that women are affected four times more often than men also speaks to how women view themselves in society and how our society treats women.

Currently, Fibromyalgia affects six million Americans or up to 1 in 10 women. Its cause is unknown, but serotonin, growth hormones, and Substance P are all being investigated. There are no tests, such as blood work or X-Rays to see FM. Diagnosis is made when 11 of 18 specific sites, called tender points, are unusually painful to touch, along with the person’s collection of symptoms.

There are no medications to take Fibromyalgia away, although elavil, desyrel, and serzone have been found to be helpful in lower dosages, as well as analgesics and mood elevators.

So what happens?

If left untreated, the symptoms of FM can persist or even worsen, preventing many to fully function at work or at home because of pain and fatigue.

But Fibromyalgia can be treated and the symptoms can be alleviated!

The most important issue in treating FM is helping a person to recognize how stress and stressful situations specifically affect their body. Many sufferers have noticed that when they are stressed, their shoulders rise up toward their ears, or they may hold their breath. They describe the way they walk and move as “driving with the emergency brake on”. All the muscles of the body tighten or contract with the simplest motion, like washing dishes, vacuuming, or typing on the computer. This constant tension wears the body down, making a person feel weak and tired. Not surprisingly, persons with FM have a high rate of tendonitis, bursitis, carpal tunnel syndrome, and other musculoskeletal ailments.

Re-learning how to move smoothly and efficiently again is the first step to healing. After identifying the exact problems, correction may be as simple as placing a post-it note over the kitchen sink or on the computer screen that says “relax your shoulders” or “take a deep breath”. Imagery also helps. For instance, a person could pretend their arm is like a ballet dancer’s arm, as it slowly and softly floats up to put away the dishes.

Sleep is another important issue to address. Persons with Fibromyalgia may have a paroxysmal sleep pattern, which means they can’t maintain a deep sleep. It may take longer than the normal 20 minutes to fall asleep or they may awaken during the night and be unable to get back to sleep. Most distressing is that they often awaken in the morning feeling stiff and tired; worse than when they went to sleep. Sleep hygiene, techniques used to get a good night sleep, is utilized. Creating a specific pre-sleep routine or ritual, avoiding stimulants before bedtime (news on TV, Stephen King novels, certain foods, etc), and learning how to turn off one’s mind so the body can slip into a deep sleep are some examples.

Counseling is also helpful to control worrying or “ruminating” at night, which fuels the insomnia. In fact, psychotherapy is recommended to fully treat the FM, as lifestyle and the emotional dilemmas of Fibromyalgia can be addressed by a trained counselor.

Aerobic exercise, as shown by research, is useful for many stress/pain related problems like FM. Optimally, 30 to 45 minutes of moderate exercise, to raise the heart rate into the “target zone”, three times per week is preferred. Unfortunately, persons with Fibromyalgia often have pain if they do one activity for more than 10 to 15 minutes, much less exercise for 45 minutes. So we trick the body. By combining three or four different activities (bike, arm exercises, water walk, stairmaster) each for only five to ten minutes, but performed consecutively, the heart gets its workout without hurting the body or flaring up the FM. Thus endorphins are released and serotonin levels are increased which can decrease the pain, the insomnia, and the FM itself.

Finally, full restoration of strength, endurance, and coordination is achieved with a specific exercise program.

Once thought of as a debilitating and chronic condition, the symptoms of Fibromyalgia can be alleviated under an individualized therapy program.