Get aerobic exercise three times a week to improve aerobic conditioning and overall pain. Brisk walking and swimming are the best types of exercise for many fibromyalgia patients. If you have significant pain or fatigue, begin slowly, exercising for just a few minutes. Then, gradually increase your time. Regular stretching and range-of-motion exercises keep muscle tissue and joints healthy, and can decrease pain.
Gentle stretching can help to ease pain and increase flexibility. Stretching helps you to avoid muscle tension and spasms. You can stretch on your own at home, or may ask a physical therapist for help. Some people with fibromyalgia find the “spray and stretch” technique to be helpful. For this method, you apply a prescription spray coolant to sore muscles to deaden the pain while you stretch. Tools such as a flexible “theraband” or a Swiss ball may make stretching easier.
Avoid caffeine and keep a regular sleep schedule.
Taking hot baths or applying heating pads to tender areas may help ease pain.
Your doctor is the best source of information on the drug treatment choices available to you.
Psychological counseling or cognitive-behavioral treatment may be beneficial. Cognitive-behavioral therapy can help relieve the intensity of your pain, reduce your number of tender points, lower your emotional distress, and increase your sense of control over pain.
Various types of cognitive-behavioral therapy have been studied, including activity pacing and patient and family education.
Occupational and physical therapy may be helpful. If repetitive job-related movements or the activities of daily living add to your pain, therapists can help by making adaptations and improvements.
Biofeedback may be a beneficial treatment. Studies have shown that people who received biofeedback treatments had fewer tender points, and lower pain intensity and morning stiffness. Biofeedback treatments consist of devices that measure your response to stress, and respond with either a flash of light or a beep. The response teaches you to recognize your own physical reaction to stress and to change your behavior to help you relax. Eventually people who have had biofeedback can recognize their own physical reactions to stress without the feedback, and can modify their behavior accordingly.
Relaxation techniques help to manage stress. Fibromyalgia symptoms are made worse by stress, and, in an ongoing cycle, the pain of the condition stresses the body. Relaxation techniques can help. Some that have proven successful are meditation, breathing exercises, progressive relaxation, guided imagery, and autogenic training. Many classes, books, and audiotapes are available to help you learn these techniques.
Acupuncture may help to relieve pain. Several studies have shown acupuncture to be effective for reducing pain in people with fibromyalgia. The National Institutes of Health concluded that acupuncture could be useful as an additional treatment, as an alternative, or as part of a comprehensive management program for fibromyalgia.
Gentle massage may help to relieve muscular pain. Massage is helpful for increasing circulation of blood to tense, sore muscles. It may be used in conjunction with ultrasound or with the application of heat or cold. Massage is also helpful for removing built-up toxins such as lactic acid, and to help re-educate muscles and joints that have become misaligned.
If you want to try herbal sleep agents such as valerian root or melatonin, use them with caution. The Food and Drug Administration does not regulate herbal remedies, and there is little good information about how they interact with other drugs and their side effects. If you do try them, be sure to let your doctor know.
Fibromyalgia cannot yet be cured, but its symptoms can be controlled. Although symptoms wax and wane over time, studies have shown that fibromyalgia rarely seems to disappear altogether. However, life expectancy is normal, and most patients can expect to lead a relatively normal life with appropriate management. The best course to achieve significant improvement is to implement a multidisciplinary approach, incorporating medication and nonpharmacologic approaches such as self-care.
Treatment of this condition must be individualized. It is helpful to learn to anticipate painful flare-ups, and to manage them before they become overwhelming. During flare-ups, it is most important to focus on sleeping well, decreasing stress and anxiety, and possibly altering medications. Learn what strategies work best for you and employ them right away. Local tender-point injections and application of heat may help. You may also benefit from attending an ongoing patient support group; they are available in many communities.
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