Monday, December 13, 2010

How to cope with chronic pain

Managing pain is not as difficult as one can imagine. Everything that the body feels and does is being coached by the mind. If one can only learn these compiled tips on how to cope with chronic pain, a lot of problems can be solved and one need not seek the help of a professional in order to be successful in this endeavor.
Reduce stress: As stress is one of the causes of chronic pain, it is better if the person resorts to learning meditation. One can reduce stress and pain that the body is experiencing by means of deep concentration or by focusing on other things. Meditation is a practice where the mind is always placed over matter.
Manage sleep problems: Insomnia can cause chronic body pains as it strains the muscles and leaves the body without rest the whole night through.  As the body bears no comfort, muscles are constricted, thus bearing pains the following day.
Take on a support group: Support groups are a group of people that can be of help. These people meet at a given time and day and talk openly about topics that they are having problems with, how to cope with chronic pain. Support groups are a venue to vent out what one really feels. They tend to exchange notes right after each meeting and help one another to battle the affliction that they are into.
Cutback on alcohol and smoking: Cutting back on these vices can help a person in pain as both can bring about muscle tension that leads to stress, likewise resulting to chronic pain if given a chance to burst inside the system.
Diversion tactics: Strategies like getting a massage and indulging in exercise are considered as the best as they will help the person forget the pain that he has been feeling. Pain can be felt if there is nothing else to do. Have you ever wondered that when you are sick and watching TV, there is a tendency for you to feel uneasy and remember having flu only during commercial breaks? Diverting the attention is a good ploy for a person to teach him how to cope with chronic pain.
There is also a method that involves the use of sensors in order to learn about the body’s inner movements. This process is called biofeedback. The sensors enable the person to see and hear the pulse beats, stomach sounds, body temperature and likewise muscle tension. These graphs and beeps reflect the goings on of the inner body system as the sensors have attached monitors. The body, as guided by the mind, would in turn learn to control the beeps, thus learning to control pain.
Monitor the daily pain levels: Daily monitoring of pain levels can be a necessity in order to know the time of day, duration of the pain, and how many times it occurs in a given period. There are really a hundred ways for a person to learn how to cope with chronic pain and most of it can come from the brain as it controls everything within the body.
Let not pain take over the mind. Always be reminded that pain is just one of these matters.

Sunday, November 28, 2010

Wednesday, November 17, 2010

Sunday, November 14, 2010

Getting your family to accept you have Fibromyalgia


Family Involvement
Expert advice from Leslie Epstein, M.S., MFCC
While only one person in a family may suffer from fibromyalgia the entire family is affected by it. Your family faces a troublesome time while learning to cope with the anxieties, fears and trauma produced by fibromyalgia. Thus, it is essential that the family become part of your therapeutic program. More explicitly, family support is crucial to the successful management of any chronic and painful condition.
A common problem for patients is disassociation, where a family member may want to deny that their is anything wrong with you. That family member seems to feel that if he/she pretends nothing serious exists, the illness and its problems will go away. This type of person rationalizes that "if their is nothing I can do (about my loved one having fibromyalgia), I may as well act as if nothing is wrong and go on living my own life." The patient, in turn, resents this apparent disinterest and interprets it incorrectly to mean that their family member does not care, creating added stress.
Open communication among family members is important. The family must learn to discuss all feelings that arise, including frustration, resentment and impatience. Expression must not be restricted. The patient should be comfortable discussing personal needs and feelings with the family, and the converse should also be true. In this connection, it is vital that changes in family roles and responsibilities be discussed openly in order to prevent repressed anger and resentment, since hostile family attitudes may cause a patient's symptoms to flare.
The difficulty seems to be in finding the best response at a particular time: empathy when the symptoms appear to be worse; support during times of fear and crisis; and allowing patient control in periods when they are feeling better. Thus, a good system of communication within your family is essential.
Finally, family members are not immune to depression. It is frustrating to watch people who are sick and in pain, and yet to have little control over their illness. This can anger family members, who typically are unwilling to vent their frustrations onto you for fear of inducing more stress and causing an exacerbation of your condition. Instead, the family member's anger turns inward, creating depression.

Maintaining Healthy Relationships
with your spouse, partner, children, family, friends, and others.

20 experts in the field answer questions posed by fibromyalgia patients in this specially crafted, 20-page Special Issue:
  • Explaining your limits to others
  • Handling demands on your time
  • Helping children understand your illness
  • Enjoying intimacy in spite of your pain and fatigue
  • Saying "No" without regrets
  • Handling unwanted advice
  • Controlling angry outbursts
Don't let chronic illness interfere with your ties to family and friends. Get our Special Issue on Relationships.

Saturday, November 13, 2010

Life in the Fibro Lane: Preparing for the Holidays Year-Around

Life in the Fibro Lane: Preparing for the Holidays Year-Around

by Fibromyalgia Network on Friday, November 5, 2010 at 11:01am
Specially made gifts (even if it is just the card that is attached to the gift) often provoke kind or loving feelings. It signals that a person went out of their way to make something just for you. Even if the gift didn't cost much, it's always the thought that counts.

Before you know it, November is here and are you prepared? Many patients suggested a great way to get ready for the holidays: make a list of the people who you wish to give presents to and then as a year-around hobby, start making them gifts.

"Bargains from flea markets and garage sales are what I dress up to make presents. Sales items help my pocketbook; already worn thin from the cost of medications. A touch of lace, a bit of ribbon, some fancy buttons and ideas from women's magazines can create unique 'made myself' gifts."

Use the arts, crafts and hobbies that you have learned to make gift-giving special. Then when the season rolls around, you will be able to enjoy it instead of wearing yourself out at the shopping malls.

To share your hobbies, pastimes, or funny stories with the Facebook world, e-mail them to Become apart of our "Life in the Fibro Lane" series!

To remain unbiased, we do not accept endorsements, advertisements, or money from the pharmaceutical industry. Articles are for informational purposes only. Consult your physician for treatment.

Fibromyalgia Network ... Helping Patients Since 1988

PO Box 31750 | Tucson, AZ 85751-1750 | (800) 853-2929 |© 2010 Fibromyalgia Network

Reduce Feelings of Resentment in Your Relationship

Reduce Feelings of Resentment in Your Relationship

by Fibromyalgia Network on Friday, October 8, 2010 at 3:00pm

Having fibromyalgia or chronic fatigue syndrome (CFS) in a partnership or marriage can dramatically change a relationship. Simple things that were once taken for granted—mobility, housework, finances, social activities, and even plans for the future have been sidetracked.

As household duties back up and the spouse suffering from FM/CFS tries to take care of herself, the partner often feels overwhelmed or overloaded while trying to manage a larger chunk of daily responsibilities. Both parties tend to hide their emotions. The partner who is taking on more duties can begin to feel frustrated, disappointed, sad, or lonely. These feelings can lead to anger or resentment.

Here are some strategies to improve communications and handle feelings of resentment with your partner:

Initiate Friendly Discussion

If the partner who is ill makes a loving effort to initiate discussion that will bring up the spouse’s feelings, the relationship can take a more constructive and supportive course, says Thomas Fuller, Ph.D., a psychologist in Grand Rapids, MI.

“This isn’t an easy topic with an easy fix,” Fuller says. “I think the real key is for couples to talk about issues openly and without penalty so things don’t get all bottled up.” Also, you have to consider that while you are dealing with pain, your spouse is experiencing some losses that are different from yours. Step back and note how your spouse’s life has changed, too.

“Don’t be defensive about your illness or the situation, and accept that your spouse’s efforts, feelings, and struggles are normal. Validate his experience. Verbally appreciate what your spouse is doing to accommodate the situation.” Let him know you recognize how much more effort he is putting forth.

Here’s how easy it could be said:
“I know that you are disappointed right now. I know that you love me and are trying not to blame me for being ill. I am so lucky to have a spouse who takes care of things like you do. I am so lucky to have you.”

Only You Know How it Feels

“Open and honest communication is the best protection against the inevitable hurt and anger that can damage a relationship, “ says Connie O’Reilly, Ph.D., a psychologist in Beaverton, OR. Only you know what it feels like to be in your body on any given day. Only you can decide how much you can do. But it is important that you make a good faith effort to contribute to the household chores, even in small ways. And at the end of a day when your spouse walks in the door and you both realize you’ve not been able to do all each of you had hoped, remember that you are not responsible for anyone’s feeling but your own. Acknowledge the situation, accept that it’s okay, and remain optimistic.

For example:
“I realize I did not accomplish many of the tasks I had hoped today. I can understand that you may be disappointed and frustrated. So am I. I plan to go to bed early tonight and try again tomorrow.”

You may even suggest to trade some duties with the kids or look at hiring an outside service to help with some chores. Consider options and alternatives. While couples work out the basics of household management, cooking, cleaning, finances, and children, the social aspects of a relationship also can suffer.

Create a Social Life

Supportive social contact is a huge buffer against chronic illness, says O’Reilly says. But couples may have to rethink and recreate a social life based on new realities.

“Develop new mutual interests,” she suggests. “The kind of socializing may be different than it was before the illness.” It’s important to continue to make plans, but be sure to make contingency plans for those inevitable disruptions because of pain or fatigue. Be prepared to be flexible with a time or date, or take a rain check.

“You need to try to let go of this idea that you can or should try to prevent someone else from being upset or disappointed,” O’Reilly says. And it’s also important to let your partner do what he needs to do to achieve his social needs.

“Your job is to engage in good self-care so that you don’t feel jealous or resentful when your partner does choose to go out without you. Your partner’s job is to decide what he needs to do to make certain he takes care of himself,” she says.

“Needs for the couple to socialize together shouldn’t be relegated to the trash heap,” says Don Uslan, M.A., M.B.A., L.M.H.C., a therapist in Seattle, WA. “Couples who are not use to individual socializing may have a very difficult time with this concept. But there aren’t a lot of choices. Either the well spouse learns to do some things alone or with his own group of friends so he can meet some social needs and lessen any possible resentment, or the couple will have to learn to enjoy and accept a less active and intense form of socializing together.

There are challenges in living with a chronic illness that “good will and good intentions cannot solve on their own,” says Uslan. Here our experts agree that couples therapy or professional counseling may be the next best backup.

Barbara Suter, Ph.D., a therapist in New York City, says, in addition, an outside support group could act as psychological support for the well spouse to let-off steam or even be a social outlet. And “if time is too limited, perhaps an online group could be an option.”

“A couple may be fortunate enough to go for many years before a major challenge strikes. Or it may be early in the relationship,” Uslan says. ”If you didn’t come down with FM/CFS, it might have been something else, cardiac problems or severe back pain. The end result is the same. Either both parties are in it for the long haul, or one partner will try to find some way out, usually by blaming the person with the illness for some failure of not living up to the relationship contract. So, if it’s clear that both parties are in it for the long haul, they just need tools and techniques to figure out how to cope.”

The Fibromyalgia Network offers a 20-page collection of helpful advice. Find out how to help others relate to your condition, improve communication, and keep a positive attitude by clicking on the picture below.

To remain unbiased, we do not accept endorsements, advertisements, or money from the pharmaceutical industry. Articles are for informational purposes only. Consult your physician for treatment.

Fibromyalgia Network ... Helping Patients Since 1988

PO Box 31750 | Tucson, AZ 85751-1750 | (800) 853-2929 |
© 2010 Fibromyalgia Network

How to Meditate - Guided Meditation Techniques - Buddhist Meditations

How to Meditate - Guided Meditation Techniques - Buddhist Meditations


Why Learn to Meditate

Eventually, we will be able to stay happy all the time, even in the most difficult circumstances.
The purpose of meditation is to make our mind calm and peaceful. If our mind is peaceful, we will be free from worries and mental discomfort, and so we will experience true happiness; but if our mind is not peaceful, we will find it very difficult to be happy, even if we are living in the very best conditions. If we train in meditation, our mind will gradually become more and more peaceful, and we will experience a purer and purer form of happiness. Eventually, we will be able to stay happy all the time, even in the most difficult circumstances.
Usually we find it difficult to control our mind. It seems as if our mind is like a balloon in the wind – blown here and there by external circumstances. If things go well, our mind is happy, but if they go badly, it immediately becomes unhappy. For example, if we get what we want, such as a new possession or a new partner, we become excited and cling to them tightly. However, since we cannot have everything we want, and since we will inevitably be separated from the friends and possessions we currently enjoy, this mental stickiness, or attachment, serves only to cause us pain. On the other hand, if we do not get what we want, or if we lose something that we like, we become despondent or irritated. For example, if we are forced to work with a colleague whom we dislike, we will probably become irritated and feel aggrieved, with the result that we will be unable to work with him or her efficiently and our time at work will become stressful and unrewarding.
By training in meditation, we create an inner space and clarity that enables us to control our mind
Such fluctuations of mood arise because we are too closely involved in the external situation. We are like a child making a sandcastle who is excited when it is first made, but who becomes upset when it is destroyed by the incoming tide. By training in meditation, we create an inner space and clarity that enables us to control our mind regardless of the external circumstances. Gradually we develop mental equilibrium, a balanced mind that is happy all the time, rather than an unbalanced mind that oscillates between the extremes of excitement and despondency.
If we train in meditation systematically, eventually we will be able to eradicate from our mind the delusions that are the causes of all our problems and suffering. In this way, we will come to experience a permanent inner peace, known as “liberation” or “nirvana”. Then, day and night in life after life, we will experience only peace and happiness.

Wednesday, November 10, 2010

Fibromyalgia and Vitamin D Deficiency Link

Chronic Pain and Vitamin D Deficiency Linked Long Ago

by Laura Owens

Multiple studies link vitamin D deficiency to chronic aches and pains, muscle fatigue or weakness, and other disorders including immunity and some cancers (Holick 2003b; ODS 2008; Plotnikoff and Quigley 2003; Reginster 2005; Tavera-Mendoza and White 2007; Vieth 1999).
A study presented at the American Society of Anesthesiologists 2007 Annual Meeting reported that about one in four patients with chronic pain also have inadequate blood levels of vitamin D. Patients with insufficient vitamin D also needed higher doses of morphine for longer periods of time.

According to study author W. Michael Hooten, MD, medical director and anesthesiologist at the Mayo Comprehensive Pain Rehabilitation Center in Rochester, Minn., researchers have long known that inadequate levels of vitamin D can cause pain and muscle weakness.
“The implications are that in chronic pain patients, vitamin D inadequacy is not the principal cause of pain and muscle weakness,” said Hooten for a press release, “However, it could be a contributing but unrecognized factor.”
The jury is still out on the exact connection between vitamin D and chronic pain but scientists believe it may begin with lower levels of circulating calcium (hypocalcemia) due to inadequate vitamin D. A cascade of biochemical reactions then occurs that hinders bone metabolism and health. Low levels of calcium elevates parathyroid hormones which impairs proper bone mineralization causing a spongy matrix to form under periosteal membranes covering the skeleton.
This gelatin-like matrix can absorb fluid, expand, and cause outward pressure on periosteal tissues, which generates pain since these tissues are highly innervated with sensory pain fibers (Holick 2003b; Shinchuk and Holick 2007; Yew and DeMieri 2002).

Fibromyalgia and Vitamin D Deficiency

The association between low levels of 25-hydroxyvitamin D and non-specific musculoskeletal pain, including fibromyalgia syndrome remains controversial.
In one study, Israeli researchers found no association between women with fibromyalgia and low levels of vitamin D (Tandeter et al. 2009). Yet researches in an earlier study in the Middle East found a significantly greater prevalence of low D concentration in women with fibromyalgia compared to women without fibromyalgia (43% vs 19%).
Yet researchers in the Middle East found that 90% of patients diagnosed with fibromyalgia and/or non-specific musculoskeletal pain treated with vitamin D improved.(Badsha et al. 2009).
One reason for the conflicting evidence is researchers have yet to adequately measure patients' response to different formulations, doses, and durations of vitamin D. In addition, scientists believe vitamin D receptors have different genetic make up and activity so individuals may respond differently to vitamin D therapy. (Kawaguchi et al. 2002; Videman et al. 2001).

Vitamin D Dose For Pain Relief

Dr. Cannell, Executive Director of The Vitamin D Council recommends supplementing with Cholecalciferol (vitamin D3). D3 is the naturally occurring form of vitamin D and is made in large quantities in skin when sunlight strikes it. Dr. Cannell explains that Calcidiol is the only blood test that should be drawn. Doctors can order calcidiol levels although labs will know calcidiol as 25-hydroxyvitamin D.
Take enough vitamin D3 to get 25(OH)D levels above substrate starvation levels, 50 ng/mL or 125 nmol/L. Current recommendations for adults and children are inadequate to maintain optimal health and certainly to treat chronic pain conditions and illness.
Dr. Cannell suggests people supplement with vitamin D before getting their blood tested, then adjust their dose so their 25(OH)D level is between 50–80 ng/ml during both the summer and the winter. These are conservative dosages explains Dr. Cannell. People who avoid the sun, and nearly all dark-skinned people need to increase their dose if their blood levels are still low, even after two months of the above dosage, particularly during the winter months.
Exact levels are difficult to determine because requirements vary by age, body weight, percent of body fat, latitude, skin coloration, season of the year, use of sun block, individual variation in sun exposure, and how sick someone is.
“If you use suntan parlors once a week,” says Dr. Cannell, “or if you live in Florida and sunbathe once a week, year-round, do nothing.” However, if you receive very little UVB exposure the Council recommends the following dosing levels of D3 (maintenance level):
  • healthy children under the age of two - 1,000 IU per day*
  • healthy children over the age of two - 2,000 IU per day*
  • adults and adolescents - 5,000 IU per day.
*The American Academy of Pediatrics recommends 400 mg per day for children.
While the exact relationship between vitamin D and chronic pain syndromes like fibromyalgia isn't fully understood, most researchers agree that vitamin D deficiency contributes to muscuskeletal pain. Patients and practitioners should consider including vitamin D supplementation in their therapy for patients suffering with chronic pain syndromes.
Further Reading:
"Vitamin D Inadequacy May Exacerbate Pain," American Academy of Anesthesiologists, Press Release, October 15, 2007.
Tandeter H, Grynbaum M, Zuili I, Shany S, Shvartzman P., "Serum 25-OH vitamin D levels in patients with fibromyalgia." Israeli Medical Association Journal, 2009.
Badsha H, Daher M, Ooi Kong K. Myalgias or non-specific muscle pain in Arab or Indo-Pakistani patients may indicate vitamin D deficiency. Clinical Rheumatology. 2009.
Leavitt, Steward, B. MA, PhD., "Vitamin D: A Neglected ‘Analgesic’ for Chronic Musculoskeletal Pain: An Evidence Based Review and Clinical Practice Guideline," June 2008,
"Vitamin D for Pain: Update of Research Evidence," Pain Treatment Topics, Accessed: January 10, 2010.
Arvold DS, et al., "Correlation of symptoms with vitamin D deficiency and symptom response to cholecalciferol treatment: a randomized controlled trial," Endocrine Practice, 2009 May-Jun.
Armstrong DJ, Meenagh GK, Bickle I, Lee AS, Curran ES, Finch MB., "Vitamin D deficiency is associated with anxiety and depression in fibromyalgia," Clinical Rheumatology. 2006 Jul 19.

Fibromyalgia Syndrome

Fibromyalgia Syndrome

An Informational Guide for FM Patients,
Their Families, Friends and Employers

Fibromyalgia syndrome (FM) is a complex, chronic condition of widespread muscular pain and fatigue. Research shows that about 2 percent of all adults in the US have fibromyalgia (3.5 percent of women, 0.5 percent of men). In total numbers, that means that more than 6 million, and possibly as many as 11 million Americans meet the criteria for fibromyalgia. It affects women more than men in an approximate ratio of 9:1. It is seen in all age groups from young children through old age, although for most patients the problem begins between their 20s and 50s. Studies have shown that FMS occurs worldwide and has no specific ethnic predisposition.

Symptoms and Diagnosis

Patients with FM report widespread musculoskeletal pain (100 percent), fatigue (96 to 100 percent) and disturbed sleep (86 to 98 percent). In 1990, the American College of Rheumatology accepted a research diagnosis of fibromyalgia that includes chronic, widespread pain and tenderness in 11 of 18 specific points on the body. Fatigue, sleep disturbances, restless legs and leg cramps, impaired memory and concentration, nervousness, depression, disorientation, headaches, irritable bowel and bladder, premenstrual syndrome, and cold intolerance are some of the symptoms associated with fibromyalgia. Other conditions which may overlap with fibromyalgia include: chronic fatigue syndrome, depression, Lupus erythematosus, rheumatoid arthritis, Lyme disease, and neurological conditions such as cervical myelopathy, small posterior fossa and Chiari I Malformation. These conditions are termed co-morbidities and may also have been the trigger for fibromyalgia. Fibromyalgia is not life threatening, but there are a number of other conditions that are associated which can be life threatening.
There is no definitive blood test or x-ray to determine the diagnosis of fibromyalgia. This initially led doctors to believe that fibromyalgia is “all in the patients’ head.” Extensive studies now show that fibromyalgia has a physiologic basis most likely mediated by the central nervous system. Tender points are sensitive to touch and pressure. Fibromyalgia patients report allodynia (a condition when normally non-painful stimuli is painful) and hyperalgesia (extreme sensitivity to painful stimuli). Functional MRI testing shows that fibromyalgia patients’ brains do in fact respond differently to painful stimuli. Musculoskeletal pain and fatigue is a chronic problem and can wax and wan in the patient. There is no generally accepted cure for fibromyalgia and most patients can expect to have this problem lifelong. Treatment can reduce the severity of symptoms and help patients to lead a more normal life.


Each person with fibromyalgia has come to the diagnosis through a different path and has a different set of symptoms. The best treatment program for each patient will include many components. For that reason, a multidisciplinary approach has been shown to be the most effective. There are also many things a person with fibromyalgia can do to improve the quality of their lives. Becoming educated about fibromyalgia is a first step. Education by both the physician and patient will decrease the frustration felt by both parties and help improve the odds of successful treatment.

It is important for the physician to determine if the patient has problems with sleep. Some of these disturbances include sleep apnea, restless legs syndrome, periodic limb movements and teeth grinding, among other disorders that affect specific stages of sleep. Physicians may request a full sleep study to determine if a patient has a specific sleep problem, and to help determine the best medication for the patient’s condition. Patients need to be sure they are doing everything they can to improve their sleep. Learning about good sleep hygiene, and the actions they can take to improve their sleep, is one of the most important ways a patient can take control of their chronic illness.

People with fibromyalgia frequently become deconditioned and lose muscle tone because even normal activities seem painful. Increasing appropriate daily activities can be beneficial for the person with fibromyalgia. Research has shown that eccentric exercises (using muscles that are both contracted and lengthening like in vacuuming) are especially hard on people with FM. However, most activities can be modified. Patients can take smaller steps when walking down hill and walk forward with the vacuum cleaner instead of pushing it out and in all with arm movements. One way to think about how to modify activities is for the person with FM to imagine they have a hoop skirt around their neck. All their arm motions should stay within the confines of the imaginary skirt. As the person with FM increases daily activities, efforts should be made to add a regular exercise and stretching routine. Regular walking, the use of a stationary bicycle, and swimming or other low impact type of activity can be beneficial to FM patients. Supervision by a physical therapist or an exercise physiologist can be of benefit. The researchers at the Oregon Health and Science University have made wonderful materials on exercise available at the Fibromyalgia Information Foundation website, It is okay to start slow—even one or two minutes a couple of times a day can begin to improve the conditioning of a person with FM.

Over the counter drugs like Advil and Tylenol are not particularly effective in fibromyalgia. Their greatest help may come in decreasing the pain of co-morbid conditions like arthritis. In June 2007, Lyrica (pregabalin) was the first medication to receive a listing for fibromyalgia from the FDA. Other medications may be listed by the FDA in the coming months. However, no medication works for all patients or for all symptoms. Caring physicians will use Lyrica and other medications that have been researched in fibromyalgia to improve livability for people with fibromyalgia. Tricyclic antidepressants such as Desyrel, Elavil, Flexeril, Pamelor, and Sinequan can help with both pain and sleep because depression and pain share similar pathways in the brain. Generally, in people with fibromyalgia these medications are prescribed at levels below where they are indicated for depression. Medications that affect the neurotransmitters serotonin, norepinephrine and dopamine are Paxil, Prozac, Zoloft, Effexor, Mirapex, and Cymbalta are frequently effective. Some patients find relief of fibromyalgia symptoms and co-morbidities with anti-anxiety medications such as Xanax and Klonopin or muscle relaxant medications such as Norflex, Flexeril and Zanaflex. Anti-convulsant medications such as Neurontin and Topomax also provide relief for many patients. Narcotic painkillers are used effectively by many physicians for the pain of fibromyalgia. However, other physicians have avoided narcotics for fear of addiction. Recent research shows that addiction seldom occurs when these medications are used in chronic pain states. It is important to understand the difference between addiction and dependence.

There is no single medication that will relieve all of the symptoms associated with fibromyalgia. Physicians must work closely with their patients to find the right combination of medications that most improve the patient’s symptoms while minimizing the negative side effects that come with each medication.

 Myofascial Trigger Points
Research studies indicate that up to 68% of persons with fibromyalgia also have myofasical trigger points. It is unclear if these are co-morbid conditions or triggers to the pain of fibromyalgia. Trigger points are different from tender points in that they are taut muscle bands that feel like a knot or lump underneath the skin. There is pain when they are pressed on that can radiate to other areas of the body. Tender points are sensitive to pressure and are part of a diffuse body wide condition. Treating the trigger points can help to reduce fibromyalgia pain. Treatment may include injecting the trigger point with Procaine and then stretching the affected area in a technique called spray and stretch. The injection can be quite painful and there is typically a two to four day period before the effects are noticed. Dry needling has also been effective when utilizing an acupuncture needle and inserting it into the trigger point which allows the muscle to relax and lengthen. Other techniques that may be helpful are heat, massage, and gentle stretching.

About 20 percent of people with fibromyalgia have a co-existing depression or anxiety state which needs to be appropriately treated with therapeutic doses of anti-depressants or anti-anxiety medications, often in conjunction with the help of a clinical psychologist or psychiatrist. Patients who have a concomitant psychiatric problem have a double burden to bear. They will find it easier to cope with their fibromyalgia symptoms if their psychiatric condition is appropriately treated. It is important to understand FM itself is not a psychogenic pain problem and that treatment of any underlying psychological problem will not cure the fibromyalgia.

 Balancing Daily Activities
Most FM patients quickly learn there are certain things they do on a daily basis that seem to make their pain worse. These actions usually involve the repetitive use of muscles or prolonged tensing of a muscle, such as the muscles of the upper back while looking at a computer screen. Careful detective work is required by the patient to note these associations and where possible to modify or eliminate them. Pacing of activities is important; we recommend patients use a stopwatch that beeps every 20 minutes. Whatever they are doing at that time should be stopped and a minute taken to do something else—possibly stretching. Patients who are involved in fairly vigorous manual occupations often need to have their work environment modified and may need to be retrained in a completely different job. Certain people are so severely affected that consideration must be given to some form of monetary disability assistance. This decision requires careful consideration, as disability can cause adverse financial consequences as well as loss of self-esteem. In general, doctors are reluctant to declare FM patients disabled and most FM applicants are automatically turned down by the Social Security Administration. Each patient needs to be evaluated on an individual basis before any recommendation for or against disability is made.

 Complementary and Alternative Therapies
There are many therapies that fall in this general category that may prove to be effective for people with fibromyalgia. Postural training, occupational therapy and relaxation therapy can help in improving body mechanics and decreasing pain instigators. Acupuncture, hypnosis and cognitive/behavioral therapy have been studied in chronic pain states such as fibromyalgia. Research is still limited, but it appears promising and these treatments may be helpful when included in a comprehensive pain management program. Nutritional therapy such as vitamin and mineral supplements can help with stress and supporting the immune system. While there is no specific fibromyalgia diet, people who suffer with fibromyalgia should work to improve the nutritional quality of the foods they eat and work with their physicians to ensure they are not suffering from conditions such as celiac disease or other treatable conditions that impact the digestive system.

101 Ideas to Empower Persons In Pain to Survive & Thrive!

As you all know, just getting through any day with persistent pain is a challenge.

These are easy-to-do, empowering tools and resources to help you better manage your pain, improve your care and, ultimately, enhance your quality of life.

Remember to have fun—and seize the day!



1. Seek out things that make you laugh—remember, laughter is the best medicine!

2. Slow down—and breath deeply…

3. Use aromatherapy—relax to your favorite scents.

4. Meditate, with a group or by yourself.

5. Listen or make music (i.e., play a CD, sing or play an instrument.)

6. Get a massage by a professional masseuse – or someone you love…

7. Take a long bubble bath and light some candles.

8. Buy a bouquet of flowers to cheer up your surroundings!

9. Grow something—commune with Mother Nature!

10. Stir your imagination—imagine a pleasant experience, moment, sensation…

11. Make or craft something (i.e., knit a scarf, do pottery, build something, do woodworking, etc.)

12. Go to an outdoor concert, and don’t forget to pack a picnic.

13. Treat yourself to a manicure and/or pedicure. Be a Queen for a day!

14. Explore an antique store—lose yourself among the treasures…

Cognitive/Mental Strategies

15. Practice mindfulness—be in the moment…

16. Try art therapy (i.e., paint or draw a picture that shows how you feel!)

17. Use narrative therapy (i.e., write your pain experience.)

18. Keep a gratitude/affirmation log (write down three things you’re grateful for each day.)

19. When depression and/or anxiety hits, don’t fight it. Know it’s a part of the natural pain experience. But don’t hold on for too long…

20. Accept that everything you’re feeling is real and normal.

21. Take a class, learn something new—and stimulate your mind!

22. Wear a bright color—they excite the senses!

23. Reflect upon affirming, positive memories…

24. Read a great book—or a breezy romance novel.

25. Express your true and authentic self. You’re the only you!

26. Think positive, affirming things about yourself.

27. Take a trip, even if it’s a virtual one.

28. Seek support through a professional pain counselor.

29. Make a change and surprise yourself (i.e., get a new haircut, try a new recipe, etc.)

30. Get dressed up and put your make-up on, just because it makes you feel good!

31. Keep a positive attitude, hang in there and keep the faith!

32. Practice appreciation for your healthcare providers—more often than not, they’re trying their best to help…

33. On a bad day, remember what Scarlet O’Hara said, “Tomorrow is another day!”

34. Notice and appreciate the splendor season changes…

35. Learn a foreign language…or two! Exercise that part of the brain that doesn’t read pain signals.

36. Choose something you love, and do it every week, same day and time. A joyful routine gives you something sweet to look forward to…

37. Don’t let your pain define you. Remember that while pain is now a part of your life experience, it’s not your identity.

Care of the Body

38. Exercise regularly and keep your body moving. Hydrotherapy in warm water is especially effective with pain conditions.

39. Eat a healthy diet (fruits, vegetables, lean meats, etc.)

40. Avoid or quit smoking!

41. Practice good sleep habits—enjoy waking up refreshed and renewed.

42. Be open to alternative and complimentary therapies (i.e., acupuncture, guided imagery, etc.)

43. Have realistic expectations about therapies (i.e., have you given your physical therapy regimen enough time to help?)

44. Educate yourself about your pain condition. But don’t obsess and let it consume you…

45. Listen to your body talk—you know it better than anyone else!

46. Learn to say “no”—avoid stress by not over-burdening/committing yourself.

47. Spend time in the sun—and don’t forget that all-important sun block!

48. Practice good posture. A well-aligned and supported spine is virtually guaranteed to help any pain condition.


49. Do something nice for someone—it feels good, and that energy is sure to come back your way.

50. Learn to forgive those who have disappointed you throughout your pain experience; anger is further fuel for pain!

51. Adopt a pet. Unconditional love is good for the soul…

52. Give someone a hug—who knows, you might just get two back!

53. Volunteer for your favorite charity, school or organization. Doing good is chicken soup for the soul!

54. Throw yourself a party. Celebrate an accomplishment with family and friends!

55. Get involved in your community (i.e., attend neighborhood council meetings, help plan a block party, etc.)

56. Seek out fellow chronic pain sufferers through on-line discussion boards and support groups at medical centers. These bonds could last a lifetime.

57. Don’t forget about lovemaking with your partner. Intimacy is second to none to revive the soul and senses!

58. Spend quality time with a child or children (yours, nieces or nephews, etc.)—they’ll help you see the world with eyes of wonder!

59. Have an afternoon tea with some girlfriends.

60. Accept an invitation to a party or other social event, even if you’re in pain. It’s great misdirection—and you’ll probably find yourself having a dandy time!

61. Be open to talking to family and friends about your pain experience—and answering their naturally inquisitive questions. If they’re curious, they probably care. Try not to shut them out…

62. Remove toxic people from your life—as stress and strain that comes from bad relationships makes pain worse. It’s appropriate to walk away from inappropriate people!


63. Remember it’s your body—and ultimately all possible treatment options are your choice.

64. Be prepared for your doctor visits (i.e., have questions ready, be educated about your pain condition(s), etc.)

65. Partner with your doctor. You’ll get better pain care results if you work as a team.
Find a good advocate at your health insurance company.

66. Bring a family member or friend with you when you go to a doctor’s appointment. They can advocate for you—and it’s good for your doctor to know someone cares and is watching out for you.

67. Examine and weigh your therapy options—the biggest “guns” may not be the answer for you.

68. Don’t let your doctor pressure you into a therapy that you don’t want to do!

69. Interview your pain management provider (i.e., What kind of therapies do you support for my condition?, Are you open to alternative/complimentary therapies?, etc.)

70. Remember, one size doesn’t fit all when it comes to pain treatments. We’re all unique—and what helps one person may not help another.

71. Seek out references with any doctor referral (i.e., talk to other patients, look up his/her standing with the state medical board, etc.)

72. Make sure your treating healthcare professional is assessing your pain level during each visit—remember, pain assessment is “the fifth vital sign.”

73. Find out if your hospital and/or clinic has a “Patient’s Bill of Rights”—and if so, make sure your treating healthcare professionals are following it.

74. Learn about the potential side effects of any and all medications you are considering or presently taking. Sometimes their adverse side effects can create more harm than the problem you’re taking the medication(s) for.

75. Run—don’t walk!—from any physician or other healthcare professional who doubts, dismisses and/or discounts your report of pain!

76. Encourage your family and friends to educate themselves about your pain condition(s) (i.e., provide them with website resources, articles, etc.)

77. Educate yourself about all of your therapy/treatment options (including complimentary and alternative choices)—this will enable you to make the best, most informed decisions about your pain management care.

Clinical Advice

78. Using a rating scale such as 0 to10 (0 = no pain, 10 = worst pain) is a useful way to communicate your pain to others and assess changes in your own pain.

79. Use the rating scale to rate how much relief you are receiving. For example, if your pain therapy relieves your pain from a “10” to a “7”, this is a good step. But knowing your pain is a “7” should suggest that you still require additional help.

80. Prevention of pain is key. Anticipate things that bring your pain on (exhaustion, dehydration, stress, etc.) and make every attempt to prevent pain versus responding only when it happens.

81. When taking pain medication, always consider what non-drug treatment you could use along with it. Using heat/cold/massage/relaxation can diminish anxiety and distract you from the pain until the medication can begin working.

82. Discover accurate and effective words to describe your pain (i.e., burning, stabbing, aching, pins and needles, electrical, throbbing, etc.) to help your healthcare provider with diagnosis and treatment.

83. For chronic pain problems, it is generally better to take medications on a regular, around-the-clock schedule rather than only on a “prn”/as needed basis only when pain is severe.

84. Fortunately, there are many choices of analgesics (be it traditional, complementary or alternative)—so if a particular pain therapy that has been prescribed doesn’t work or causes side-effects, ask to try another.

85. In general for chronic pain, long-lasting medications are preferred to offer several hours of undisturbed sleep or activity.

86. If your doctor prescribes physical therapy, be sure to find a therapist you have a repore with. Explain your symptoms carefully, and go over your doctor’s report together. Also be sure to immediately alert your therapist to any pain you’re experiencing as a result of a therapy exercise.

87. “Breakthrough pain” is pain that occurs in episodes between doses of medications. Discuss this with your physician to determine if breakthrough medications are needed.

88. Inactivity or decreased function is a major problem in chronic pain and results in muscle weakness, dependence, depression—and this cycle only worsens over time. Try to maintain activity if at all possible.

89. Depression and anxiety are generally an integral part of the pain experience—and can become severe. Don’t hesitate to tell your pain management provider about these feelings and indeed ask for a referral for a support group and/or psychologist. Your doctor should know psychologists who specialize in pain.

Web-based Resources

90. Check out The Intractable Pain Patient’s Handbook for Survival by Dr. Forrest Tennent. Download a copy here:

91. Here’s a wonderful resource to help the people who care about you. Surviving a Loved One’s Chronic Pain by David Kannerstein, PhD and Sarah M. Whitman, MD. Download a copy [

92. Here’s a great, up-to-date resource about pain medications! American Chronic Pain Association’s 2007 Medication & Chronic Pain Supplement. Download a copy

93. Get educated and informed about your pain condition(s)! Pain Information Library sponsored by the American Pain Foundation.

94. Go to the American Chronic Pain Association’s website and read their “Ten Steps from Patient to Person”

95. Review For Grace’s “Women In Pain Bill of Rights” to get a better understanding of what you should expect in your patient/doctor relationship.

96. Go the National Pain Foundation’s “My Journey” section and find links to patient support groups throughout the US:

97. Go to’s website and find an excellent section on pain patient resources, tools and information:

98. Download a notebook from the American Pain Foundation to journal your pain experience:

99. Visit and see their full array of consumer support tools and forms:

100.Become a member of American Pain Foundation’s thriving on-line PainAid community. Take the first step

101.Power Over Pain is a grassroots movement that encourages those in pain to become advocates in their own communities. Join the charge to put pain on the map as a major health issue: