It is clear that fibromyalgia is a multi-faceted disease.  Even if I could read all the different studies for all the different theories of all the different possible underlying causes of fibromyalgia, the odds of being able to distill everything into one cohesive treatable trigger is looking to be pretty unlikely.  I don’t see why management of fibromyalgia would be any less complex.  Since not all fibro patients have the same symptom array, wouldn’t it stand to reason that not all fibro patients will react similarly to the same management strategies? Wouldn’t individualizing management strategies be most successful?

In our bottom-line-sensitive healthcare culture, this type of treatment is not going to be readily available through traditional doctors’ offices where visits are often limited in time and scope and dependent on reimbursement from tyrannical insurance companies.  So what to do?

If you want something done right… do it yourself?

We are talking management, not cure.  There are things we can do to minimize discomfort and increase quality of life by looking at some of the possible triggers for fibromyalgia:

1. Mindset. Set your mind to feeling better.  Talk yourself into it.  Don’t react to pain – try not to wince when you stand up and shooting pains hit your legs or back.  Try not to verbalize pain (groaning, repeating phrases like “I feel like crap” or “ouch”).  Don’t give in to pain.  If you want to do something, do it, even if it hurts.  Pain does not equal injury in the case of fibromyalgia.  Don’t let pain stop you.  You take control of the pain, not the reverse.
2. Sleep. Because so many hormones and chemicals in our bodies are regulated by sleep, and the way our bodies react to pain is apparently regulated by hormones and chemicals, make sure you are getting not only enough sleep but enough deep, restorative sleep.  If you snore, have a sleep study done to see if you have sleep apnea.  If you have sleep apnea, compliance with a C-PAP machine makes an enormous difference in sleep quality.  Sexy, no.  But miraculous, and sleeping pills not required.
3. Diet.  Comfort eating is wonderful, isn’t it?  Unfortunately, it often involves foods that contribute to discomfort and pain.  However, foods that cause pain and discomfort in me may not be a problem for someone else.  Certainly, look at recommended daily intakes of the different food groups; take a hard look at your typical diet to see how good or bad it is.  Avoid extreme or fad dieting.  But listen first to your body.  For example, even though grains are a large part of the food pyramid, I can’t partake in that many suggested servings without having skin troubles at least, if not swelling and aching.  Personally, I feel better on a heavy protein and vegetable diet with minimal sugars and grains.
4. Supplements.  There are some supplements that can help: B complex (pain reduction), D (aids with depression), C (fights infection), fish oil (brain health).  Experimentation will again be necessary to get the right combination and levels.
5. Exercise.  Movement is a vicious cycle.  Not moving increases pain, but the wrong movements can also increase pain.  Vigorous aerobic exercises have been proven to increase pain tolerance in healthy people – it may be a good theory that they would help people with chronic pain as well.  Stretching and weight training seems to have a much lower rate of pain reduction or an increase in pain tolerance, but again, it is necessary to experiment.  First and foremost, the exercises have to be sustainable.  If you can’t keep up exercising on your own, joining or creating an exercise group to add peer pressure and get support may help to keep going.
6. Medications.  Taking pain meds or antidepressants or sleep aids is all going to depend on you.  There are a lot of options for fibromyalgia right now pharmacologically, and discussing them with your doctor would be a good idea.  I have to weigh the pros and cons of taking meds because the side effects are so often worse than the benefits.  A foggy mind is more intolerable than shooting pains or chronic “white noise” pain, and that eliminates most fibro meds for me.  The ones that I have tried have been minimally effective in terms of pain reduction.  I find a very low-dose antidepressant helps me to focus and think, and then I can make the right choices in terms of other methods of pain management.  But that’s me….
7. Physician visits.  Avoid the doctor for fibro-related ailments.  There are a few reasons for this.  First, cost. Second, you may be taken more seriously if you only appear when really necessary.  My rule of thumb is that I appear when there is a new symptom that may not be fibro-related.  I confirm that it is fibro-related and go my way.  Certainly there are years I’m in and out more than others… Third, visiting the doctor every time something hurts or feels intolerable without waiting for this particular episode to pass reinforces at least subconsciously that you are ill, that you hurt.  That kind of negative reinforcement can block the first suggestion above, to get into the mindset of feeling better.

Finally, take charge.  Be the boss.