Fibromyalgia

What is it?

Fibromyalgia is a chronic pain condition characterised by fatigue, stiffness and widespread pain in muscles, ligaments and tendons. People with fibromyalgia are also abnormally sensitive to touch, with certain areas, known as ‘tender points’, being super-sensitive. Sleep disturbance is common and people with fibromyalgia often wake up tired and un-refreshed. Headaches, facial pain, irritable bowel and bladder, poor memory and concentration, nausea, restless legs, numbness or tingling in the hands and feet are frequently accompanying symptoms.

What causes it?

While the exact cause of this condition remains unknown, it is believed to result from an abnormal activation of the central pain system where pain becomes amplified. Triggers for this activation may include emotional distress, sleep disturbance, injury, chronic poor posture, certain infections and possibly genetic factors.

Fibromyalgia affects predominantly women, between the ages of 35 to 60 years. It is more common in people with a rheumatic disease. The severity of symptoms can be highly variable but the majority of patients have mild symptoms that are reversible.

Diagnosis

The diagnosis of fibromyalgia is made on the history of widespread pain for three months or longer and the presence of abnormal tenderness in specific parts of the body. There are no blood tests to confirm the diagnosis although these may be useful in excluding other conditions such as rheumatoid arthritis.

Management

Effective management of fibromyalgia begins with a correct diagnosis.

While there are many possible components to treatment, management programs should be designed individually incorporating a combination of strategies.

These include:

Education: people with fibromyalgia need to understand their condition so that they can decide what combination of treatments will be effective for their individual circumstances.

Exercise: regular exercise is extremely important for those with fibromyalgia. Despite exercise being initially painful, gradual persistence, especially of an aerobic-based program, will result in a reduction of pain, fatigue and sleep disturbance. The aim should be to exercise at least 30 minutes a day 3 to 4 times a week. Low impact exercises such as walking, swimming or bike-riding are ideal. Incorporating daily stretches may also be useful.

Medication: in combination with other strategies, medication can help improve sleep, reduce pain and help manage stress.

Stress management: for many patients with fibromyalgia, psychological factors play an important part in their condition. There are many options as to how best to address these. They range from seeking professional counselling from a psychologist through to stress management, meditation and relaxation techniques conducted in a group setting.

Body-Mind Disciplines: approaches such as yoga, Tai Chi, Feldenkrais and Alexander Technique have in common their focus on awareness of the body in movement. Relaxation, improved posture and breathing are often resultant outcomes of such exercises and can be of help for some patients with fibromyalgia.

Massage: massage can help relax muscles, improve the range of movement in joints and help alleviate anxiety and stress. Many people with fibromyalgia derive benefit from such treatments.

Useful Links

The Mayo Clinic: www.mayoclinic.com

Any advice offered from such a site should still be verified to be appropriate for you by a medical practitioner knowledgeable about fibromyalgia.

Meditation

Meditation is a tool that helps relax the body, calm the mind and enhance awareness. For more information about meditation the reader is directed to the work of Jon Kabat-Zinn www.mindfulnesscds.com

Yoga

For those interested in trying Yoga as a tool to help manage their condition. I often recommend Vicky Adamson’s classes in Rayne, near Braintree, and Billericay. For more information about her Yoga sessions click here.

My thanks to Body Logic Physiotherapy, Perth for permission to reproduce some text