Fibromyalgia is a chronic, debilitating condition where patients experience widespread pain, fatigue, mood changes, sleep and memory problems, known as “fibro-fog”. Fibromyalgia sufferers experience a high sensitivity to pain and may also suffer from migraines and IBS (irritable bowel syndrome).
The exact cause of fibromyalgia is unknown but it is thought to be caused by abnormal signaling in the pain pathways in the brain. Recent research by Dr Ethan Russo shows that most of this abnormal signaling occurs in the endocannabinoid system and that explains why patients with fibromyalgia respond so well to cannabis-based medicines. Dr Russo also claims that migraines and IBS, which are commonly associated with fibromyalgia, may also be caused by endocannabinoid deficiency and also respond very well to cannabinoid medicines.
In many cases, the condition seems to be triggered off by a stressful life event, such as a viral infection, surgery, physical trauma or severe psychological stress. In other cases, symptoms develop slowly and get worse over time. It is commoner in women and typically develops between ages 30-50 although it can affect persons of any age. Fibromyalgia is now officially recognized as a medical condition and affects approximately 1 in 20 persons. Early diagnosis is important so that patients can be advised on how to manage their condition in the right way. There is still no cure for fibromyalgia but there is a lot that can be done to help persons suffering from this condition to lead a normal life.
The management of fibromyalgia needs to be based on a combination of lifestyle changes, each of which will help the affected person cope better with the symptoms of the condition. Self-management a priority when dealing with such chronic conditions and there is no person that can manage your condition better than yourself:
1) Diet is extremely important. It has been shown that certain foods can worsen the pain in fibromyalgia sufferers. One should try to avoid processed foods, refined sugars, artificial sweeteners, caffeine, fast food, gluten and lactose-containing products. The best diet for chronic pain is based on small frequent meals, consuming fresh, organic green, leafy vegetables, fresh fish, salmon, free-range chicken, organic fruit and gluten-free cereals and snacks. One should drink plenty of water which can be flavoured with fresh fruit but no artificial sweeteners or sugars.
2) Exercise is the most underused therapy that can help with fibromyalgia. Patients with chronic pain are often stiff and do not move much. This causes their pain to increase, resulting in more stiffness. Gentle, regular exercises can make a big difference for patients with fibromyalgia. Not all patients are capable of enduring a 30-minute walk. However, there are many other options which can help, such as yoga and hydrotherapy, or just swimming in a pool. For patients who haven’t exercised in a long time, a physiotherapist would help to get that person moving slowly and back on track. Although there may be no significant immediate improvement with exercise, patients who exercise regularly find that their pain levels are much more tolerable.
3) Stress has been shown to worsen symptoms of fibromyalgia and by controlling stress levels, one can manage this condition better. Time management is important when living with a chronic condition. One needs to pace activities and find time to rest and relax, both mentally and physically. Mindfulness meditation has been shown to help acceptance of fibromyalgia symptoms and to reduce pain levels. It also helps to reduce stress and anxiety and improve symptoms of depression and insomnia, which are often associated with this condition.
4) Correcting vitamin deficiencies may sometimes make a big difference in some patients. It has been shown that many patients with fibromyalgia have Vitamin D deficiency. It has also been found that up 80% of us may be Magnesium deficient. Omega 3 fatty acids and the Vitamin B’s are important for nerve conduction and pain signalling. Because of the link between the gut and the brain, some functional medicine specialists are now emphasizing the importance of probiotics to optimize gut bacteria and improve overall health in these patients. When choosing a probiotic, go for one with multiple strains and more than 20billion bacteria per capsule.
5) Unfortunately, most medications for fibromyalgia have significant side effects and many patients prefer not to take any medication rather than having to experience the side effects of medication as well as poorly-controlled pain. The ideal medication for fibromyalgia would be one that can adequately control the pain while producing little or no side effects. Cannabis-based medicines have been shown to be the best alternative in such cases as research shows they are the most effective for pain relief with much less side effects when compared to opiates, anti-epileptics or anti-depressants which are sometimes prescribed for this condition. The right combination and ratio of cannabinoids and terpenes can provide almost complete relief of symptoms in severely affected patients who may also be suffering from concurrent symptoms such as anxiety, insomnia and depression.
A consultation for fibromyalgia usually lasts around 1 hour. The doctor will ask you to talk about your condition, when it started, what professionals you visited and what treatments have been tried. You will be asked about your pain and how it is affecting your life. Any past medical issues, surgeries, drugs or medications that have been taken should be noted. You will be asked about sleep patterns, diet, exercise, past traumas, infections and previous mental health problems.
Once the history-taking is complete, some tests are carried out to assess the severity of the pain and how it is affecting the various activities in your life. Anxiety and depression levels are measured using a special tool and all results are recorded for future reference.
After the interview, the doctor will examine you, paying special attention to the areas of your body where the pain is more severe. He may also listen to your heart and lungs and check your blood pressure to get a better indication of how the pain is affecting you.
Following the examination, the doctor will discuss the probable diagnosis and let you know if there is any need for further tests. In some cases, the necessary tests would have already been completed. If any investigations are necessary, the doctor will guide you on how you need to go about getting them done.
Once the diagnosis is clear, treatment options are discussed by going through the consultation and point out areas in the patient’s life which need to be improved. The patient’s diet, exercise and sleep patterns are discussed. The doctor will let you know about the various forms of pain relief which are available and which are most likely to help. Once a plan is agreed upon, you are given a list of the team members which could help you with your condition. You may also opt to enroll your own personal health care professional (e.g. physiotherapist, nutritionist) and allow them to liaise with the doctor to maximize pain management. A follow-up appointment is given and the doctor’s contact details are given to you to refer to in case of any difficulties.
If you need an assessment for fibromyalgia, kindly contact us for an appointment or book online. You may be asked a few questions about your condition over the phone or by email before your visit so that the doctor will be better prepared for the consultation.