For people with chronic pain and fibromyalgia, daily life can be a struggle: but what causes it, and how can it be treated?
Fibromyalgia is a long-term condition causing pain all over the body. It hit the headlines earlier this year when Lady Gaga was forced to postpone her European tour, and literally means pain (-algia) in the fibrous tissues (fibro-) and muscles (-my-).
What does fibromyalgia feel like?
Some describe it as a widespread pain and profound fatigue, causing a diffuse aching or burning from head to toe. The pain can change in intensity and location, becoming more severe in frequently used areas. Others experience increased sensitivity to pain, fatigue and difficulty sleeping, and problems with mental processes such as memory and concentration – a symptom termed fibro-fog. Other symptoms include irritable bowel, allergies and sensitivity to weather, noise and bright light and if they are severe enough, it can be hard to hold down a job, or have a social life.
Sallyann Cox experienced the first symptoms of fibromyalgia in 1988 with a bout of sciatica:
“After that the symptoms snowballed until I was only able to function with the aid of slow release morphine patches. These allowed me to continue to do just enough to support myself and in between, I was bedridden,” she explains. “Over the 23 years, I tried every kind of treatment and therapy that gave any glimmer of hope of getting well and being able to feel normal.”
The pain took the joy out of life, Sallyann says, everything was painful. If she wanted to go out socially, she’d have to stay in bed all day beforehand.
Differing symptoms of fibromyalgia
Each person with fibromyalgia will experience different symptoms which fluctuate, and because they are similar to many other conditions it can be hard to diagnose. There are no official figures for how many people have fibromyalgia, perhaps down to the complexity of diagnosis or underreporting, but research suggests as many as one in 20 people could be affected to some degree.
I was bedridden
What causes the chronic condition?
According to the NHS, the causes of fibromyalgia are unknown, but it’s thought to be related to abnormal levels of certain chemicals in the brain and changes in how the central nervous system processes pain messages.
In many cases, it’s triggered by a physically or emotionally stressful event – injury or infection, giving birth or bereavement. It can affect anyone of any age, but is most common in those aged 30-50, with seven times as many women suffering than men.
Treatment for fibromyalgia
It’s widely believed fibromyalgia has no cure: doctors can only treat the symptoms and make the condition easier to manage. Treatments aim to reduce pain and improve sleep (because many people with fibromyalgia have been shown to be deprived of deep restorative sleep) and antidepressants are often prescribed. Other treatments include counselling, cognitive behaviour therapy (CBT), and lifestyle changes such as exercise – which can have important benefits for reducing pain and relaxation techniques to reduce tension and sooth muscles.
“I had all sorts of treatments – conventional and alternative. I visited a rheumatologist but they ruled that out and so I was given medication to cope with the pain by my GP,” says Sallyann. “I tried different painkillers but the only one that made any difference was morphine patches which allowed me to keep on working. However, it was not a good long-term solution.”
The brain and fibromyalgia
She also tried alternative therapies such as naturopathy, acupuncture and homeopathy – even a costly nutritional programme – but nothing worked. Six years ago she discovered the work of Dr John Sarno, who believes there is a psychological and emotional basis to physical health and pain.
“Functional brain scans of people with chronic pain show that the areas activated in the brain are no longer in the areas related to the physical area where the pain is felt but to the emotional areas of the brain,” explains UK Chartered Physiotherapist and student of Dr Sarno, Georgie Oldfield. “This doesn’t mean the pain is not real, but that chronic pain persists due to activated neural pathways in the brain which have become sensitised and learned and emotional factors play a primary role in its perpetuation.”
Georgie, who is founder of the Stress Illness Recovery Practitioner’s Association (SIRPA), believes traditional treatments are failing patients with chronic pain conditions, and that through education and understanding how and why an individual has pain and other persistent symptoms, as well as using self-empowering strategies, full recovery is possible.
Chronic pain is part of our primal ‘fight or flight’ response, Georgie says, and today our perceived stresses are more psychological issues, such as financial, legal, relationship problems. Rather than acknowledge our feelings, we cope as best we can which can result in the unresolved or avoided emotions manifesting in physical pain, from a tension headache and back pain to fibromyalgia.
“Because chronic pain, including fibromyalgia, is generally considered to be due to a physical cause, many treatments target the area of the body that is painful using physical approaches, rather than the underlying root cause,” says Georgie.
“The evidence that stress does increase our perception of pain is more widely accepted, but it is less known that stress and the unresolved emotions involved can be the actual cause of persistent pain.”
The importance of self-care
Georgie employs strategies to help patients safely acknowledge any traumas, while also becoming more emotionally aware and learning to express emotions more easily. She also advocates self-care and to find a balance in life.
“Therapeutic journaling can be very helpful with emotional awareness and expression and other strategies such as slow, belly breathing help calm the ‘stress response’ which is driving the pain cycle,” she explains. “By identifying and addressing the unresolved emotions as well as focusing on self-care and learning how to reduce the self-induced stress caused on a day-to-day basis, the ‘drivers’ of the pain can be addressed, and it then might be possible for the pain to resolve.”
If you are concerned about symptoms of fibromyalgia, always visit your GP or visit Fibromyalgia Association UK.