Medications
You can sometimes get dramatic pain relief in minutes with trigger-point injections, a technique in which the anaesthetic lignocaine is injected into the muscle 'tender points' that are so sensitive to touch in those with fibromyalgia. Such injections help to break the pain cycle, in some cases providing lasting relief. A small pilot study from the United Kingdom found that giving lignocaine intravenously may alos help to relieve pain. In those who got the IV infusions, pain intensity dropped from 9 to 5 on an 11-point scale. Patients also felt less depressed, better able to cope and reported improvements in their social and sex lives.
Taking low doses of an antidepressant medication can help to treat any underlying sleep disorder and alleviate its accompanying pain and fatigue. These medicines are called anitdepressants only because they were first used to treat depression, one of many ailments caused by a disturbance of serotonin. Because these drugs work in different ways to increase levels of this chemical in the brain, 'serotonin modulators' is probably a far better name for them. The older tricyclic antidepressants, such as amitriptyline (Endep, Tryptanol), may be particularly effective for relieving pain. The newer SSRI antidepressants, such as fluoxetine (Prozac), sertraline (Zoloft) and paroxetine (Aropax), may help to lift depression.
Because not getting a good night's sleep is probably contributing to your problem, a gentle sedative sleep aid, such as zolpidem (Stilnox) or temazepam (Normison), may work wonders. These take effect within 30 minutes and you will wake up with none of the drug 'handover' so common with stronger sleeping pills. Muscle relaxants may also be beneficial.
PROMISING DEVELOPMENTS
Will my fibromyalgia ever lead to a more serious medical condition?
It's very unlikely. Fibromyalgia is not a degenerative disease (such as arthritis) that gets progressively worse. Odds are, you will begin to feel better after starting a multiprognge approach that combines sensible self-help and targeted medication.
ProceduresA psychological counselling approach called cognitive-behavrioural therapy may offer great benefits for those with fibromyalgia. The technique combines cognitive approaches, which help you address self-defeating thoughts that can aggravate pain, with behavioural therapies, which help you initiate changes that will improve your symptoms. Unlike other types of counselling, the course of treatment may be relatively brief, lasting from one to several months. If you feel that nothing can help you improve or you can't take the pain another day, cognitive-behaviour therapy may be a good step for you.
Lifestyle changes
There are a number of strategies you can follow in your day-to-day life that will make a real difference in how you feel.
You can sometimes get dramatic pain relief in minutes with trigger-point injections, a technique in which the anaesthetic lignocaine is injected into the muscle 'tender points' that are so sensitive to touch in those with fibromyalgia. Such injections help to break the pain cycle, in some cases providing lasting relief. A small pilot study from the United Kingdom found that giving lignocaine intravenously may alos help to relieve pain. In those who got the IV infusions, pain intensity dropped from 9 to 5 on an 11-point scale. Patients also felt less depressed, better able to cope and reported improvements in their social and sex lives.
Taking low doses of an antidepressant medication can help to treat any underlying sleep disorder and alleviate its accompanying pain and fatigue. These medicines are called anitdepressants only because they were first used to treat depression, one of many ailments caused by a disturbance of serotonin. Because these drugs work in different ways to increase levels of this chemical in the brain, 'serotonin modulators' is probably a far better name for them. The older tricyclic antidepressants, such as amitriptyline (Endep, Tryptanol), may be particularly effective for relieving pain. The newer SSRI antidepressants, such as fluoxetine (Prozac), sertraline (Zoloft) and paroxetine (Aropax), may help to lift depression.
Because not getting a good night's sleep is probably contributing to your problem, a gentle sedative sleep aid, such as zolpidem (Stilnox) or temazepam (Normison), may work wonders. These take effect within 30 minutes and you will wake up with none of the drug 'handover' so common with stronger sleeping pills. Muscle relaxants may also be beneficial.
PROMISING DEVELOPMENTS
- Even with modest treatment, fibromyaglia is likely to get better, not worse, according to a long-term follow-up study published in the Journal of Rheumatology. Investigations in Norway questioned 33 women with fibromyalgia who had participated in patient education and exercise programs back in the early 1990s. At six and eight years later, the women had fewer tender points, and those who had taken part in an education program had less pain and fatigue. Those who had been working all along still held down their jobs, and most of the women with long-term illness were managing quite well.
- Strength training and aerobic exercise may ease symptoms of fibromyalgia. A small trial of 15 women published in Arthritis Care and Research found that those women who participated in 20 weeks of graduated exercise had less pain, fatigue, stiffness and depression. The women began with water exercises in a pool, then advanced to walking and, finally, to weights and to other resistance devices.
Will my fibromyalgia ever lead to a more serious medical condition?
It's very unlikely. Fibromyalgia is not a degenerative disease (such as arthritis) that gets progressively worse. Odds are, you will begin to feel better after starting a multiprognge approach that combines sensible self-help and targeted medication.
ProceduresA psychological counselling approach called cognitive-behavrioural therapy may offer great benefits for those with fibromyalgia. The technique combines cognitive approaches, which help you address self-defeating thoughts that can aggravate pain, with behavioural therapies, which help you initiate changes that will improve your symptoms. Unlike other types of counselling, the course of treatment may be relatively brief, lasting from one to several months. If you feel that nothing can help you improve or you can't take the pain another day, cognitive-behaviour therapy may be a good step for you.
Lifestyle changes
There are a number of strategies you can follow in your day-to-day life that will make a real difference in how you feel.
- Reduce stress. Schedule a time out each day to relax. Pace yourself, and don't overcommit.
- Exercise regularly. The key is to start slow and not overdo it. Doing low-impact activities such as swimming or aqua aerobics a few days a week is an excellent way to start. Then you can graduate to other aerobic activities like walking, and work up to strength training using light hand weights or machines. Stretching the muscles is also important for reconditioning them and reducing pain.
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BRAIN SURGERY FOR FIBROMYALGIA?
When TV reports aired severla years ago showing how skull surgery dramatically relieved symptoms in two women with a fibromyalgia-like illness, many people took notice. People with fibromyalgia and maladies such as
chronic fatigue syndrome thought the four-hour, expensive operation might be a magic cure for their persistently aching muscles and disabling fatigue. Doctors were concerned it was a medical scam.
Pioneerd by surgeon Michael J Rosner of Park Ridge Hospital in Fletcher, North Carolina, the procedure invloves removing a piece of the skull at the back of the patient's head. Medical follow-up indicates that the brain
surgery may be effective--but not for fibromyalgia.
Instead, this procedure may benefit those who have a rare skull abnormality called the Chiari malformation, a defect that squeezes the brain and causes severe pain, numbness, difficulty concentrating and other complaints.
Surgery may also help those with a narrowed spinal canal. Some of the patients are mistakenly diagnosed with
fibromyalgia--but their conditions are rare and can be diagnosed with scanning techniques.
The bottom line: people with fibromyalgia will not get any benefit from such surgery.
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Relaxation techniques (meditation, yoga, hypnosis) can all be beneficial for those with fibromyalgia. Massage may also help to relieve stress and pain, as may a massage variant known as myopractic or myofascial trigger point therapy, in which deep tissue around tender points is vigorously worked. Chiropractic manipulation of the back may also ease soreness. Some sufferers find relief by applying magnets to painful areas, although this approach remains unproven.
Acupuncture, in which thin needles are placed at strategically situated points in the body, is a popular Chinese remedy for relieving the pain of fibromyalgia. You should begin to feel and sleep better within six to eight sessions. Another traditional Chinese treatment to bolster the body against stress is qigong, a 4000 year-year-old healing art combining movement, focus and controlled breathing. In a study at the University of Maryland, an eight-week program of qigong, combined with cognitive-behavioural therapy and meditation, effectively eased fibromyalgia symptoms.
Outlook
Try to stay upbeat. Although there is no cure for fibromyalgia, many people with this condition experience marked, even near-total, pain relief after just a few weeks of specialised treatment.
BRAIN SURGERY FOR FIBROMYALGIA?
When TV reports aired severla years ago showing how skull surgery dramatically relieved symptoms in two women with a fibromyalgia-like illness, many people took notice. People with fibromyalgia and maladies such as
chronic fatigue syndrome thought the four-hour, expensive operation might be a magic cure for their persistently aching muscles and disabling fatigue. Doctors were concerned it was a medical scam.
Pioneerd by surgeon Michael J Rosner of Park Ridge Hospital in Fletcher, North Carolina, the procedure invloves removing a piece of the skull at the back of the patient's head. Medical follow-up indicates that the brain
surgery may be effective--but not for fibromyalgia.
Instead, this procedure may benefit those who have a rare skull abnormality called the Chiari malformation, a defect that squeezes the brain and causes severe pain, numbness, difficulty concentrating and other complaints.
Surgery may also help those with a narrowed spinal canal. Some of the patients are mistakenly diagnosed with
fibromyalgia--but their conditions are rare and can be diagnosed with scanning techniques.
The bottom line: people with fibromyalgia will not get any benefit from such surgery.
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- Consider physiotherapy, which concentrates on different muscle groups, as a complement to a therapeutic exercise regimen.
- Get enough rest. Try to follow a regular sleep schedule, limit daytime napping and use your bed for sleeping or sex only.
Relaxation techniques (meditation, yoga, hypnosis) can all be beneficial for those with fibromyalgia. Massage may also help to relieve stress and pain, as may a massage variant known as myopractic or myofascial trigger point therapy, in which deep tissue around tender points is vigorously worked. Chiropractic manipulation of the back may also ease soreness. Some sufferers find relief by applying magnets to painful areas, although this approach remains unproven.
Acupuncture, in which thin needles are placed at strategically situated points in the body, is a popular Chinese remedy for relieving the pain of fibromyalgia. You should begin to feel and sleep better within six to eight sessions. Another traditional Chinese treatment to bolster the body against stress is qigong, a 4000 year-year-old healing art combining movement, focus and controlled breathing. In a study at the University of Maryland, an eight-week program of qigong, combined with cognitive-behavioural therapy and meditation, effectively eased fibromyalgia symptoms.
Outlook
Try to stay upbeat. Although there is no cure for fibromyalgia, many people with this condition experience marked, even near-total, pain relief after just a few weeks of specialised treatment.
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