Posted by MERM on 5/26/2009, 10:39 am
Exercise can be a touchy subject for fibromyalgia patients. When it hurts to move, the idea of exercising seems unfathomable.
But multiple studies have shown that exercise is an important component of any FM treatment plan.
Part of the problem is that most people think of exercise as jogging, aerobics and other strenuous activities.
FM and ME/CFS specialist Dr. Charles Lapp suggests redefining “exercise” for FM patients. Perhaps a better word would be “movement” or “activity.”
He says the main thing is to avoid strict bed rest, which causes deconditioning, which in turn makes symptoms worse.
Important FM “exercise” tips:
Move your body as much and as often as you are able – even if it’s just walking to the kitchen for a glass of water.
Deep breathing exercises – learning to breathe from the lower part of the diaphragm – is essential. Shallow breathing increases neck and shoulder pain and can cause chest tightness, shortness of breath and spasms in the postural muscles. Deep breathing eases tension and improves the circulation of oxygen in your body.
Stretch your muscles periodically throughout the day. Begin slowly with seated stretches. After several weeks, if you are able, progress to standing stretches.
When you first begin any new type of exercise, begin very slowly. Depending on the severity of your illness, start with as little as one minute and build up very gradually (i.e., spend several weeks at each level).
Take frequent rest breaks. Try resting three minutes for each minute of exercise. Once you’ve moved into strength training or cardiovascular exercise, it’s a good idea to only exercise every other day, allowing yourself a day of rest between workouts.
Break up your exercise sessions. Five three-minute sessions are better for FM patients than one fifteen-minute session.
For those who are able to tolerate a longer period of exertion, water exercise may be a good option. Water’s buoyancy decreases the effects of gravity, displacing 85 percent of your weight. As a result, it takes less effort to move because you don’t have to support your whole weight. Also, immersion in water promotes relaxation, reduces muscle fatigue and lessens pain perception.
Pharmaceuticals
Two pharmaceutical drugs have been approved by the FDA for the treatment of fibromyalgia: Lyrica and Cymbalta. Lyrica is an anticonvulsant that binds to a specific protein within overexcited nerve cells and works to calm damaged nerves. This is thought to reduce the level of pain in FM patients. Cymbalta is a serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant. It is thought to work by increasing the activity of serotonin and norepinephrine in the central nervous system. These are two neurochemicals known to be low in FM patients.
Other medications may be prescribed off-label to treat FM symptoms. Some of these include:
Anticonvulsants – for pain, sleep and mood stabilization
Antidepressants (SSRI, SNRI or tricyclic) – for depression, sleep and pain
Sleep initiators and sustainers
Analgesics (NSAID, Cox II inhibitor, opioid, topical) – for pain
Stimulants – for energy improvement and mental acuity
Muscle Relaxants – for pain and sleep
People with fibromyalgia are often highly sensitive to medications, therefore, dosages should usually started at low levels and gradually adjusted to a level that is both well-tolerated and therapeutic.
Every patient is different. What works for one may not work for another. Physicians and patients need to work together to discover which drug, or combination of drugs, works best.
Supplements & Herbs
Many fibromyalgia patients take a variety of supplements and herbs along with, or sometimes instead of, pharmaceutical drugs. Because FM patients are often sensitive to medications, supplements and herbs can provide a healthy, helpful alternative.
Recent research has shown vitamin D to be particularly effective for the musculoskeletal pain of fibromyalgia. (See BELOW “Vitamin D – A Neglected ‘Analgesic’ for Chronic Musculoskeletal Pain”)
LINKS TO ALL VIT D TOPICS IN PDF FORMAT
http://pain-topics.org/pdf/vitamind-briefing.pdf
http://pain-topics.org/pdf/vitamind-report.pdf
http://pain-topics.org/pdf/vitamind-brochure.pdf
The articles acknowledge that vitamin D does not act palliatively like pharmaceutical interventions, but systemically, and thus takes weeks to months to kick in, as a person's system is nourished with ample vitamin D over time.
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