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Characteristically for most people, analgesics or non-steroidal anti-inflammatory drugs do not usually help the pain. Some people will receive some help from pain relievers such as aspirin, panadol, ibuprofen or codeine but it should be remembered that anti-inflammatories could irritate the stomach. Anti-depressants and muscle relaxants may also be helpful. Two interventions shown in clinical trials to be useful to some patients are:
- A low dose of a drug called amitriptyline at night, given because of its effects on the brain’s sleep centre to help normalize sleep and because it has been shown to help control pain in other chronic pain syndromes.
- A low dose of another drug that acts on the central nervous system, fluoxetine, in the morning to help control pain during the day.
These drugs help some people but not all and if they do not work within 4-6 weeks, they are discontinued. Discuss the use of any medications with your doctor. People with chronic pain are encouraged to look beyond pills to find other ways of managing their lives.
The last thing people with pain want to consider is exercise – surely that will only increase the pain. Because people with fibromyalgia find moving painful, they limit their movement. The muscles can then become shorter and weaker because they do not get enough work and the tendons, ligaments and cartilage become more prone to injury.
Exercise for people with fibromyalgia has many benefits – it helps you feel better, increases muscle tone, improves blood flow, eases digestive problems and helps you sleep better at night. The key to an exercise programme is to start gradually. Walking or pool exercise for example might be limited to 5 or 10 minutes to begin and be slowly increased. An exercise program should include stretching, strengthening and aerobic exercise.
Aerobic exercise is particularly important to improve sleep by non-drug means. There is an excellent pamphlet put out by The Arthritis Foundation called ‘Move It or Lose It: an exercise guide for people with arthritis. You can also talk with a physiotherapist or your Arthritis Foundation Field Officer about an exercise program that is right for you.
Physical Treatment
Various forms of physical therapy may help ease the pain of fibromyalgia, at least temporarily. They can also improve mobility and decrease muscle tightness. These therapies can include:
Rest may not sound like a therapy but it can be crucial for the management of fibromyalgia. You will need more rest than others – for one thing, you will get exhausted more quickly and muscle endurance is also lower than average. Try to schedule regular rest periods for certain times of the day. If at all possible, lie down when you rest. Even 5 minutes on the bed or couch can be quite restorative.
During activity, rest can also be important. Rather than pushing yourself to climb all the stairs when your body is in pain, pause halfway, count to ten and then carry on. This principle can be applied to many other situations as well. Watch for opportunities to rest the parts of your body that you are using the most.
Stress will aggravate most symptoms of fibromyalgia. Unfortunately, stress is a part of everyday life that cannot be avoided entirely but it is important to look at ways of reducing its effect. Learning to relax has big payoffs for people with fibromyalgia. Relaxation both reduces pain and promotes restful sleep – two major goals of treatment.
Choose a variety of ways to relax both physically and emotionally. Watch television, read a book or mentally picture yourself on an exotic beach. Meditation is also an excellent form of relaxation. There are many first-class publications on this topic. Talk over with your family how they can help you reduce stress in your life. Often just having them understand what fibromyalgia is will help you ease the stress and they may be able to take some of the strain of family life when the pain is getting you down.
In fibromyalgia, sleep does not do the restorative work for the body and merely increasing the hours cannot solve the problem. You will still wake up in the morning feeling tired, stiff, aching and grumpy! Sleeping pills can sometimes be used but used sparingly and for short periods of time only. People with fibromyalgia can enhance their sleep in a variety of ways other than using medication.
Some Tips for a Good Night’s Sleep
Some of these suggestions may not be practical for your household but talk with your family so they can support you for better management of your fibromyalgia. The outlook for people with fibromyalgia is improving and there are indications that milder cases do respond well too simple treatments and exercise. The management of your fibromyalgia is a team effort and you can help yourself by better management.