Fibromyalgia is a term we use for people who experience heightened nerve sensitivity and pain in many places across someone’s body. The pain can be in muscles and joints or can be in other body parts such as in the head causing headaches, around the stomach causing abdominal pain and bloating or just complete body fatigue from the body always being sent a stream of these sensitive nerve messages.
There is no doubt that this is a real and painful condition that affects many parts of people’s lives.
Science has proven that people with fibromyalgia have different pain systems and subsequently have different brain scans to those who do not have fibromyalgia. For example, if we apply firm pressure to the skin of someone with fibromyalgia, areas of the brain that we know are involved in giving us pain signals, become very active. These same areas do not become active in a person who does not have fibromyalgia.
We are also discovering genetic changes that can be ‘switched on’ to start this widespread nerve sensitivity in some people. Not everyone has these genes, but if you do, and you experience a traumatic experience, significant stress or lots of worry, then these genes can turn on and make all the body nerves more sensitive – leading to the all over body pain, sleep difficulties and fatigue.
We don’t yet know why this is yet – but essentially the person releases so much stress hormone (cortisol) and adrenaline as a ‘fight or flight’ response, that all the nerves start looking for danger and turn the volume knob up to a 10! This causes the fibromyalgia pains and other symptoms (e.g., stomach upset (such as reflux or irritable bowel syndrome), depression, headaches (including migraines), muscle aches etc.) It can even lead to difficulty thinking – a condition we call ‘fibro fog’.
In pain medicine we are now calling the pain in this condition ‘Chronic widespread pain’ meaning it is occurring all over the body.
So, if this is the case, then what can we do about it? Well – we need to attempt to reverse the processes that has turned on those genes in the first place. We need to get the person strong again. We need to address the common depression and anxiety caused by both the sensitive nerves and the stress and trauma that caused those genes to turn on. We need to support the persons life that has often changed due to their fibromyalgia.
Some of the life changes people find include becoming less social because they are so tired, they may stop or reduce work due to pain and fatigue leading to financial pressures and lower self-esteem, and they may have had arguments with family and friends because they were so exhausted and in pain, and they may have gained or lost weight because of low motivation for exercise and unstable eating habits. Sadly, there is not one therapy or tablet that can fix all these things at once. But we need to work on each of these things in turn and improve the improvable!
Many patients have had their symptoms significantly improve and their lives get better – but it can sometimes take some time and there can be ‘good times and less good times!’
So, our suggested management may include some of the following:
1. Gentle movement and exercise. Getting our body moving and telling our nerves that normal movement is ok and doesn’t cause pain – has been shown to be VERY helpful. This can be in a pool, with a physiotherapist, yoga etc.
2. Address stress, anxiety, depression and fibromyalgia’s effect on our lives. We have expert psychologists who will focus on practical ways to improve your life, deal with stress, and make life just that little bit easier
3. Use medications to help settle the symptoms to help us cope and recover. We will often talk about antidepressant/antianxiety medications to use – not to treat specifically depression or anxiety often, but the body has many nerves that need to be settled – not just in the head! These medications can be used for a time – like a cast on a broken leg – used when we need them while we try to heal, and then they can be removed when no longer needed hopefully in future.
4. Getting back to work, back to life etc. This can happen as we gently feel better, but a pain specific occupational therapist is someone who has many tips/tricks and ways to maximise your function and get you back into life. If you have a level of private cover, you may be eligible for our pain rehabilitation program at Buderim Private Hospital. This is a program over five weeks two days a week with education, health professionals support, exercise etc.
It can really offer a boost and a great start for those who experience fibromyalgia and chronic widespread pain. It is a team effort – and we would like to help you on that journey. There are some links below for more information and if you have more questions, please ask our expert team of health professionals who come to work every day to help people who experience these symptoms, feel better and lead happier more comfortable lives.