Articles on Fibromyalgia

Fibromyalgia is a chronic pain syndrome that typically provides the basis for a number of different symptoms and clinical signs. Here you can read more about the various articles we have written about the chronic pain disorder fibromyalgia - and not least what kind of treatment and self-measures are available for this diagnosis.

 

Fibromyalgia is also known as soft tissue rheumatism. The condition can include symptoms such as chronic pain in the muscles and joints, fatigue and depression.

Fibromyalgia and Fatigue: How to Drain Your Energy

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Fibromyalgia and Fatigue: How to Drain Your Energy

Fibromyalgia is strongly linked to fatigue and exhaustion. Here we take a closer look at the causes - and what can be done about it.

There is no doubt that fibromyalgia is a complex pain syndrome. But in addition to causing widespread pain in the body, it is also linked to possible effects on cognitive function. Fibrofog is the term used to describe the impact of short-term memory and mental presence. Such brain fog is also very exhausting. As many as 4 out of 5 people with fibromyalgia report that they experience fatigue - and unfortunately we are not surprised by that.

 

- Fatigue is not the same as being tired

Here it is important to distinguish between extreme exhaustion (fatigue) and being tired. Patients with fibromyalgia experience physically and mentally exhausting symptoms on a daily basis - often in combination with poor sleep - which can lead to deep-seated exhaustion. Therefore, it is extremely important that both patients with fibromyalgia and those around them facilitate an adapted everyday life with less stress.

 

Take Fatigue Seriously

We know you have a lot you want to do, and we know you'd rather do it today. But have we all gone on a rampage by burning all the gunpowder at once? The first step towards an everyday life that is less affected by fatigue and fibro fog is to take it seriously. Acknowledge that you are tired. Recognize that the physical and mental challenges affect you - it's only natural. By being open about how the diagnosis affects you, both to yourself and to those around you, it will be easier for all parties to show consideration.

 

With fibro, the energy level is often very unstable, which is precisely why - on good days - it can be tempting to do all the things you haven't been able to do before. One of the most important lessons is learning the importance of saving energy, and rather using it conservatively to get through today's smaller and bigger challenges.

 

- At our interdisciplinary departments at Vondtklinikkene in Oslo (Lambert seats) and Viken (Eidsvoll Sound og Raw wood) our clinicians have a uniquely high professional competence in assessment, treatment and rehabilitation training for chronic pain syndromes. Click on the links or here to read more about our departments.

 

Sleepless Nights and Fatigue

sleeping problems

Fibromyalgia is often also associated with sleep problems. Difficulty falling asleep and restless sleep are both factors that mean you don't recharge your energy optimally for the next day. Extra bad nights can also cause you to wake up with a feeling of brain fog - which makes it easy to forget things and which can cause concentration difficulties. Earlier we wrote an article called '9 tips for better sleep with fibromyalgia'(opens in a new link - so you can finish reading this article first) where we go through a sleep expert's advice to sleep better.

 

The sleep problems in those with chronic pain syndromes appear to be linked to, among other things, pain sensitization. And this is negatively affected by stress. That is why it is so incredibly important, for everyone with chronic pain, that you find the personal measures and adaptations that suit you. Many people with fibromyalgia make use of daily self-time acupressure mat (The link opens in a new window) or trigger point balls. Using one like this before bedtime can be particularly effective, as it lowers both muscle tension and stress levels. The recommended time of use is 10-30 minutes daily, and can be well combined with meditation and/or breathing techniques.

 

- Read more about the acupressure mat via the image below:

 

Adapted Activity and Training

Unfortunately, exhaustion and lack of energy can lead you into a negative spiral. The doorpost mile will be at least a couple of miles higher if we have slept badly and feel directly exhausted. There is no doubt that it can be difficult to combine fibromyalgia with regular exercise, but it can become somewhat easier if you find the right forms of exercise and activities. Some like to go for a walk, others think exercise in a hot water pool is best, and others may like home exercises or yoga exercises better.

 

If you feel that you are too tired to train, this unfortunately leads over time to further muscle weakness and even more exhaustion. This is precisely why it is so important to find low-threshold activities even on the bad days. Many people with rheumatism and chronic pain syndromes feel that exercise with rubber band is both gentle and effective. Start calmly and work with a physiotherapist or modern chiropractor to find the right exercise program for you. Eventually you can gradually increase the training load, but remember to take it all at your own pace.

 

In the video below you can see a customized elastic training program for shoulders and neck - prepared by chiropractor Alexander Andorff in Lambertseter Chiropractor Center and Physiotherapy.

 

VIDEO: Strengthening exercises for the shoulders and neck (with elastic)

Join our family! Subscribe for free to our Youtube channel here (link opens in a new window)

 

- Save your energy and set intermediate goals

Do you often get frustrated by things you can't do? Try to make adjustments. Try to weed out less important things that steal your energy - so that you have more energy to do things that are important to you. Break larger tasks into smaller, more manageable chunks. In this way, you will get a feeling of mastery as you gradually work your way towards the goal.

 

Take rest breaks throughout the day. Here we also recommend that you keep notes on what you feel works best for you. Remember to recognize that rest is good for you - and use the time to relax with something you enjoy, such as listening to an audiobook or meditating.

 

Make your day more Fibro-friendly

As mentioned earlier in the article, we know all too well that both physical and mental stress are linked to flare-ups (fibro flare-ups) of fibromyalgia pain. This is precisely why we are so incredibly keen to get the message across that you must take care of yourself. If you go and bite the pain today it will only build up more and more. If you are at work or at school, it is also very important to communicate with management about your needs.

 

Concrete ways to make your day less stressful can include:
  • Taking more breaks (preferably with stretching exercises for the neck and shoulders)
  • Get work assignments that better suit your abilities
  • Communicate your needs outwardly to those around you
  • Seek palliative physical therapy (fibromyalgia is a muscle sensitivity syndrome after all)

 

Be open about your ailments and pain

Fibromyalgia is a form of "invisible disease". That is, to the extent that you cannot see if another person is in physical pain. This is precisely why it is very important that you communicate with those around you and are open about the disease. It is, after all, a chronic pain syndrome that causes muscle pain, joint stiffness and sometimes affects cognitive function.

 

It may be useful to refer to studies that have shown that the brain misinterprets/oversensitizes pain signals in those with fibromyalgia (1). This misinterpretation of nerve signals in the central nervous system thus causes stronger pain than is normal.

 

Own measures for Relaxation

Earlier in the article we mentioned both acupressure mats and trigger point balls. But something that is as simple as it is ingenious is actually reusable multi-packs (can be used both as a heat pack and as a cooling pack).

Tips: Reusable Heat Pack (link opens in a new window)

Unfortunately, it is a fact that muscle tension and joint stiffness are two things that are directly linked to soft tissue rheumatism. You simply heat it up - and then place it against the area that is particularly tense and stiff. Can be used time after time… after time. A simple and effective self-measure for those who suffer a lot from tense muscles, especially in the neck and shoulder area.

 

Summary: Main points

One of the keys to avoiding extreme fatigue is to make changes in your everyday life. We hope that the article has given you inspiration to not always put yourself second in line. In fact, it is the case that by paying more attention to yourself and your own illness, others around you will also feel better. Also remember that it is permissible to ask for help - it does not make you a weak person, on the contrary, it shows that you are strong and sensible. Here we summarize our main points to avoid severe exhaustion:

  • Map which activities and events drain you of energy
  • Adapt your everyday life according to your own daily routine
  • Be open about your ailments and pains with those around you
  • Remember to take several breaks with your own time

 

We end the article with an apt quote from Finn Carling:

“The deepest pain

in your pains are

that they are not even understood 

of those close to you"

 

Join our Fibromyalgia Support Group

Feel free to join the Facebook group «Rheumatism and Chronic Pain - Norway: Research and news» (Press here) for the latest updates on research and media writing about rheumatic and chronic disorders. Here, members can also get help and support - at all times of the day - through the exchange of their own experiences and advice. Otherwise, we would greatly appreciate it if you would follow us on our Facebook page and YouTube channel.

 

Feel free to share to Support Those With Rheumatism And Chronic Pain

We kindly ask you to share this article in social media or via your blog (please link directly to the article). We also exchange links with relevant websites (contact us on Facebook if you want to exchange a link with your website). Understanding, general knowledge and increased focus are the first steps towards a better everyday life for those with chronic pain diagnoses.

Sources and Research:

1. Boomershine et al, 2015. Fibromyalgia: the prototypical central sensitivity syndrome. Curr Rheumatol Rev. 2015; 11 (2): 131-45.

Fibromyalgia and Central Sensitization

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Fibromyalgia and Central Sensitization: The Mechanism Behind the Pain

Central sensitization is considered to be one of the main mechanisms behind fibromyalgia pain.

But what is central sensitization? Well, here it helps to break down the words a bit. Central refers to the central nervous system - ie the brain and the nerves in the spinal cord. It is this part of the nervous system that interprets and responds to stimuli from other parts of the body. Sensitization is a gradual change in how the body responds to certain stimuli or substances. Sometimes it is also called pain sensitivity syndrome.

 

- Fibromyalgia is Linked to an Overactive Central Nervous System

Fibromyalgia is a chronic pain syndrome that can be defined as both neurological and rheumatological. Among other things, studies have shown that the diagnosis causes extensive pain in combination with a number of other symptoms (1). In the study we link to here, it is defined as a central sensitivity syndrome. In other words, they believe that fibromyalgia is a pain syndrome in which overactivity in the central nervous system leads to errors in the pain interpretation mechanisms (which are thus increased).

 

What is the Central Nervous System?

The central nervous system is the part of the nervous system that refers to the brain and spinal cord. In contrast to the peripheral nervous system which involves nerves outside these areas - such as branches further out into the arms and legs. The central nervous system is the body's control system for receiving and sending information. The brain controls the majority of body functions - such as movement, thoughts, speech function, consciousness and thinking. In addition to this, it has control over sight, hearing, sensitivity, taste and smells. The fact is that one can consider the spinal cord to be a kind of 'extension' of the brain. The fact that fibromyalgia is linked to oversensitization of this can therefore cause a wide variety of symptoms and pain - including effects on the intestines and digestion.

 

We take a closer look at Central Sensitization

Sensitization involves a gradual change in how your body responds to a stimulus. A good and simple example can be an allergy. With allergies, it is the overreaction from the immune system that is behind the symptoms you experience. In fibromyalgia and other pain syndromes, it is believed that the central nervous system has become overactive, and that this is the basis for episodes of hypersensitivity in muscles and allodynia.

 

Central sensitization in fibromyalgia means that the body and brain overreport pain signals. This may also help explain why and how the pain syndrome causes widespread muscle pain.

 

- At our interdisciplinary departments at Vondtklinikkene in Oslo (Lambert seats) and Viken (Eidsvoll Sound og Raw wood) our clinicians have a uniquely high professional competence in assessment, treatment and rehabilitation training for chronic pain syndromes. Click on the links or here to read more about our departments.

 

Allodynia and Hyperalgesia: When Touch is Painful

Nerve receptors in the skin send signals to the central nervous system when touched. When lightly touched, the brain should interpret this as stimuli that are not painful, but this is not always the case. In so-called flare-ups, ie bad periods for fibromyalgia patients, even such light touches can be painful. This is called allodynia and is due - you guessed it - to central sensitization.

 

Allodynia thus means that the nerve signals are misinterpreted and overreported to the central nervous system. The result can be that light touching is reported as painful - even if it is not. Such episodes occur more frequently during bad periods with a lot of stress and other strain (flare-ups). Allodynia is the most powerful version of hyperalgesia - which of the latter means that pain signals are amplified to varying degrees.

 

- Fibromyalgia is Linked to Episodic Flare-ups and Remission

Here it is very important to point out that such episodes can vary from person to person. Fibromyalgia often goes through periods of time with more intense symptoms and pain - called flare-ups. But, fortunately, there are also periods of minor pain and symptoms (remission periods). Such episodic changes also explain why light touching can be painful at certain times.

 

Fortunately, there is help available to control the pain in a better way. In a chronic pain syndrome, there is of course pain - in the form of both muscle pain and often joint stiffness. Seek help for both assessment, treatment and rehabilitation of sore muscles and stiff joints. A clinician will also be able to help you identify which rehabilitation exercises and self-measures are best for you. Both muscular therapy and adapted joint mobilization can help reduce tension and pain.

 

What is the Cause of Central Sensitization in Fibro Patients?

No one questions that fibromyalgia is a complex and extensive pain syndrome. Central sensitization is due to physical changes in the nervous system. For example, that touch and pain are interpreted differently / errors in the brain. However, researchers are not entirely sure how these changes occur. It has been seen, however, that in most cases the changes appear to be linked to a specific event, trauma, course of the disease, infection or mental strain.

 

Studies have shown that up to 5-10% of those affected by stroke may experience central sensitization in parts of the body after the trauma (2). A significantly higher incidence has also been seen among people after spinal cord injuries and in those with multiple sclerosis (MS). But it is also known that central sensitization occurs in people without such injuries or trauma - and here it is speculated, among other things, whether there may be certain genetic and epigenetic factors at play. Research has also shown that poor sleep quality and lack of sleep - two factors that often affect fibromyalgia patients - are linked to sensitization.

 

Conditions and Diagnoses Linked to Central Sensitization

stomach ache

As there is more and more research in the field, a possible connection has been seen with several diagnoses. Among other things, it is believed that sensitization explains the pain associated with a number of chronic musculoskeletal diagnoses. Among other things, this includes mechanisms seen by, for example:

  • Fibromyalgia
  • Irritable Bowel Syndrome (IBS)
  • Chronic Fatigue Syndrome (CFS)
  • Migraine and chronic headache
  • Chronic jaw tension
  • Chronic lumbago
  • Chronic neck pain
  • Pelvic syndrome
  • Neck sprain
  • Post-trauma pain
  • Scar pain (after surgery for example)
  • Rheumatic arthritis
  • Rheumatoid arthritis (RA)
  • Endometriosis

 

As we see from the list above, further research on this topic is incredibly important. Perhaps one can gradually use the increased understanding to develop modern, new assessment and treatment methods? We hope so at least, but in the meantime it is primarily the focus on preventive and symptom-relieving measures that applies.

 

Treatments and Self-Measures for Pain Sensitization

(Image: Treatment of muscle tension and joint stiffness in between the shoulder blades)

Bad and more symptomatic periods among fibromyalgia patients are called flare-ups. These are often the cause of what we call triggers - that is, triggering causes. In the article linked to here are we talking about seven common triggers (the link opens in a new reader window so you can finish reading the article here). We know that it is especially stress reactions (physical, mental and chemical) that can lead to such bad periods. It is also known that stress-reducing measures can have a preventive, but also soothing effect.

 

- Physical treatment has a documented effect

Treatment methods that can help include physical therapy techniques such as muscle work, custom joint mobilization, laser therapy, traction and intramuscular acupuncture. The purpose of the treatment is to desensitize pain signals, reduce muscle tension, stimulate improved circulation and improve mobility. Special laser therapy - which is performed at all departments The pain clinics - has shown extremely good results for fibromyalgia patients. The treatment is usually performed by a modern chiropractor and / or physiotherapist.

 

A systematic review study consisting of 9 studies and 325 fibromyalgia patients concluded that laser therapy was a safe and effective treatment for fibromyalgia (3). Among other things, it was seen, in comparison with those who only did exercises, that when combined with laser therapy, a significant pain reduction, reduction in trigger points and less fatigue were seen. In the research hierarchy, such a systematic overview study is the strongest form of research - which emphasizes the importance of these results. According to the Radiation Protection Regulations, only a doctor, physiotherapist and chiropractor are allowed to use this type of laser (class 3B).

 

- Other Good Self-Measures

In addition to physical therapy, it is important to find good self-measures that work relaxing for you. Here there are individual preferences and results, so you have to try and find the right measures for yourself. Here is a list of measures we recommend trying:

1. Daily free time on acupressure mat (massage point mat with accompanying neck pillow) or use of trigger point balls (read more about them via the link here - opens in a new window)

(Picture: Acupressure mat with own neck pillow)

Regarding this tip, we have received several questions from interested parties regarding how long they should stay on the acupressure mat. This is subjective, but with the mat we have linked to above, we usually recommend from between 15 to 40 minutes. Feel free to combine it with training in deep breathing and awareness of the right breathing technique.

2. Training in a hot water pool

Contact your local rheumatology team to inquire if there are any regular group classes near you.

3. Yoga and movement exercises (see video below)

In the video below shows chiropractor Alexander Andorff in Lambertseter Chiropractor Center and Physiotherapy developed customized movement exercises for rheumatologists. Remember to adapt the exercises to your own medical history and daily form. Our Youtube channel also has significantly kinder training programs than this if you find this to be too difficult.

4. Take a daily walk
Spend time on hobbies you relax with
Map out negative influences - and try to weed them out

 

Exercises That Can Help With Desensitization And Relaxation

In the video below you can see a movement program whose main purpose is to stimulate joint movement and to provide muscle relaxation. The program is prepared by chiropractor Alexander Andorff (feel free to follow his Facebook page) by Lambertseter Chiropractor Center and Physiotherapy in Oslo. It can be done daily.

 

VIDEO: 5 Exercise Exercises for Rheumatists

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Join our Rheumatologist & Fibromyalgia Support Group - and Follow us Actively in Social Media

Feel free to join the Facebook group «Rheumatism and Chronic Pain - Norway: Research and news» (Press here) for the latest updates on research and media writing about rheumatic and chronic disorders. Here, members can also get help and support - at all hours of the day - through the exchange of their own experiences and advice. Otherwise, we really appreciate if you want to follow us Facebook page og Our Youtube channel - and remember that we appreciate comments, shares and likes.

 

Feel free to share to Support Those With Rheumatism And Chronic Pain

We kindly ask you to share this article in social media or via your blog (please link directly to the article). We also exchange links with relevant websites (contact us on Facebook if you want to exchange a link with your website). Understanding, general knowledge and increased focus are the first steps towards a better everyday life for those with chronic pain diagnoses.

 

With wishes for good health on to you and yours,

The pain clinics - Interdisciplinary Health

Click here to see an overview of our clinics. Remember that our modern interdisciplinary clinics are happy to help you with your ailments in muscles, tendons, nerves and joints.

Sources and Research:

1. Boomershine et al, 2015. Fibromyalgia: the prototypical central sensitivity syndrome. Curr Rheumatol Rev. 2015; 11 (2): 131-45.

2. Finnerup et al, 2009. Central post-stroke pain: clinical characteristics, pathophysiology, and management. Lancet Neurol. 2009 Sep; 8 (9): 857-68.