What can you do to control symptoms and flares.
What can you do to improve symptoms and flares
Fibromyalgia is the same as any other chronic medical or neurological condition, in that there are things that you need to do to control the severity of your symptoms. Think of diabetes for example (a common chronic medical condition) medicines and insulin will help but you would also need to watch what you eat and exercise regularly to maintain a stable blood glucose level.
There are some simple lifestyle changes you can make which will help your symptoms, unfortunately like any lifestyle change, it is not a quick fix and won't work immediately. Your practice nurse or GP will be able to support you with them, so book an appointment and discuss what you would like to do.
First of all decide what you would like to achieve, make it simple and achievable. It may be something like loosing weight or increasing the amount of activity you do. Or it may be to reduce the number of flare ups you are having or the amount of pain. It may be to improve your sleep pattern. There are lots of things you want to do, but it's important to do only one at a time.
Planning, prioritising and pacing
You need to balance periods of activity with periods of rest. There is a well known theory called boom and bust theory. we all do this, without realising or without intention. On a good day you do everything you can because you don't know when your next good day will be. Then, the next day you are in pain and severely fatigued so you do nothing to recover and hope you have another good day soon.
First you need to become an expert planner. think about the activities you need to do. prioritize what is most important or the most likely to cause increased pain and fatigue. Then decide what will be done each day. Look at the exercise section below as this will help you work out timings for activities and tasks. Then pace yourself and try not to do all of the big things in one day.
People, advisers and health care professionals, like saying things like, listen to your body. Unfortunately, sometimes FMS doesn't tell you until the next day, which, from my own experience, is at the very least frustrating. If you feel tired or are in pain, you must rest. It's about taking care of yourself, not the task.
Even the word sounds daunting doesn't it? but don't ignore it. You don't have to go to the gym and do treadmills and gym classes. So the theory is, do less on good days and more on bad days. The idea is to become time focused instead of task focused. In other words, set a time for activity instead of just your normal full task.
To start with, work out your tolerance level.
To do this you set a tolerance level by working out your baseline [Baseline= normal amt of time it takes to do a task ÷ 2 then reduced by 10%]
For instance, on a good day I walk the dog for 40 mins, therefore I divide it by 2 which gives me 20 mins. Then reduce 20 mins by 10%. Therefore reduce again by 2 mins. So on both good and bad days I should walk the dog for 18 mins.
I should then stick at the tolerance level (18 mins) until there is no rebound symptoms (pain and fatigue) and then step up in 1 or 2 min increment trials.
It may be that you are exhausted and in pain after 10 mins of washing up or cooking for instance, so using the information, reduce it by half then again by 10%, this will give you 4 mins. That doesn't mean you have to rush and get it all done in 4 mins, it means you are allowed to leave it until later. It's about taking care of yourself, not the task.
Once you have built up a tolerance then start doing a little stretching or walking. Take it easy to start with, don't overdo it, take care of you. It may be a bit hit and miss to start with, but it will get easier with practice and time. Then when you feel ready, think about longer walks, swimming or yoga.
Just remember, some is better than none.
Relaxation / meditation
I know, it sounds a bit airy fairy and I am guilty of thinking the same thing for a very long time. Believe me its one of the best things you can do. Don't mistake coming in from work, cooking tea sorting the kids out then putting your feet up for the rest of the evening as relaxation. And don't mistake laying in bed all day in pain as relaxation either. It is not!
Quite simply, buy a CD and some ear phones or download an app and just try it. Most of the relaxation apps are free. Just try it, it may not improve your pain, but you will sleep better and you will feel better in yourself. Its worth a try.
It is well known that FMS can cause stress, anxiety and depression, it is also well observed that depression can be a causative factor for FMS. Some of the symptoms of depression are similar to FMS.
Persistently sad, anxious, or empty moods
Loss of pleasure in usual activities
Feelings of helplessness, guilt, or worthlessness
Crying, hopelessness, or persistent pessimism
Fatigue or decreased energy
Loss of memory, concentration, or decision-making capability
Change in appetite or weight
Physical symptoms that defy diagnosis and do not respond to treatment (especially pain and gastrointestinal complaints)
Thoughts of suicide or death, or suicide attempts
Poor self-image or self-esteem.
If you feel you have any of these symptoms, it is important to see your GP and ask for a referral for counselling.
It can be difficult to sleep with FMS, you may also wake several times during the night and wake up feeling tired. FMS can also prevent you from sleeping deeply enough to make you feel refreshed in the morning therefore you may need to nap during the day. This is known as ''non restorative sleep.''
It may help to
- Try relaxation before bed.
- Get up at the same time each morning.
- avoid caffeine and sugary drinks before bed.
- Avoid eating late in the evening and before bed.
- Avoid having a TV , phones and other media devices in the bedroom.
- Create a routine before bed, take a bath, have a milky drink.
- Avoid alcohol and tobacco. See your quit smoking advisor for help
By improving your sleeping habits and routines, you are more likely to improve the severity and frequency of flare ups.
There are lots more information at NHS choices, please follow the link below.