Researchers discovered recently that pain is not one but two different phenomena occurring within the central nervous system. One establishes the sensation, but the other interprets it, dampening or increasing awareness of it depending upon the situation and our emotional state. When we feel pain but are distracted by something else, our awareness of the pain decreases. Yet, when we are worried as to whether we will experience pain that concern can make the sensation so much worse. So pain is not just the sensation itself but how we interpret it.
This discovery may lead to new treatment methods for pain management, although some of those proposed might sound a bit left of center. Pain catastrophizing is an irrational fear of pain usually in anticipation of or just after a pain-inducing event, such as surgery. According to a new study published in April’s issue of Anesthesiology, antidepressants may be helpful for those who experience this psychological condition.
Researchers at the Department of Anaesthesiology and Intensive Care at University of Copenhagen, Denmark conducted the study, led by Troels H. Lunn, M.D., Ph.D. Lunn said that just after surgery, patients with pain catastrophizing report feeling far more pain. He and colleagues wanted to see if selective serotonin reuptake inhibitors (SSRIs), a common class of antidepressants, could help mitigate the sensation. 120 patients with pain catastrophizing disorder were recruited for the study.
Each was scheduled for knee replacement surgery. The subjects were given either an SSRI called escitalopram or a placebo for six days after the surgery had taken place. Each patient’s pain level was recorded each day. There was no difference between those receiving the SSRI and the placebo 24 hours after surgery. But the antidepressant did make a significant difference from day two thru day six. Dr. Lunn believes beginning the SSRI earlier could help relieve worry leading up to the surgery and pain afterwards.
Those anticipating a painful surgery should discuss with their doctor what they can do to help control or lessen pain. Anyone dealing with acute or chronic pain in the aftermath of an operation should talk to a doctor or specialist to find relief.
If you suffer from fibromyalgia, it’s very likely you’re experiencing a significant amount of stress. Too much of this, coupled with a sedentary lifestyle is particularly harmful. Not engaging in enough exercise will slow down blood flow to your muscles, causing an increase in pain. While, you’re already in enough pain.
According to studies, stretching, walking and strength training all aid in controlling the pain and muscle tenderness that accompany fibromyalgia. Even exercising three times per week can greatly improve your quality of life. Also, this activity will help boost confidence and relieve fatigue and depression. Start out slowly; maybe participate in yoga or another less rigorous activity.
Water exercise (water aerobics) is an exceptionally helpful way to help with fibromyalgia pain and it’s the easiest. You need not be a swimmer to participate in water exercise; it’s often the case that you’ll be working out with your head above the water, away from the deep end. There are some times you might be asked to go into deeper waters, but not without a life jacket or foam belt. Water therapy is a great beginning to your more active life if you have trouble exercising due to obesity.
Doris Cope, MD, director of Pain Management at the University of Pittsburgh Medical Center says, “If you can’t exercise because of obesity, water therapy is a good place to start”. “Warm water can be very comforting. The exercise gets blood flow to muscles and tendons. And if you’re in the water, your joints are not being stressed during exercise.”
You’ll be able to do exercises you wouldn’t otherwise be able to tolerate, as they would cause pain. Water’s natural buoyancy is what gets you moving with ease. You’ll also benefit from the resistance that water provides–you’ll build muscles. And, you’ll have a fun way to spend your free time.
Chronic pain alone hurts, but it’s often accompanied by anxiety and depression. There are some remedies that can help with different types of chronic pain, including meditation. It’s not meant to replace certain needed medications, but can definitely reduce the need. Jon Kabat-Zinn, PhD, former executive director of the Center for Mindfulness in Medicine says, “You have to be ready for meditation, and there’s no one more ready than people who are suffering from pain.”
The following are three types of chronic pain that can be relieved with meditation:
Chronic back pain
Several studies show that meditation can improve the brain’s response to pain along with relaxing the body and providing a type of pain management for the patient. One 2005 Duke University Medical Center study showed that those suffering from chronic back pain showed great improvement in pain and psychological symptoms after engaging in a type of meditation that focused on anger release.
Researchers at the University of Basel Hospital in Switzerland found that mindfulness-based stress reduction was of benefit to those with fibromyalgia in a number of ways which included, the ability to cope with pain, depression and anxiety. Three years later, it was shown that those who continued with some form of the meditation continued to receive benefits.
Specialist in migraine management and assistant clinical professor of neurology at Vanderbilt University School of Medicine, Lewis Brandes, MD, says many patients have been observed who benefitted from meditation and various relaxation techniques to go along with their migraine medication. This is especially helpful for those who have migraines triggered by anxiety. Meditation, breathing techniques and yoga can be used in an effort to avoid a migraine attack. Dr. Brandes says, “It can give them an edge that medication can’t.” Even if the patient is rating their actual pain on the same level, they’re better able to cope, their sleep improves, and they experience less depression and anxiety.
70 and 80 percent of those with fibromyalgia experience skin issues
Skin complications go deeper than the surface. Many suffer from lack of sleep, fatigue and pain. Skin problems can present the sufferer with many limitations with activities that would seem otherwise simple such as clothing choice and food restrictions.
Frequent skin problems seen in fibromyalgia patients:
They look like raised bumps on the skin and often feel scaly. Usually these appear due to itchy, dry skin.
It’s a tenderness that fibromyalgia patients frequently report. Their skin hurts just from a touch. This painful symptom can cause bruising, redness, swelling and scarring.
Dry and itchy skin
A lot of patients suffer from constantly dry, flaky, cracked skin that mainly affects their hands. They sometimes experience pain from peeling skin on the affected areas. Itchiness is very common, especially on areas of the body plagued with rash. The act of excessively scratching at the itches can sometimes lead to infections and sores.
Why are we seeing these problems?
No one seems to know exactly why these uncomfortable skin problems occur in fibromyalgia patients. A few theories do exist. Allodynia might be from a dysfunction in the central nervous system of the brain. The itching could be from pain signals that are misinterpreted by the brain. And an overactive pituitary gland in the brain may be causing skin discoloration.
What are some treatment options?
First, it’s important to speak with your doctor about your symptoms in order to receive treatment for your specific needs. There are some options for side effects experienced by sufferers of fibromyalgia:
- Corticosteroid prescription creams for dry skin
- Ultraviolet light therapy and bleach creams for blotchy skin
- Over-the-counter creams and moisturizers applied to damp, clean skin to combat cracked, dry skin.
Taking a vitamin D capsule can be a miracle for some.
Often inexplicable symptoms are eased after a person’s vitamin D level has been brought up to a therapeutic level. Many times people suffer needlessly from a deficiency and an illness they might already have is intensified due to an unhealthy level of this important vitamin. Fibromyalgia is one example. It’s somewhat of a mystery of an invisible illness with symptoms that cause fatigue, joint pain and other issues that affect the entire body.
Research has provided evidence that patients with fibromyalgia can alleviate chronic pain by using vitamin D supplements if the level in their blood is low. This backs up information from previous studies showing a possible link between vitamin D and a reduction of chronic pain.
The study, which was conducted in Austria, tested whether an alleviation of symptoms would occur if the patients’ level of vitamin D was brought up to a healthy range. The research involved the use of a placebo and oral vitamin D supplements, and took place over several weeks. Patients had to have a low level of vitamin D in their blood, below 32 nanograms per milliliter, in order to participate.
An issue in the journal Pain reported that patients who took vitamin D supplements said their fatigue and pain decreased during that time, more than the placebo group reported. Dr. Florian Wepner, who led the study, said that using vitamin D as a supplement can be a relatively safe and economical treatment for those with fibromyalgia, but not a cure for the condition. Wepner said, fibromyalgia “cannot be explained by a vitamin D deficiency alone”. It should be noted that patients who noticed a decrease in pain didn’t recognize changes in psychological symptoms.
It’s crucial to check in with your doctor if you think you might have a deficiency in vitamin D. It’s extremely common to have lower than healthy levels, and if you’re suffering with fibromyalgia, you might just get some relief. Any ease in symptoms helps, especially when you’re living with an illness where one of the primary complications is chronic fatigue.
A long-term study found that Lyme disease is not a trigger for fibromyalgia as was once thought.
In fact, Lyme patients were no more likely to develop fibro than the general population. Patients at the Lyme Disease Diagnostic Center in Westchester County, New York were followed for between one and two decades to come to this conclusion. Researchers out of New York Medical College in Valhalla, NY conducted the study. The lead author was Gary P. Wormser, MD and the results were published online in the journal Arthritis & Rheumatology. Previous research suggested that a Lyme disease infection did trigger fibromyalgia. But these did not follow patients long-term.
100 patients participated in this investigation. The average age was 64 at the time of fibromyalgia testing. Each had confirmed Lyme disease via a culture. These participants were periodically evaluated for Lyme disease. They were also checked for fibromyalgia somewhere between 11 and 20 years after the first confirmed diagnosis. Patients were treated with antibiotics when diagnosed, as is standard.
Fibromyalgia was evaluated by using a system called a tender point examination. 18 specific areas are tested for tenderness to determine whether or not the patient indeed has fibro. The average time for a follow-up was 15.4 years. Out of 100 patients, 24% had Lyme disease previous to their confirmed diagnosis. 16% had it before and eight since the original diagnosis. Yet, only one person interviewed had been declared as having fibromyalgia. 24% had had Lyme disease multiple times.
Researchers said that if Lyme disease caused fibro there would have been many more showing signs in this study. Experts say Lyme disease patients often complain of fibro-like symptoms during and just after treatment. It could be that Lyme patients do develop fibro but that it lasts only for a certain period and then passes. Researchers believe more studies should be conducted to know more about this phenomenon.
For those living with chronic pain, some days are worse than others and ibuprofen just isn’t enough.
For others, over-the-counter pain medications bother their stomach. And then there are those who just prefer a natural method of pain relief. Whatever your reason, there are lots of options when it comes to natural pain relief. Find the right item for you and feel your pain just melt away.
For neuropathy, shingles and arthritis, capsaicin is the way to go. This is the same substance found in chili peppers. It tingles, rushes blood to the area and helps soothe and tingle the pain away. There are topical creams at your pharmacy or the medicine aisle at the supermarket.
For rheumatoid arthritis, psoriasis and any disease where inflammation is an issue, try InflaThera or Zyflamend. These are supplements that contain turmeric, ginger and holy basil. All of these have potent anti-inflammatory properties. Turmeric is spice often used in curry dishes. The active component is curcumin. It has amazing anti-inflammatory properties. The best way to enjoy these is to add them as foods into your diet, all but holy basil that is.
If you would rather go with the supplements, know that ProThera is not over-the-counter. Your physican must order it. Zyflamend is a less potent version sold in pharmacies and supermarkets.
To quell swelling post-surgery or to treat an acute injury, arnica is recommended. This is derived from a European flower which has tremendous anti-inflammatory properties. Homeopathic arnica is to be used in tandem with traditional pain medications, herbs or even ice. There are arnica ointments for bruises and strains as well.
Lastly, for osteoporosis pain and inflammation try Aquamin. This is derived from red seaweed rich in magnesium and calcium. Two capsules or 2,400 mg a day is recommended. Aquamin is sold in stores.
Fibromyalgia can be painful.
The fatigue can also act as a barrier between you and the life you want. Regardless, many who have the condition still continue to work part-time or even full-time jobs. For them, managing pain and fatigue is extremely important to maintain a full and satisfying lifestyle. Whether you can work with fibromyalgia or not depends very much on the severity of the condition. Those whose symptoms are too severe should consider going on disability. There are many rules to navigate, however, in terms of work capacity and so on. Most people with fibromyalgia can work if they can properly manage their stress level, pain and fatigue symptoms. Here are some ways to adjust your work life in order to manage fibromyalgia.
The first thing you should do is discuss your condition with your employer and colleagues. Let them know what symptoms you experience and their severity. Explain how it works and how there are good days and bad.
Next, think of what accommodations they can provide you. On days when your symptoms are bad, will your supervisor allow you a little rest? On days when you just can’t make it to the office, can you work remotely? Perhaps you could stay late on days you feel better, spread the hours over the course of the week or see if you could come in on a weekend.
You could write your own list of accommodations, but luckily the U.S. Department of Labor’s Job Accommodation Network has written one for you. For fibromyalgia, they suggest minimizing distractions, providing memory aids or organizers, reducing stress, getting written instructions for the tasks to be performed and allowing flexible work hours. Make your workspace friendly, easy to maneuver in and comfortable. Try to avoid really bright harsh lighting. Practice daily stress reducers such as breathing techniques, stretches or meditation at your desk. Don’t overexert yourself physically. Get as many ergonomically designed features into your workspace as possible.
It’s hard to find balance with fibromyalgia but it can be achieved if you keep on trying and formulate a plan that’s right for you.
The results of a recent trial study found a new medication to bevery effective in treating the symptoms of fibromyalgia.
This was a phase II clinical trial regarding a medication known as IMC-1. The results were presented at the annual meeting of the American College of Rheumatology this year in Boston. The study was funded by Innovative Med Concepts, the maker of the drug. William L. Pridgen, M.D., the founder and CEO of the company, gave the presentation.
Director of the Chronic Pain & Fatigue Research Center at the University of Michigan Daniel J. Clauw, M.D said, “IMC-1 shows promise as a potentially new treatment for the millions of people who suffer from this debilitating condition.” 10 million people in the U.S. suffer from fibromyalgia, while between 3-6% of the world’s population struggles with the condition. Symptoms include headaches, pain in various areas of the body, disturbances in sleep patterns, and inability to concentrate, mood changes, and more.
143 fibromyalgia patients took part in the study, of which the objective was to test the safety and efficacy of IMC-1. This medication is a combination of two drugs used currently to fight herpes — famciclovir and celecoxib. Pridgen said, “Many herpes viruses are known to significantly upregulate COX enzymes in the body, which in turn are important for efficient viral replication.” He went on, “In theory, physical or emotional stress in patients can reactivate the virus and result in perpetuation of the symptoms of fibromyalgia. Effectively suppressing latent viruses may significantly improve the pain and related symptoms of fibromyalgia.”
Most patients saw a 30-50% reduction in pain after 16 weeks of treatment. Dr. Clauw said, “Compared to placebo, the relatively high completion rate, improved pain scores and the low rate of discontinuation because of adverse events are consistent with a well-tolerated and effective therapy.” After a successful phase III trial and approval by the FDA, the drug should be available on the market for fibromyalgia sufferers.
Fibromyalgia can be very painful.
Doctors often look for tender points around the body. Fibromyalgia sufferers often have tender points on, but not in the joints. These are muscle pains that tend to feel worse when pressed down with one’s finger. They aren’t areas of deep pains, but reside just below the skin’s surface. About the size of a penny, these painful areas can inhabit regions like the chest, back, neck, elbow or shoulder, buttocks or hips. When touched, the pain can be so great it can cause the person to flinch.
Other symptoms of fibromyalgia include fatigue, trouble sleeping, irritable bowel syndrome, and depression. When testing for fibromyalgia and checking tender points, the doctor will compare these to non-tender or test points on the body. These “control” areas are used to see the difference between the areas that give pain and those that do not.
For the doctor to conclude the condition is fibromyalgia, the patient must have symptoms for at least three continuous months. Though not a lot is known about the condition, treatment for it has many facets. One strange aspect, medical experts still don’t know why, but fibromyalgia patients often react well to low doses of antidepressants. For tender points, exercise, stress management, hydrotherapy, ice and heat therapy and medication may all be employed. Therapeutic massage can also help. Whether it is a Jacuzzi, a hot shower or bath or a moist heating pad, moist heat can provide wonderful relief to tender points and relieve other kinds of muscle aches too.
Managing stress is a big part of living with fibromyalgia. Relaxation techniques add a lot to managing this disease. These include meditation, deep breathing exercises, yoga and practical things like managing one’s schedule so as to not spread one’s self too thin. Getting enough sleep and the right amount of exercise is also vital.
Talk to your doctor if you think you have fibromyalgia.