The thought of living with a constant daily pain seems nightmarish for most, even the slightest headache of pain can slow a days productivity. But for many people pain is a way of life. For many Canadians this is a way of life. The Arthritis Society estimates that 900,000 Canadians live with Fibromyalgia, a condition characterized by chronic muscle pain and accompanying exhaustion. It is an obscure disease difficult to diagnose as there is as yet no known cause or cure. What is known is that women are affect four to six times more often then men and aside from muscle pain, sufferers also often have varying degrees of depression, sleep deprivation, loss of memory, and headaches. With very few modes of treatment in the past most Fibromyalgia suferers had no choice but medications. Heavy duty pain killers, anti-depressants and sleep aids to help deal with the chronic pain. As more and more studies become available it appears that a few modalities may offer stronger benefits for those living with the condition.

Exercise

It appears that one of the most effective treatments emerging for those with Fibromyalgia is simply exercise. While that may sound easy to most those with Fibromyalgia often experience increased pain with physical exertion. Because those with fibromyalgia are often unfit even lighter activities become a source of exacerbated muscle pain. With the expectation that pain will result from activity many simply refrain from engaging in regular exercise. Though this is the case and it may be hard initially for those with Fibromyalgia studies are showing consistently that a regular exercise program is to the benefit of those suffering. While specific muscle strength routines have not been fully analyzed and the results of which are unclear what does show clear signs of effectiveness is Aerobic training. One study printed in the journal Current Opinion in Rheumatology showed that aerobic exercise has the potential to generate a “decrease central pain perception, which is believed to be increased in fibromyalgia.”. The training has also shown favorable results in an increase in the Fibromyalgia patients self sufficiency, improvement in physical function, mood and decrease in levels of pain. Another study on exercise in Fibromyalgia published in the British Medical Journal noted that subjects in an exercise class rated themselves as feeling much better after three months, and those who continued the program had maintainted or improved on the benefits a year later. Following a simple aerobic program just under the capabilities of the patient seems best, and as the abilities and level of fitness increase more activities can be done allowing for the greatest benefit. Simply walking for 30minutes 2-3 times a week may be enough for those with Fibromyalgia to begin seeing benefits.

Massage

As Complimentary and Alternative Medicines are becoming more and more accepted in Western Medicine new options are opening up to Fibromyalgia and Chronic Pain patients. In the 90’s Massage Therapy became regulated in a few Canadian provinces. Today’s Massage Therapists are dedicated health professionals trained in treating musculoskeletal conditions. The few studies that have been done are showing promising results when using a trained Massage Therapist. One study indicated that immediately following the first and last treatments the massage group showed a reduction in anxiety, depression and salivary cortisol levels when compared with a control group. In a meta-analysis of massage-therapy research Moyen et al Concluded that massage had evidenced a reduction in pain across many studies on average 62% lower than the control group.

Another recent study has shown “significant and progressive” improvements for Fibromyalgia patients treated with Manual Lymphatic Drainage (MLD) and Connective Tissue Massage. Published in the Journal of Manipulative and Physiological Therapeutics (Feb 2009) and gaining an overview in Massage Magainze ( Sep 2009) the study contained 50 women with primary Fibromyalgia with half the group receiving MLD and half receiving Connective Tissue massage. The reasons for the effectiveness of massage lies directly in the massage therapists ability to manipulate and mechanically stimulate the muscles. In Lymphatic massage the therapist stimulates the bodies natural lymph system through rhythmic gentle motions in the direction of the lymph nodes. This aids in the bodies natural defense system by helping the body to act as a pump and facilitate the movement and processing of lymphatic fluid with unwanted metabolic wastes and reduce excess fluid accumulation. Manual therapy can work to break down adhesions in the muscle, reduce muscle spasms, reduce tension and restrictions. As well as stimulating pressure and pain nerve receptors to “close” the pain gate responsible for the perception of muscle pain.

For those suffering with Fibromyalgia or chronic pain Massage Therapy could be a part of the solution in coping with the condition.

Meditation

Aside from symptoms of increased pain perception and limitation in physcial activity many with Fibromyalgia suffer from psychological symptoms. Depression and anxiety are high among those with Fibromyalgia and recently attempts at using meditation to help quell those feelings has been proving useful in the few studies that have tried. Dr. Kabat-Zinn along with colleagues at the University of Massachusetts Medical School have been teaching a meditation training course titled Mindfulness-Based Stress Reduction (MBSR). The focus of the program is to help participants see and relate to their emotions and thoughts in the present moment to help restore calmness and a clearer view to the current frame. There have been a few published studies of which the findings show a benefit for those recieving MBSR, notably in General Hospital Psychiatry(1993) and another featured in the journal Arthritis and Rheumatology(2007). Both articles had evidence that clients recieving meditation and stress reducing treatments had shown improvement. Those completing the programs improved upon depressive symptoms and general mood. This is often the first hurdle for those with Fibromyalgia to over come if they are to undertake further courses of action to help improve their condition like those noted above. If the client is in a depressive state or feels as though because of their condition they are helpless or hopeless any other treatment may not warrant the full benefits. Although a MBSR course may be difficult to obtain across the country many people offer meditation courses. Finding a qualified instructor in the chinese art of Qi Gong or a Yogi master (Yoga extends beyond positioning) may be of benefit to those with Fibromyalgia. A calmer more relaxed sense of being is beneficial to anyone who takes the time to discover it, and could be even more so for those with Fibromyalgia.

While no treatment for Fibromyalgia has shown to be complete or have the ability to cure the problem having the tools at hand to effectively manage the condition seems to be key. Many no longer want to rely on medication and are eager to find ways to ease the strain of fibromyalgia. The greatest benefit will be in finding a qualified practitioner who can work with a Fibromyalgia client to bring about the best results. Hopefully the suggestions above find some of you in good health.

Further reading:

^{Curr Op Rheuma: Effectivenes of Exercise in Management of Fibromyalgia; Susan E. Gowans; Amy deHueck}

^{BMJ. 2002;325:185-187}

^{Gen Hosp Psychiatry 1993 Sep;15(5): 284-9}

^{Arthritis Rheum. 2007 Feb 15;57(1):77-85.}

^{J Clin Rheumatol;2:18–22.}

Massage Mag; 2009 Sep; 98-99

Journal of Manipulative and Physiological Therapeutics; Feb 2009

^{J Clin Rheumatol. 2002;8(2):72-76}

^{Psychol Bull 2004;130:3–18.}