Fibromyalgia and Exercise: Yes, You Can

 

By Denise Mann

Reviewed by Louise Chang, MD

Exercise eases the pain of fibromyalgia. Getting started may not be easy, but it’s worth it

Fibromyalgia and Exercise: Slow and Steady

“Exercise improves a person’s overall sense of well-being and reduces pain and tenderness over time,” says Lesley M. Arnold, M.D. a psychiatrist and fibromyalgia expert at the University of Cincinnati College of Medicine in Ohio. 

“We try to pace it slowly and make sure that their symptoms of pain and fatigue are under control before we introduce it.”

The first step is typically an assessment of the person’s current fitness level. “We like to start them on a program that is a level or two below their current level, improve their stamina, and build up to 20 to 30 minutes of moderate aerobic activity on most days of the week,” Arnold tells WebMD. “We really encourage them to pace things and set reasonable goals.”

Water Aerobics Soothe and Strengthen

For people with fibromyalgia, low-impact aerobics is the way to go. “We really like an aerobic water class and people tend to go back,” Arnold says.

The research backs her up. A study in Arthritis Research & Therapy found that water aerobics improve health-related quality of life in women with fibromyalgia.

These classes often start in warm-water pools, which can be soothing. What’s more, they are typically group-based, so people can garner support and motivation from other members of the group. 

Holthaun says that this helps people stick to a program. “People with fibromyalgia tend to isolate, but being in a group helps motivation,” she says.

Strength Training and Low-Impact Exercise

What if you don’t have access to a pool? Don’t despair: Walking, biking, and other forms of low-impact aerobic activity also provide benefits. “Grab a buddy, take a class, or look into physical therapy,” Arnold suggests.

And don’t rule out strength training. Although doctors once believed that strength training could worsen pain in people with fibromyalgia, new research suggests that this is not the case. 

In fact, the latest research -- presented at the 2008 annual meeting of the American Society of Anesthesiologists in Orlando -- suggests that strength training can have the same ameliorating effect on pain as aerobic exercise.

Lynne Matallana, president and founder of the National Fibromyalgia Association in Anaheim, Calif., says the benefits of exercise for people with the condition are tremendous. “This has been shown scientifically and anecdotally,” she says.

Matallana’s own experience has shown her that exercise can also soothe the mind. 

A former dancer, she was diagnosed with fibromyalgia in 1995. “I have watched how exercise has improved my symptoms and my overall outlook,” she says. “When I got in water, I could do movements that were almost like dance. That touched my soul again.”

Getting Over the Mental Hurdles

Let’s face it: It may hurt just to think about going from couch potato to marathon runner. To avoid getting overwhelmed, take it in stages.

“If you have fibromyalgia, you have this amplified pain signal telling you that something is wrong,” Mattalana says. 

“It’s a natural instinct to want to protect your body by going to bed, but that actually makes pain worse.”

Try these two tips to get your mind on board:

• Give yourself a pep talk. 
• “Tell yourself that this is going to be beneficial,” Mattalana says. “Say, ‘Today I will do just this amount because I know this will help me feel better.” 
•  
• Set realistic goals. Arnold often prescribes five minutes of walking to start.
•  
•  “People may think that won’t be too difficult, but it can be if you have fibromyalgia,” she says. 
• “We start very slow and build up from there, and emphasize that there is no hurry.”

From Skeptic to Believer

In the beginning, Mattalana scoffed at the thought of doing only three minutes on the treadmill, but it wasn’t as easy as she thought it would be. 

“I slowly got my body conditioned and got to a point where I could add more exercise,” she says. “It is a slow process, but every time you get up, stretch, walk, get into a pool, or take a yoga class, you are one step closer to feeling better.”

“Once you convince people to start exercising, they become believers,” says Daniel J. Clauw, MD, professor of anesthesiology and medicine at the University of Michigan in Ann Arbor. 

“It’s not until they do it and see how much it helps that they embrace it.”

How long does that usually take? 

“Some people will notice changes right away, but for others, it may take a couple of weeks,” he says.

Exercise is not a panacea for fibromyalgia, Clauw says. But, he says, “it works in more people than anything else. I can’t remember an instance where someone got into an exercise program and didn’t notice a significant improvement in symptoms.”

Fibromyalgia and Diet Will changing your diet help you cope with fibromyalgia?

 

By Jen Uscher
WebMD Feature

Reviewed by Melinda Ratini, DO, MS

 

If you have fibromyalgia, you've probably wondered if there are ways to modify your diet to improve symptoms such as fatigue and muscle pain.

Research hasn't shown that there are specific foods that all fibromyalgia patients should avoid or add to their diets. But it may still be worthwhile to take a closer look at how foods impact the way you feel.

"There aren't many good studies that have looked at how diet can affect fibromyalgia symptoms. But I think we can gather a lot from anecdotal evidence -- from what patients tell us," says Ginevra Liptan, MD, medical director of the Frida Center for Fibromyalgia in Portland, Ore., and author of Figuring Out Fibromyalgia: Current Science and the Most Effective Treatments.

Here are some of the ways doctors say food can play a role in fibromyalgia and tips on how you can tweak your diet to support your overall health.

Pay Attention to How Food Makes You Feel

"A lot of people with fibromyalgia have sensitivities to particular foods, but it varies from person to person," Liptan tells WebMD.

"They might be sensitive to MSG, certain preservatives, eggs, gluten, dairy, or other common allergens."

In fact, in a survey published in the journal Clinical Rheumatology, 42% of fibromyalgia patients said their symptoms worsened after eating certain foods.

A good way to start identifying the foods that may aggravate your symptoms, Liptan and other experts say, is keeping a daily food journal.

"I have some patients keep a food journal for two weeks," says James McKoy, MD, chief of pain medicine, director of complementary medicine, and staff rheumatologist at Kaiser Permanente in Honolulu.

"They write down the foods they ate each day and whether they had symptoms like headaches, indigestion, or fatigue. It can be very helpful, because sometimes we see, for instance, that they have more fatigue when they eat a particular food."

Try Eliminating Certain Foods

If a fibromyalgia patient has a lot of irritable bowel symptoms, Liptan often recommends they try an elimination challenge diet.

They stop eating a certain food they suspect they're sensitive to for six to eight weeks. Then they add it back to their diet and see how they feel.

 Liptan's patients most often try eliminating dairy products or foods containing gluten.

"When you discover you're sensitive to a food and then eliminate it from your diet, it can make a huge difference," Liptan says. "Some people get a lot of benefit in terms of reduction of pain, but more often we see a reduction in fatigue and an improvement in irritable bowel symptoms like bloating and constipation."

If you think you might have food sensitivities or allergies, talk with your doctor.
In some cases, they may refer you to an allergist for food allergy testing.

You may also want to consult a dietitian to make sure you don't miss out on essential nutrients when you eliminate certain foods from your diet.

Make It Easier to Eat Healthfully

It makes sense for people with fibromyalgia -- just like everyone else -- to try to eat a diet high in fruits, vegetables, whole grains, and lean protein.

A well-balanced diet can give you more energy to stay physically active and can potentially improve your overall health.

If you're struggling with pain and exhaustion, however, it's hard to cook nutritious meals. Liptan says she encourages her patients to make it easier on themselves by seeking out healthy foods that don't require much preparation.

"Buy vegetables that are pre-washed and cut up," she suggests. "If you have a health food store nearby, go to the deli section and buy small portions of pre-prepared foods like beet salad or quinoa to vary your diet."

Use Food to Help Fight Fatigue

Choosing the right foods may help you keep your energy level more consistent and prevent fatigue.

"We know anecdotally that certain dietary choices -- like eating small meals frequently throughout the day -- can help energy levels," says Ann Vincent, MD, assistant professor of medicine and medical director of Mayo Clinic's Fibromyalgia Clinic in Rochester, Minn.

"It can help to eat a snack with a little protein, for example, when you're feeling tired at three in the afternoon," she says.

Make sure you eat breakfast, which should include some protein and whole grains, says Christine Gerbstadt, MD, RD, MPH, a spokeswoman for the Academy of Nutrition and Dietetics and a registered dietician and practicing physician in Sarasota, Fla.

"You could try eating a boiled egg and some oatmeal," Gerbstadt says. "That will prevent your blood sugar from spiking and will give you the right kind of energy to get you going through the morning, even if your body is aching and you're feeling tired."

Of course, diet is not the only factor in how much energy you have. Getting enough sleep and being active during the day can also help.

Check on Your Supplements

Always tell your health care providers about any supplements you're taking to treat your fibromyalgia. Some supplements, such as SAMe, can have significant side effects and may interact with medications, Vincent says.

In addition to checking on any possible interactions, your doctor should also be able to help you gauge any claims you might read about what supplements can, or cannot, do for your health.

Focus on Your Overall Well-Being

As you make changes to your diet, keep in mind that people with fibromyalgia tend to benefit most from taking a variety of approaches to managing their symptoms.

Along with leading a healthy lifestyle (including a nutritious diet) and taking any medications your doctor may prescribe for pain or other symptoms, there are many other therapies worth exploring.

"Look into trying things like yoga, massage, and deep-breathing exercises," says Gerbstadt. "Each individual with fibromyalgia has different symptoms and will need different solutions to get the best possible quality of life."

Lidocaine Injection May Help Treat Fibromyalgia

By Mary Elizabeth Dallas

HealthDay Reporter

TUESDAY, Aug. 5, 2014 (HealthDay News) -- The pain of fibromyalgia might be eased with injections of the painkiller lidocaine, a new study suggests.

People with fibromyalgia complain of chronic pain throughout their body as well as an increased sensitivity to pain. Doctors often have trouble treating this pain because it's unclear what causes it, the study authors noted.

In the new study, injecting lidocaine into peripheral tissues -- such as the muscles in the shoulders or buttocks -- effectively reduced pain sensitivity, the researchers found.

"We hypothesized that if pain comes from the peripheral tissues, and we can take this pain away by injecting local anesthetics, then this would be indirect proof of the importance of peripheral tissues for the clinical pain of these individuals," study lead author Dr. Roland Staud, a professor of medicine at the University of Florida College of Medicine, said in a university news release.

"Over-the-counter medications and [narcotic] prescriptions such as opiates aren't really effective for controlling chronic pain conditions," he added. But with the new therapy, "we are able to explain the pain of chronic patients better and manage it better," Staud said. "We are making progress but it will take time."

The study involved 62 women with fibromyalgia. Each woman received four injections: two in certain muscles in their shoulders and two more in their buttocks. Some of the women received lidocaine injections, while a "control group" received saline injections.

Right before the injections were given and 30 minutes afterwards, the women received mild pain stimulations delivered through mechanical means or through heat.

Compared to "dummy" saline injections, the lidocaine significantly eased the women's sensitivity to pain, according to the study published recently in the European Journal of Pain.

The researchers noted, however, that both lidocaine and the placebo resulted in a 38 percent reduction in pain at or near the point of injury.

But chronic pain affects the body differently than a specific injury, like a broken leg, the study authors pointed out. Chronic pain, they explained, actually alters nerve function along the spinal cord.

"The best way to treat chronic pain conditions is . . . [by] looking at emotional, sensory and tissue damage," 

Michael Robinson, director of the University of Florida Center for Pain Research and Behavioral Health, said in a university news release. "We know there are central and peripheral and social and behavioral components to someone saying, 'Ow, it hurts.'"

Cancer survivors who experience pain, for example, may associate it with their disease and fears about their prognosis -- even if it's been treated and in remission.

"That sensation may well feel more painful than if they just thought it was a tweaked muscle," Robinson explained.

Two experts in fibromyalgia were unsure about the significance of the findings, however.

"There was no significant difference between the pain reduction in the placebo versus the treatment group -- this signifies that it does not matter what the injection product is, but the act of injection itself might be the cause of pain reduction," said Dr. Waseem Mir, a rheumatologist at Lenox Hill Hospital in New York City.

"One can then argue that the pain reduction was placebo," he said. "To examine the placebo point, another arm in the experiment might need to be introduced where patients are not getting injected but taking a placebo pill."

Dr. Houman Danesh is director of integrative pain management at Mount Sinai Hospital in New York City. He said that "fibromyalgia is a complex disorder where patients are more sensitive to pain. 

It is mainly diagnosed by a rheumatologist by touching 18 diagnostic pressure points, and if 11 of them are sensitive, then the diagnosis is made," he explained.

"This study offers insight as to a potential contributor to fibromyalgia and a possible treatment," Danesh said. 

"It is interesting to note that the points which were used were acupuncture points, therefore suggesting acupuncture as a possible treatment to help patients with fibromyalgia."

7 things people with anxiety want yo to know.

Found this on face book.


have anxiety, and I believe I can speak for everyone with anxiety when I say this: it’s gotta be hard to be close to us. But there are seven things we want you to know that we don’t always know how to tell you.

1. It doesn’t have to do with you.
It can be pretty exhausting ruminating about everything we possibly have done wrong, are doing wrong, or could do wrong. We may want to sit and cry sometimes. We may be uninterested in our activities. We may snap at you, even though you absolutely don’t deserve it. We may even get nervous that you don’t love us anymore, even if you’ve given us no indication of this.
We want you to know above all else that it doesn’t have to do with you. It’s not your fault. We love you, and we’re so, so sorry if we ever give the impression that we don’t. We just don’t love our brain right now, and we don’t know how to deal with it.

2. Never try to talk us out of our emotions.
Trying to relieve us of our fear or sadness might seem like a good idea. And sometimes, it is. In fact, we might even ask you if we have any reason to be worried, so that we can try to combat that irrational part of us that is constantly afraid.
But there’s a fine line between trying to help us and trying to talk us out of it. Never tell us that our worries don’t exist, or that we can get over it if we just stop thinking about it. All that does is make us feel like we’re broken—that there’s something wrong with us that even our closest loved ones don’t understand.

3. Part of us knows that our fears aren’t rational, but we can’t shake the part that doesn’t.
Sure, we know that the embarrassing thing we said wasn’t really all that embarrassing, and it probably didn’t influence anyone’s opinions of us whatsoever, and that the entire group we were with today probably isn’t talking about how terrible we are behind our backs. We know how ridiculous that sounds, and it sounds even more ridiculous saying it out loud.
But that other part of us. . .that’s where anxiety lives. That’s where it can stay, feeding on us, popping out its head occasionally to remind us that it’s still there. That’s the part that always reminds us, “What if this time, my worries are correct?”

4. We are grateful for what we have—and for you.
Often, anxious people are labeled as pessimists. And that’s actually quite understandable. We’re pretty talented at coming to the worst possible conclusion almost instantaneously.
But that’s not always who we are. In fact, many of us are pretty optimistic between anxiety bouts. We do love our life, and we are grateful for what we have, and we are especially grateful for you. We don’t mean to focus on the negative, but sometimes, we can’t help it. Know we always appreciate you. You are the light at the end of our tunnel. You are the one who tries your hardest to understand, who knows us in and out and still is willing to stay.

5. We know you can’t always see things from our perspective, but we appreciate you trying.
As someone who doesn’t suffer from anxiety, we know you won’t be able to fully understand. We know that we might sometimes sound crazy, and we’re sure it can be frustrating to have to drop everything and calm us down.
But every time you answer our fearful texts with reassurance and kindness, or pull us into another room to ask us what we’re worrying about, or are simply there, steady, supportive, without questioning the way we operate. . .we can’t even express how much that means, because it’s rare to find.

6. We wish we could turn it off, but we can’t.
Though it might seem otherwise, we don’t want to focus on what could go wrong. We don’t want to be negative, or bring the mood down, or nitpick about things that may seem little to an outsider. We’re not trying to get attention.
We know how we sound sometimes, and we wish we could turn it off. But it’s just a part of who we are.

7. It doesn’t define us.
We may have anxiety, and it may be a part of us. But so are our passions, our quirks, our personalities. Anxiety is one of countless parts. We still laugh. We still feel the wind in our hair. We still appreciate a steaming mug of coffee early in the morning, or the sun warming our skin in the summer.
We still love you. We always will.


Sammy Nickalls is a writer and the content manager of Inspiyr.com, an online magazine helping people get healthier, happier, and more successful. She is an avid health nut, as well as a lover of yoga, gaming, books, and tea.

Really? The Claim: Fibromyalgia Is Affected by Weather

THE FACTS

No one really knows precisely what causes the debilitating fatigue and muscle pain of fibromyalgia. But some people who have the disorder say they know what can make it worse: changes in the weather.

Cold, damp days and drops in barometric pressure are widely associated with flare-ups in symptoms of the condition, which affects mostly women. In one study by the National Fibromyalgia Association, people with the condition ranked weather changes as one of the leading aggravating influences on pain and stiffness.

Unlike the reported connection between arthritis and changes in temperature and pressure – which has mostly been debunked – the belief that fibromyalgia symptoms fluctuate with the weather has not been the subject of thorough research. The few studies that have investigated it have mostly found little evidence of a link.

In the latest report, published this month in the journal Arthritis Care & Research, Dutch researchers followed 333 middle-aged women who had fibromyalgia, looking for relationships between environmental conditions and their levels of pain and fatigue. Over the course of a month, the researchers monitored humidity levels, atmospheric pressure, precipitation, temperature and sunshine duration, using data from a meteorological institute.

In some cases, they did find that weather variables had “significant but small” effects on pain and fatigue. But for the most part, they concluded, there was “more evidence against than in support of a uniform influence of weather on daily pain and fatigue.”

THE BOTTOM LINE

Most studies have not found much evidence of a link between fibromyalgia symptoms and weather patterns.

However those of us who have it may disagree. 

Smoking with Fibromyalgia

If you smoke and you have fibromyalgia, you may be hurting more than you have to.

I'm not going to preach at you to quit - I know that's just annoying and doesn't do any good - but I do want you to have the information you need to make informed decisions about your health. And we have mounting evidence showing that smoking and other tobacco use makes fibromyalgia symptoms worse.



Do you smoke cigarettes or chew tobacco?

When you have fibromyalgia, tobacco use may have even greater health risks than you thought.

Multiple studies have shown that tobacco use is associated with worse fibromyalgia symptoms. Smoking may also be a risk factor for developing this condition.

The Studies

In 2009, Mayo Clinic researchers published a study that included data from 984 patients, 145 of whom were tobacco users.
Researchers said tobacco use was linked to:

• Greater pain intensity
• Higher scores on the Fibromyalgia Impact Questionnaire
• Fewer good days
• More missed work

Also in 2009, a study published in Rheumatology International found that the following symptoms were more severe in cigarette smokers:

• Chronic widespread pain severity
• Unrestorative sleep
• Paresthesia (odd nerve sensations)
• Anxiety and depression

Those researchers compared smoking rates of fibromyalgia and rheumatoid arthritis patients and found that fibromyalgia patients were more likely to smoke.

A 2011 study involving 336 people with fibromyalgia found that about 10% of participants were current smokers. Researchers concluded that smokers:

• Had more tender points
• Were more likely to be depressed (women only)

The authors called for more research into the impact of smoking on pain, function, and psychiatric features in the illness.

A 2010 study suggested that smoking cigarettes appeared to be linked to the development of fibromyalgia, and that smoking may be a risk factor.

Trying to Quit

Go to one of my links about E-Cigs. as of 2/6/14 I have been smoke free for 3years 2 months and 6 days using an E-Cig. My pain decreased by at least 10%.

'More Exercise' for Fibromyalgia & Chronic Fatigue Syndrome

It's basic physiology -- when you feel sluggish, unmotivated and fatigued, getting up and doing some exercise causes changes in your body that boost your energy. Exercise also releases endorphins in the brain, and endorphins are great pain killers. So when people say those of us with fibromyalgia and chronic fatigue syndrome would feel better if we got "more exercise," there's something to it, right?


Actually, no. In normal, healthy people, yes -- exercise creates energy. Problem is, we're not normal and healthy.

Exercise is a tough subject, whether you have fibromyalgia or chronic fatigue syndrome. However, it's not the same for both groups, so let's look at them separately.


Fibromyalgia & 'More Exercise'

This myth is compounded by numerous studies showing that exercise lowers our pain levels and does in fact give us more energy. Doctors glance at the titles of these studies and tell the next fibromite who walks through the door to go to the gym. What they're missing is that the amount and type of exercise we need is far from what most people would even consider exercise.


If we exert ourselves to the point of exhaustion, we're probably going to trigger a major flare that lands us on the couch for days or even weeks. We all have different fitness levels so the exact amount of exertion we can handle varies greatly, but generally speaking, we should exert moderate effort for just a few minutes on a regular basis. There's ample clinical and anecdotal evidence to support that regular exercise, done with extreme moderation, helps us. That means, for us, an exercise regimen might consist of 2 minutes of gentle yoga per day. If you're in better shape, maybe you can handle a 10-minute walk or 20 minutes of aquatic exercise to start with.


I consider myself in moderately good shape for someone with fibromyalgia -- I can go grocery shopping, clean the kitchen and do a couple loads of laundry in the same day (most of the time, anyway.) I can also get through a 30-minute yoga routine without wiping myself out or having nasty repercussions. I couldn't do that a year ago, though, and if I'd tried, I would have crashed afterward. Two years ago, I would have crashed 10 minutes in; and three years ago, just getting into the first pose would have done me in on bad days. While I'm not the most consistent about exercise, I have worked hard to slowly and steadily increase my activity level.


That slow, steady pace is what we need. If all you can do is 2 minutes, try to be consistent about your 2 minutes. Eventually, you'll be able to handle 4. The key is not pushing yourself too far too fast, and expecting setbacks along the way.

Chronic Fatigue Syndrome & 'More Exercise'

A key symptom of chronic fatigue syndrome is post-exertional malaise. It's a period of intense, often debilitating symptoms that follows any kind of exercise or exertion and lasts for a day or more (usually more.) Research actually shows abnormalities in the blood chemistry of people with chronic fatigue syndrome after they exercise, and those abnormalities could very well provide the long-awaited diagnostic test for this condition. Some preliminary research also shows abnormal heart rhythms during exercise, which could mean that exercise is actually damaging your health.


For years, some chronic fatigue syndrome doctors and researchers have touted a treatment called graded exercise therapy (GET). It's controversial to say the least, and while some studies have shown that it can help some people, the methods used to arrive at that conclusion are frequently called into question. Looking over the available research, it seems to me that GET is only recommended because it's more effective than most treatments that have been studied -- and that's not saying a lot. However, it does help some people, as evidenced by the comment below from Dr. Donnica Moore, a well-respected expert who just signed on to work with the Whittemore Peterson Institute.


So what does all this mean about exercise and chronic fatigue syndrome? It really depends. There's clearly a reduced exercise tolerance, but you're the only one who can determine exactly what your body can tolerate. It all depends on your current fitness level and severity of your illness. We all know that being sedentary increases muscle aches and pains, so at the very least you might want to learn some simple stretches you can do while laying in bed. Because of the evidence suggesting heart abnormalities, you should talk to your doctor about testing your heart to make sure exercise is OK -- here's a link to studies you can show your doctor, and they contain testing information: Cardiac Involvement in Chronic Fatigue Syndrome.


What If You Have Both?

If you're diagnosed with both fibromyalgia and chronic fatigue syndrome, you're in a particularly difficult situation -- the right kind of exercise may relieve some symptoms while exacerbating others. Again, you're the only one who can figure out the right level of exertion for yourself.


The Persistent Myth

The exercise myth is one that's not likely to go away -- it's pretty firmly entrenched in the medical establishment, and a consequence of an uninformed public. What we need to do is know our own bodies, try to educate those who are receptive, and ignore those who aren't. We're not doing any good for anyone by over exerting ourselves and winding up in bed for a week.

 How has the exercise myth impacted you? 
Are there people in your life who just won't let it go? 
 How do you deal with them? 
Leave your comments below!