Long-term condition Fibromyalgia can cause unpleasant symptoms, including chronic pain. Leading expert on pain management Dr Deepak Ravindran, reveals 6 ways to manage pain using lifestyle medicine principles
Fibromyalgia is now considered to be a long-term condition and is due to an excessive sensitisation of the entire nervous and often the immune system leading to the characteristic symptoms of chronic widespread pain, debilitating fatigue, sleep disturbances and memory issues.
These are often due to a phenomenon called central sensitization which refers to increased sensitivity within the spinal cord and areas of the brain. The usual diagnosis is made according to the American College of Rheumatologist’s criteria in 2016.
According to these new guidelines, the older approach of just using tender points in the various parts of the body to diagnose fibromyalgia is outdated and flawed. The new guidelines recognise that pain is just one of the many symptoms that people with fibromyalgia have.
Apart from the pain and fatigue, presence of headache or stomach pain and mood disturbance are all to be considered to decide on the overall impact this condition has on a person’s life.
new guidelines recognise that pain is just one of the many symptoms that people with fibromyalgia have
Such a widespread set of symptoms has made medical professionals realise that traditional pain medications do not work as painkillers and are rarely effective on their own.
Therefore, an integrated approach is now advocated where medications should be combined with other lifestyle-based techniques to achieve maximal best outcomes.
To help patients get a personalised toolkit, a template I recommend is the MINDSET acronym that can be used to help patients build their own set of strategies. This will help them in routine day-to-day management and will also provide an option for support during flare ups.
While there is no known cure for fibromyalgia, there are various strategies and approaches that can help manage the pain and improve overall well-being.
there are various strategies and approaches that can help manage the pain
Living with fibromyalgia requires a holistic approach to pain management. While medications and interventions play a vital role, incorporating stress management techniques, adopting a healthy diet, prioritizing sleep hygiene, engaging in regular exercise, and exploring mind-body therapies & techniques can significantly improve quality of life.
Each person’s experience with fibromyalgia is unique, so it’s important to work closely with your healthcare team to develop an individualized pain management plan that addresses your specific needs and goals. With a comprehensive approach, it is possible to effectively manage fibromyalgia symptoms and enhance overall well-being.
In this article, we will explore different aspects of pain management for fibromyalgia, from medications and interventions to stress management, diet and nutrition options, sleep hygiene, exercise, and mind-body therapies and techniques.
Pain Management Approach #1 Medication
Medications play a crucial role in managing fibromyalgia symptoms, particularly when it comes to reducing pain. Simple medications like nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol are available over the counter but stronger forms of codeine or trials of medications like tramadol or antidepressants like amitriptyline need to be prescribed by the GP.
Medications play a crucial role in managing fibromyalgia symptoms
They help by dampening the pain signals and reduce the pain intensity and improve sleep. Antidepressants, such as tricyclic antidepressants or selective serotonin reuptake inhibitors (SSRIs), can help modulate pain signals and improve mood.
Stronger nerve pain drugs like gabapentin and pregabalin are less often used these days due to the rising profile of side effects and the potential for dependence.
READ MORE: 7 ways to manage sciatica pain – the expert’s guide
Pain Management Approach #2 Interventions
There are several interventions that can be incorporated into a fibromyalgia pain management plan. Physical therapy can help improve flexibility, strength, and overall physical function.
Occupational therapy can provide strategies to manage daily activities and reduce stress on the body. Some individuals find relief through acupuncture. Chiropractic care or massage therapy may also offer relief by addressing musculoskeletal imbalances and reducing muscle tension.
Physical therapy can help improve flexibility, strength, and overall physical function
There are some more specialised interventions like trigger point injections of local anaesthetics plus steroid that can help in carefully identified populations. Some pain clinics may also offer specialised infusions of local anaesthetics that can also make a difference in some patients.
It is important with any intervention to explore and discuss the benefits of, risks and plans to reduce them before going for an infusion.
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Pain Management Approach #3 Improved Sleep Hygiene
Sleep disturbances are common in fibromyalgia. Indeed, some experts say that sleep disturbances can often herald the onset of fibromyalgia years later. So good sleep hygiene practices can significantly improve the quality of your sleep.
Create a soothing sleep environment by keeping your bedroom cool, dark, and quiet. Establish a consistent sleep schedule, aiming for the same bedtime and wake-up time each day, and develop a relaxing bedtime routine, which may include activities like reading a book, taking a warm bath, or listening to calming music.
Avoiding stimulating activities close to bedtime can also promote better sleep
Limiting caffeine intake by 30min in the afternoon particularly in the late afternoon and early evening and alcohol intake by early evening . Avoiding stimulating activities close to bedtime can also promote better sleep.
If sleep disturbances persist, your doctor may discuss options such as sleep medications or supplements to support sleep quality.
READ MORE: Insomnia? Too stressed to sleep? 5 tried & tested sleep hacks to beat stress
Pain Management Approach #4 Healthy Diet and Nutrition Options
Although there is no specific diet that can cure fibromyalgia, adopting a healthy and balanced eating plan can help manage symptoms and improve energy levels. Incorporating anti-inflammatory foods can be beneficial.
Focus on consuming a variety of fruits, vegetables, whole grains, and lean proteins. Omega-3 fatty acids found in fish, flaxseed, and walnuts have been shown to have anti-inflammatory properties and may help reduce pain.
maintain adequate hydration by drinking plenty of water throughout the day is essential
Additionally, maintain adequate hydration by drinking plenty of water throughout the day is essential. It’s important to listen to your body and identify any potential trigger foods that may exacerbate symptoms, such as caffeine, artificial sweeteners, or processed foods.
Keeping a food diary can help you pinpoint any patterns between your diet and symptom flare-ups.
READ MORE: Carbs are NOT the enemy – these delicious healthy recipes prove it
Pain Management Approach #5 Physical Activity
Regular exercise is an essential component of fibromyalgia pain management. While it may seem counterintuitive to exercise when experiencing pain, engaging in low-impact activities can help reduce pain and stiffness.
Walking, swimming, cycling, or practicing yoga are excellent options. Start slowly and gradually increase the intensity and duration of your workouts, listening to your body’s signals.
engaging in low-impact activities can help reduce pain and stiffness
Consider incorporating gentle stretching exercises to improve flexibility and range of motion. It’s important to find a balance between activity and rest, avoiding overexertion that can lead to increased pain.
Working with a physical therapist or an exercise specialist who understands fibromyalgia can provide valuable guidance and support in developing an exercise plan tailored to your needs.
READ MORE: 3 ways yoga will change your body
Pain Management Approach #6 Mind-Body Therapies & Techniques
Mind-body therapies offer additional tools to manage fibromyalgia pain and improve overall well-being.
Practices such as yoga, tai chi, and qigong combine gentle movements, breathing exercises, and meditation to promote relaxation, reduce stress, and increase body awareness. These practices can help improve flexibility, balance, and overall physical function.
Cognitive-behavioral therapy (CBT) can also be beneficial by helping individuals develop coping strategies, change negative thought patterns, and improve overall emotional well-being.
CBT can help you develop effective pain management techniques, identify triggers, and reframe negative thoughts associated with fibromyalgia. Additionally, techniques like deep breathing, guided imagery, and progressive muscle relaxation can be incorporated into daily routines to help manage stress and reduce pain.
Dr Deepak Ravindran is the UK’s leading expert on pain and pain management. He is the author of bestselling book The Pain-Free Mindset out now.
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