So many doctors are unfamiliar with the painful and confusing condition called fibromyalgia that just getting a diagnosis may be something of a relief. You can now begin an effective treatment program and get on the road to recovery fast.
Fibromyalgia, which means 'pain in the muscles', is more a condition defined by symptoms than a specific ailment. Nobody is sure what causes it, although the widespread soreness, headaches, poor sleep and myriad other symptoms are very real, disrupting the lives of an estimated 2 percent of the population. Although you may feel extremely uncomfortable, there is no evidence of an actual disease occurring in your body. Nor are there any laboratory tests to identify it (one reason why you may have gone to many doctors before it was finally identified).
Some experts believe fibromyalgia may originate in the brain, possibly due to low levels of a nervous system chemical called serotonin. Females have especially low levels of serotonin, which may explain why 9 out of 10 fibromyalgia cases occur in this sex. Women are also most often victims of other disorders that may be due to low serotonin levels, such as migraines, irritable bowel syndrome, depression, anxiety and panic attacks. Serotonin seems have been installed in humans as a buffer against the 'fight or flight' response. Without enough serotonin, your body becomes more suspectible to stressful events. (Picture James Bond as one person you know of who has plenty of serotonin!) When you are constantly stressed, your muscles contract, setting off a destructive chain of events.
Serotonin is also important for assuring deep, restorative sleep, and disruptive sleep patterns have been blamed for bringing on fibromyalgia or making it worse. Because your muscle pain makes it hard to get a good night's rest, you get tired. Lack of sleep causes even more stress. Understandably, you may also become anxious, forgetful and depressed, which further contributes to the downward spiral of out-of-control stress that may ultimately lead to fibromyalgia. Other poosible causes include injuries, infections or hormonal disturbances, although these, too, remain uncertain.
LIKELY FIRST STEPS
Even though fibromyalgia is poorly understood , effectiveness therapies are at hand. Treatement usually follows four key steps. The first step is to have your doctor prescribe a good pain medicine. The second is to get something to help you sleep better, if necessary. Third, antidepressants will help raise your serotonin levels. And finally, but no less importantly, you'll need to address the sources of stress in your life and start making changes. Learning some relaxation techniques can help.
Getting fibromyalgia out of your life is truly a matter of trial and error: a nightly hot bath with Epsom salts, an electric blanket, a weekly massage, acupuncture, low-impact aerobics, muscle relaxants, antidepressants--all have helped others. If you're in a stressful life situation and can't figure out how to solve it, consider visiting a therapist, particularly one who has worked with other fibromyalgia patients. The sooner you begin treatment, the better. Someone who has been suffering from fibromyalgia for only a few months, for example, typically responds much better than someone who has endured the condition for more than a decade.
Medications
Once you are taking the appropriate medications, you may start feeling better in just a matter of hours. Most doctors begin by treating different sets of symptoms with specific drugs. Pain relievers, for instance, may bring rapid belief to your sore and aching muscles. Paracetamol is often recommended, but stronger medications may
be more appropriate. Opioids such as Panadeine, available as a tablet, or fentanyl (Duragesic), worn as a skin patch, act on the central nervous system and can be very effective for relieving pain. However, some doctors and patients worry about overdependence on these drugs. Tramadol (Tramal) may be a good alternative, although it, too, may cause dependence. Because fibromyalgia is not caused by inflammation, the anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen and naproxen, won't provide and long-term benefit.
What is happening
Fibromyalgia, which means 'pain in the muscles', is more a condition defined by symptoms than a specific ailment. Nobody is sure what causes it, although the widespread soreness, headaches, poor sleep and myriad other symptoms are very real, disrupting the lives of an estimated 2 percent of the population. Although you may feel extremely uncomfortable, there is no evidence of an actual disease occurring in your body. Nor are there any laboratory tests to identify it (one reason why you may have gone to many doctors before it was finally identified).
Some experts believe fibromyalgia may originate in the brain, possibly due to low levels of a nervous system chemical called serotonin. Females have especially low levels of serotonin, which may explain why 9 out of 10 fibromyalgia cases occur in this sex. Women are also most often victims of other disorders that may be due to low serotonin levels, such as migraines, irritable bowel syndrome, depression, anxiety and panic attacks. Serotonin seems have been installed in humans as a buffer against the 'fight or flight' response. Without enough serotonin, your body becomes more suspectible to stressful events. (Picture James Bond as one person you know of who has plenty of serotonin!) When you are constantly stressed, your muscles contract, setting off a destructive chain of events.
Serotonin is also important for assuring deep, restorative sleep, and disruptive sleep patterns have been blamed for bringing on fibromyalgia or making it worse. Because your muscle pain makes it hard to get a good night's rest, you get tired. Lack of sleep causes even more stress. Understandably, you may also become anxious, forgetful and depressed, which further contributes to the downward spiral of out-of-control stress that may ultimately lead to fibromyalgia. Other poosible causes include injuries, infections or hormonal disturbances, although these, too, remain uncertain.
- Pain relieving medications to reduce muscle aches and soreness
- Sleep aids to restore healthy sleeping patterns
- Antidepressant medications to boost serotonin levels in the brain.
- Stress-relieving measures such as relaxation and cognitive-behavioural therapies.
- Low-Impact and stretching exercises at first, with aerobics and strengthening added gradually.
QUESTIONS TO ASK
- Will my pain and fatigue keep getting worse?
- How is it that all my tests and X-rays show there is nothing wrong with me?
- Why are you prescribing antidepressants when I'm not depressed?
- Are some of my other problems, such as irritable bowel syndrome and PMS, related to my fibromyalgia?
Treatments
Even though fibromyalgia is poorly understood , effectiveness therapies are at hand. Treatement usually follows four key steps. The first step is to have your doctor prescribe a good pain medicine. The second is to get something to help you sleep better, if necessary. Third, antidepressants will help raise your serotonin levels. And finally, but no less importantly, you'll need to address the sources of stress in your life and start making changes. Learning some relaxation techniques can help.
Getting fibromyalgia out of your life is truly a matter of trial and error: a nightly hot bath with Epsom salts, an electric blanket, a weekly massage, acupuncture, low-impact aerobics, muscle relaxants, antidepressants--all have helped others. If you're in a stressful life situation and can't figure out how to solve it, consider visiting a therapist, particularly one who has worked with other fibromyalgia patients. The sooner you begin treatment, the better. Someone who has been suffering from fibromyalgia for only a few months, for example, typically responds much better than someone who has endured the condition for more than a decade.
Treatment Options
MEDICATIONS
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Pain relievers Soothe sore and aching muscles.
------------------------------------------------------------------------------------------------------------------------------------------
Trigger-point injections Quick relief: lignocaine into tender points.
-------------------------------------------------------------------------------------------------------------------------------------------
Antidepressants Increase serotonin levels and ease fatigue.
-------------------------------------------------------------------------------------------------------------------------------------------
Sedatives Very helpful as a sleep aid.
--------------------------------------------------------------------------------------------------------------------------------------------
Muscle relaxants Diazepam is an option.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Counselling Cognitive-behavioural therapy quite effective.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
De-stress Try meditation, yoga or biofeedback.
----------------------------------------------------------------------------------------------------------------------------------------------
Exercise Start slow; streching reduces muscle pain.
----------------------------------------------------------------------------------------------------------------------------------------------
Rest Devise a healthy sleep regimen.
NATURAL METHODS
-----------------------------------------------------------------------------------------------------------------------------------------------
Massage Especially deep tissue (myofascial) therapy.
-----------------------------------------------------------------------------------------------------------------------------------------------
Asian medicine Acupuncture and qigong may help.
TAKING CONTROL
MEDICATIONS
------------------------------------------------------------------------------------------------------------------------------------------
Pain relievers Soothe sore and aching muscles.
------------------------------------------------------------------------------------------------------------------------------------------
Trigger-point injections Quick relief: lignocaine into tender points.
-------------------------------------------------------------------------------------------------------------------------------------------
Antidepressants Increase serotonin levels and ease fatigue.
-------------------------------------------------------------------------------------------------------------------------------------------
Sedatives Very helpful as a sleep aid.
--------------------------------------------------------------------------------------------------------------------------------------------
Muscle relaxants Diazepam is an option.
PROCEDURES
---------------------------------------------------------------------------------------------------------------------------------------------
Counselling Cognitive-behavioural therapy quite effective.
LIFESTYLE CHANGES
---------------------------------------------------------------------------------------------------------------------------------------------
De-stress Try meditation, yoga or biofeedback.
----------------------------------------------------------------------------------------------------------------------------------------------
Exercise Start slow; streching reduces muscle pain.
----------------------------------------------------------------------------------------------------------------------------------------------
Rest Devise a healthy sleep regimen.
NATURAL METHODS
-----------------------------------------------------------------------------------------------------------------------------------------------
Massage Especially deep tissue (myofascial) therapy.
-----------------------------------------------------------------------------------------------------------------------------------------------
Asian medicine Acupuncture and qigong may help.
TAKING CONTROL
- Choose a doctor who has experience treating fibromyalgia--and not someone who thinks it's all in your head'. A good choice may be a rheumatologist ( a physician who specialises in diseases of the joints and muscles) or a specialist in management. It may also be a good idea to see a phsiotherapist or an occuptional therapist.
- Use memory aids. If you suffer from bouts of forgetfulness and poor concentration, try some basic memory rechargers. Repeat things to yourself, write items down and make plenty of lists. Break up complex tasks into smaller steps, and keep distractions such as loud music to a minimum.
- Keep a diary of your pain and energy levels to record your best times a day. Use those periods to do important things such as writing letters or paying bills. Many people with fibromyaglia say they function best early in the day.
- Try heat. A heating pad, electric blanket or warm bath may bring relief.
Medications
Once you are taking the appropriate medications, you may start feeling better in just a matter of hours. Most doctors begin by treating different sets of symptoms with specific drugs. Pain relievers, for instance, may bring rapid belief to your sore and aching muscles. Paracetamol is often recommended, but stronger medications may
be more appropriate. Opioids such as Panadeine, available as a tablet, or fentanyl (Duragesic), worn as a skin patch, act on the central nervous system and can be very effective for relieving pain. However, some doctors and patients worry about overdependence on these drugs. Tramadol (Tramal) may be a good alternative, although it, too, may cause dependence. Because fibromyalgia is not caused by inflammation, the anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen and naproxen, won't provide and long-term benefit.
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