Mysterious fibromyalgia and you

Fibromyalgia is a painful and confusing condition that many doctors don't understand. A diagnosis can bring relief: now you can begin an effective treatment program and get on the road to recovery fast.

Fibromyalgia, which means "pain in the muscles," is more a condition defined by symptoms than a specific ailment. Nobody is sure what causes it, although the widespread soreness, headaches, poor sleep and myriad other symptoms are very real, disrupting the lives of thousands of Canadians — estimates range from 600,000 to more than 1.2 million.

• Although you may feel extremely uncomfortable, there is no evidence of an actual disease occurring in your body. Nor are there any lab tests to identify it. Some experts believe fibromyalgia may originate in the brain, possibly due to low levels of a nervous system chemical called serotonin. Females have especially low levels of serotonin, which may explain why nine out of 10 fibromyalgia cases occur in this sex.
• Women are also most often victims of other disorders that may be due to low serotonin levels, such as migraines, irritable bowel syndrome, depression, anxiety and panic attacks. Serotonin seems to have been installed in humans as a buffer against the "fight or flight" response. Without enough serotonin, your body becomes more susceptible to stressful events. When you're constantly stressed, your muscles contract, setting off a destructive chain of events.
• Serotonin is also important for assuring deep, restorative sleep, and disruptive sleep patterns have been blamed for bringing on fibromyalgia or making it worse. Because your muscle pain makes it hard to get a good night’s rest, you get tired. Lack of sleep causes even more stress. Understandably, you may also become anxious, forgetful and depressed, which further contributes to the downward spiral of out-of-control stress that may ultimately lead to fibromyalgia. Other possible causes include injuries, infections or hormonal disturbances, although these, too, remain uncertain.

• Pain medication: Pain-relieving medications to reduce muscle aches and soreness.
• Sleep aids: to restore healthy sleeping patterns.
• Antidepressant medications: to boost serotonin levels in the brain.
• Stress-relieving measures: such as relaxation and cognitive-behavioural therapies.
• Exercise: Low-impact and stretching exercises at first, with aerobics and strengthening added gradually.

• Choose a doctor who has experience treating fibromyalgia: Don't choose a doctor and not someone who thinks it’s "all in your head." A good choice may be a rheumatologist (a physician who specializes in diseases of the joints and muscles), a physiatrist (a doctor who is expert in physical medicine and rehabilitation) or a specialist in pain management. It may also be a good idea to see a physical or occupational therapist.
• Use memory aids: If you suffer from the bouts of forgetfulness and poor concentration commonly called "fibro fog," try some basic memory rechargers. Repeat things to yourself, write items down and make plenty of lists. Break up complex tasks into smaller steps, and keep distractions like loud music to a minimum.
• Keep a diary of your pain and energy levels: to record your best times of day. Use those periods to do important things, like writing letters or paying bills. Many people with fibromyalgia say they function best early in the day.
• Try heat: A heating pad, electric blanket or warm bath may bring relief.

• FM-CFS Canada Compassion in Action, a patient advocacy group, provides a wealth of information for those with fibromyalgia and chronic fatigue syndrome (1-­­877-437-4673 or http://fm-cfs.ca).
• Fibrohugs maintains a comprehensive website of fibromyalgia support groups across Canada. Log on to http://fibrohugs.com.