Coping with a chronic disorder
If you suffer from fibromyalgia, you know there’s no simple fix for the chronic pain disorder. Fibromyalgia affects an estimated 10 million people in the U.S., according to the National Fibromyalgia Association, and about 80 percent of people with the disorder are women. There’s no single cause, says Dr. Kevin Fleming, director of the Fibromyalgia and Chronic Fatigue Clinic at the Mayo Clinic in Rochester, Minnesota. The brains of people with fibromyalgia amplify pain signals, which can cause constant and sometimes severe pain in the muscles even when there’s no apparent injury. “The part of the brain that detects pain becomes ‘hijacked’ over time,” Fleming says. The disorder can be painfully debilitating. “Fibromyalgia has a significant impact on the quality of life for those who suffer from it,” says Dr. Bruce S. Gillis, chief executive officer of EpicGenetics Inc., a private biomedical firm in Los Angeles that focuses on the treatment and diagnosis of fibromyalgia. He’s part of a team of researchers conducting a clinical study looking for genetic markers that cause fibromyalgia.
Manage your pain.
There’s no cure for fibromyalgia, and medication can only do so much to mitigate the chronic pain it causes, says Dr. Robert Bolash, a pain management physician at the Cleveland Clinic. By itself, medication can mitigate pain caused by the disorder by up to 20 percent, he says. What a patient does for himself or herself, such as exercising and cultivating good sleeping habits, can reduce the pain by up to 90 percent. “It’s not like pneumonia, where we can give the patient an antibiotic and it’s cured,” Bolash says. “It’s a management disease, not a curative disease.” If you’re suffering with fibromyalgia, experts recommend these nine strategies to manage the pain caused by the disorder:
Get diagnosed.
As with any medical condition, getting the right diagnosis is crucial for developing coping strategies for fibroymyalgia, Bolash says. There’s no specific diagnostic test for the disorder, according to the Cleveland Clinic. To arrive at a diagnosis, doctors consider an array of symptoms — such as widespread body pain, fatigue, poor sleep and mood problems. “It’s a constellation of symptoms that point in one direction,” Bolash says. Having fibromyalgia doesn’t preclude you from having another painful condition, like arthritis. Complicating matters, fibromyalgia symptoms can come and go over time.
Stretch lightly.
People with fibromyalgia typically suffer from muscle pain and stiffness, which can make even the simplest movements difficult. Developing a daily routine of light stretching can help mitigate fibromyalgia pain and improve function, says Richard Sedillo, a certified orthopedic manual therapist at Arizona Manual Therapy Centers, which has facilities in North Scottsdale and Chandler, Arizona. “Light stretching will help you improve the ability to move with less pain,” he says. For example, someone with fibromyalgia might start out by stretching his or her arms up and down. Clutching a pillow to your chest while bending your torso at the side is another good light stretch that people with fibromyalgia may be able to do without pain. “If you do five light stretches without pain,” you can gradually increase both the number of stretches and the number of repetitions, Sedillo says. “Your body gets into a good rhythm, and the rhythm builds on itself.” Light stretching before bedtime can contribute to a more restful sleep, he adds.
Practice yoga.
Research suggests that practicing yoga can provide relief for some people with fibromyalgia. For example, an analysis in the journal Musculoskeletal Care reported that yoga helped reduce sleep disturbances, fatigue and depression. It also helped improve overall quality of life, researchers found. Celeste Cooper, a co-author of five books about dealing with chronic pain, is a retired registered nurse from Mesa, Arizona. Cooper, who has fibromyalgia, says yoga can provide relief to sufferers of the chronic condition. She cautions against holding yoga postures for too long or stretching muscles beyond their limits. “This is particularly important if muscles have been overused, are weak or have developed knots,” she says. If you want to try yoga to ease the pain of your fibromyalgia, “look for an instructor who has experience modifying his or her practice of people with movement challenges and limitations,” says Steffany Moonaz, director of clinical and academic research at the Maryland University of Integrative Health and co-author of “Yoga Therapy for Arthritis,” scheduled to be released in December. She recommends starting with gentle yoga and going from there. Gentle yoga isn’t a specific type of yoga, like Bikram or power yoga, which are more physically rigorous. Rather, it’s a type of yoga that moves at a slower pace and uses props like straps or foam blocks to help with positions that may otherwise feel uncomfortable.
Try tai chi.
If her fibromyalgia’s not causing her too much pain, Cooper includes tai chi — an ancient Chinese practice that involves a series of movements and deep breathing performed in a slow, focused manner — in her wellness regimen. “The rhythmic nature and dance-like movement of tai chi promotes mental focus and physical balance, something often in short supply for those of us who live with fibromyalgia,” she says. “I also experience less fatigue, disabling pain and tenderness, and I sometimes get a better night’s sleep.” A study of 226 adults with fibromyalgia found people with fibromyalgia participating in tai chi resulted in “similar or greater improvement in symptoms than aerobic exercise, the current most commonly prescribed non-drug treatment.” The study, published in March 2018 in the British Medical Journal, involved 226 adults with fibromyalgia, 151 of whom were assigned to four tai chi groups and 75 to an aerobic exercise group. Those who practiced tai chi did so for 12 or 24 weeks, once or twice weekly. “Longer duration of tai chi showed greater improvement,” researchers concluded.
Do aerobic exercise.
People with fibromyalgia may not be up to playing in a vigorous game of pickup basketball or taking a long run, but they can still do — and benefit from — aerobic exercise, says Connie Luedtke, nurse manager of the Fibromyalgia and Chronic Fatigue Clinic at the Mayo Clinic. “We don’t suggest you train like you are a triathlete, but rather start with a slow walk and gradually increase the amount of time and/or the speed of your walk,” she says. “You might start out with a five-minute walk one day and add to it.” Research indicates that physical exercise can reduce pain. Luedtke notes that exercise releases endorphins in the body; these are brain chemicals known as neurotransmitters, which transmit electrical signals in the body and interact with opiate receptors to reduce pain and boost feelings of pleasure. “Laying in bed or on the couch won’t make anything better. In fact, it will make things worse,” Luedtke says.
Have a massage.
Massage therapy over a duration of more than five weeks had “beneficial effects on improving pain, anxiety and depression in patients with [fibromyalgia],” according to a 2014 meta-analysis published in PLOS ONE in 2014. And research by the Touch Research Institute at the University of Miami School of Medicine showed massage therapy diminished pain in fibromyalgia patients. Cooper says massages have been effective in mitigating the pain caused by her fibromyalgia. Deep-tissue massages were most helpful for her, but she advises this type of therapy may not work for other people with fibromyalgia. “A deeper massage that helps one person may be very painful for someone else,” she says. “Fibromyalgia is often accompanied by another pain condition, and our individual health needs are individual, so it is imperative that whatever we choose, the therapy be artfully executed by an intuitive and skilled therapist who understands the role of pain in fibromyalgia and is willing to be your partner. Always talk to your doctor so you know the choice is safe for you.”
Develop good sleeping habits.
Getting enough sleep is important for everyone — and that’s particularly true for people with fibromyalgia, says Sharon Roth Maguire, a registered nurse and chief clinical quality officer at BrightStar Care, a private duty home care and medical staffing franchise. “Sleep is restorative and important for the body to heal,” she says. “Inadequate sleep has been shown to contribute to increased pain levels as well as many other physiologic consequences. Create a restful environment in advance of your sleep time so that you can fall asleep peacefully. Whatever it is that helps you relax and get ready for bed will help promote a more restful sleep.” That could entail taking a warm bath before you go to bed, drinking a cup of herbal tea or reading.
Consider acupuncture.
Clinical studies suggest that acupuncture can be effective in mitigating fibromyalgia pain. “Some people have gotten good results with acupuncture,” Cooper says. “It’s like any other kind of therapy: It works as long as you have a skilled acupuncturist.” One woman who is part of a fibromyalgia Facebook group Cooper belongs to wrote that she had great results with acupuncture, but didn’t get the same relief after she moved to a different state and received treatment from a different acupuncturist. It’s important to keep in mind that just because one acupuncturist doesn’t work for you doesn’t mean the treatment won’t help you if you find the right one. Cooper suggests asking people in local fibromyalgia support groups if they can recommend an acupuncturist. It’s always a good idea to run it by your doctor before you try acupuncture, she adds.
Don’t overthink it.
Thinking too much about your pain and what level it’s at from day to day can create stress, which is counterproductive, Fleming says. That’s because your anxiety over your fibromyalgia amplifies your adrenaline and cortisol levels, which can make you more susceptible to feeling pain. Try instead to remain focused on other things, whether it’s a hobby, work that you enjoy or a physical activity, Fleming says.
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