Symptoms treatment fibromyalgia

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Fibromyalgia is one of the most common forms of arthritic conditions. It often masquerades as other conditions. Therefore, the diagnosis is often difficult to make. Even more difficult is effective treatment. Because of the constellation of problems a patient with fibromyalgia may have, the task of treatment can be daunting.

From the Arthritis Foundation

One of the problems patients have is obtaining restful sleep.The following tips will help achieve restful sleep.

• Try to go to bed at the same time everyday. Even on weekends, try to go to bed and wake at the same time. This will help your body get used to a set schedule.

• Avoid any caffeine-containing beverages such as coffee or soda before going to bed. Also, alcohol drinking should be kept to a minimum. Alcohol disturbs normal sleep patterns.

• Don’t eat a lot before bedtime.

• Have a comfortable mattress and pillow. Something that is not too firm and not too soft is best. Cervical pillows mold to the natural shape of your neck and are a good thing to use.

• A regular exercise program will help achieve deep and refreshing sleep on a consistent basis. The exercise should incorporate stretching, mild strengthening, and non-impact aerobic components.

• Try and avoid daytime naps.

• Keep a proper sleeping environment. This involves a quiet and cool room. A slightly cooler room is ideal for sleeping since this mimics the internal temperature drop during sleep.

• Try not to rely on sleeping pills.

All fibromyalgia patients need to have a home program with muscle stretching, strengthening, and aerobic conditioning. Engaging in an appropriate exercise program will provide the following benefits:

• Improved energy. • Weight loss, which reduces stress on joints and improves self-image.
• Relieves stress.
• Increases natural endorphin production, thereby alleviating anxiety, depression and pain associated with fibromyalgia.

A regular exercise program designed to improve physical fitness should include:

1. Stretching.
2. Strength Training.
3. Non- impact aerobic activities.

It is also important to remember that exercise accompanied with some of the other possible treatments for fibromyalgia will work better than exercise alone. Recent studies have indicated that exercise combined with cognitive behavioural therapy or meditation, is more effective than exercise alone.

Stretching improves flexibility, ensuring that joints can move through a full range of motion. It also prevents injury. Do gentle stretching every day to keep muscles loose.

Strength Training
Developing stronger muscles help with activities of daily living (ADLs) with more ease, thereby reducing fatigue. Having stronger muscles also means an increase in lean body mass and a decrease in body fat. This helps burn more calories. Decreasing weight will have positive effects on joint pain.

Non-impact aerobic
Aerobic exercises such as jogging or bicycling improve the function of the heart, lungs and muscles. Exercising just a few times a will improve the amount of energy, preventing fatigue. Below are a few types of aerobic exercise:

• Walking. You may want to start your slowly by walking for 5 minutes the first day. The following day you should add a minute to your walk. Keep adding 1 or 2 minutes a day until you are walking for 60 minutes a day. When you reach this point, try to walk for one hour a day, 3 to 4 days a week. If you find it very difficult or uncomfortable to stay at one hour walks, then you can try going back to a time that is a little more comfortable until you feel ready to start increasing your times again.

• Light jogging. After you have reached a point where you are very comfortable with walking for one hour, 3 to 4 times a week you can start alternating your walks with slow jogs. You can try walking for 2 blocks, then jog for 1 block, walk for 2 blocks, jog for 1 block etc. After you are comfortable with this you can try walking for 1 block, jog for 2 blocks, walk for 1 block jog for 2 blocks etc. Continue to increase the number of blocks you jog before you have to walk for 1 block. Do this until you can jog the entire distance. After this point, you can begin to extend the distance that you jog or speed up your jog.

• Bicycling. Whether you bicycle outdoors or you prefer exercising indoors on stationary bicycles (exercise bikes), bicycling is a very good anaerobic exercise. As with the other types of exercises, begin slowly and work your way up to a goal of bicycling for 60 minutes.

• Water exercise. Aerobic water exercise may be best tolerated because it eliminates any weight-bearing, but it may be hard for you to get to a pool every day. Water temperature is important. You should avoid any situations with extremely warm or cold water as this may make your symptoms worse. Water exercise may be particularly useful for you if you can’t tolerate anything else. Once your stamina improves you should add another form of exercise on the days you don’t swim.

Your program should incorporate all of these activities. Try stretching in the mornings, and before and after any physical activity. Low-impact aerobic exercises such as walking, swimming, and stationary bicycling can be very helpful. Make sure not to overdo it. Overdoing exercise or even rigorous daily tasks will actually make your muscles contract, the opposite of what you want to accomplish. You may need to begin at a very low level of exercise such as 5 minutes every other day. You should continue to increase the length and frequency of exercise until you are exercising for at least 20 to 60 minutes 4 times a week. At first you may experience a little pain and soreness following a workout. Some muscle soreness is normal when you’re starting to exercise, but sharp pain may be a sign that you have overworked your muscles. As time progresses, you will find that the pain following an exercise workout will lessen, as will your fibromyalgia symptoms.

Remember, the type of exercise that you choose is up to you. The most important thing is that you start exercising and keep doing it. Unfortunately, maintenance of exercise regimens tends to be poor in patients with fibromyalgia. Without a consistent exercise program you will not see much improvement in your symptoms. Staying compliant with your exercise routine will not only help relieve your pain, it will also make you feel better by giving you back some control over your own care and well-being. Having another person who supports you and maybe even exercises with you can keep you motivated.

Cognitive behavioral therapy

This type of therapy combines cognitive therapy – which can modify or eliminate thought patterns contribution to your symptoms – and behavioral therapy, which aims to help you change any behavior that may contribute to your symptoms. It is a form of psychotherapy that emphasizes the important role of thinking in how you feel and what you do. When our brains are healthy, it is our thinking that causes us to feel and act the way we do. Thus, if we are going through stressful situations or experiencing destructive feelings and behaviors, it is vital to identify the importance that the mind has in causing the feelings and behaviors. By identifying the destructive thoughts you can learn how to replace them with thoughts that lead to more desirable reactions.

Cognitive-behavior therapy has been proven effective for reducing sleep disturbances perpetuated by underlying factors common among fibromyalgia sufferers such as conditioned bedtime arousal, erratic sleep/wake scheduling, and spending too much time in bed. A program of 20 hours of relaxation response training and movement therapy in treating patients with low back pain included 28 patients with fibromyalgia. Patients who completed the program reported reduced pain and other symptoms, as well as improved function and general health. Combining cognitive-behavioural therapy with other treatment options such as physical fitness training may be even more effective. A recent study showed that fibromyalgia sufferers showed much less impairment in daily lives after a taking part in a program that combined behavioural strategies, physical exercise, relaxation and information about chronic pain.


Studies have shown that hypnosis may improve functioning and reduce pain even more than physical therapy.

Relaxation Therapy

Effective stress management programs that help to alleviate stress include: breathing exercises, yoga, tai chi, progressive relaxation, guided imagery and autogenic training. Most of these techniques can be practiced on your own at home and usually only require some initial training.

Myofascial trigger point injections using lidocaine may provide temporary relief of pain. In order to obtain any success from injections, they must be integrated into a treatment program of systemic pain relief, sleep improvement, physical modalities, and education.

Antidepressant medications may help elevate mood, improve quality of sleep, and relax your muscles. In fibromyalgia sufferers, they may produce mild to moderate improvement in symptoms with one third to one half of patients responding to treatment. The doses of antidepressants taken by fibromyalgia sufferers are often much less than taken with depression.

Before taking any type of antidepressant be sure to indicate to your doctor if you have a history of seizures, urinary retention, heart problems or glaucoma. Combining any of these drugs with alcohol or other central nervous system depressants, including antihistamines, narcotics and some dental anesthetics can increase their side effects. Also, since adverse drug reactions can occur if you stop using these drugs abruptly, discontinue them gradually. Lastly, a significant portion of patients may find their symptoms worsen while using these drugs so it is very important that you monitor yourself carefully for any complications. Some commonly prescribed antidepressants include:

• Tricyclics

• Selective Serotonin Reuptake Inhibitors (SSRIs) and selective serotonin and nor-epinephrine reuptake inhibitors

Other medications that are useful include GABA stimulators such as Neurontin and Lyrica.

Analgesics that have been used successfully include tramadol.

Get more information about symptoms treatment fibromyalgia and related topics as well as...

• Insider arthritis tips that help you erase the pain and fatigue of rheumatoid arthritis almost overnight!

• Devastating ammunition against low back pain... discover 9 secrets!

• Ignored remedies that eliminate fibromyalgia symptoms quickly!

• Obsolete treatments for knee osteoarthritis that still are used... and may still work for you!

• The stiff penalties you face if you ignore this type of hip pain...

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• And much more...

Click here Second Opinion Arthritis Treatment Kit

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