Fibromyalgia affects an estimated 2-5 in 100 people in Australia, with women being more likely to experience the condition. Fibromyalgia pain and tenderness can occur throughout the body, and can lasts days, weeks, months, or longer. Fibromyalgia is considered to be a “pain regulation” or “neurosensory” disorder because people with fibromyalgia seem to experience more pain and a higher intensity of pain than others, even under gentle pressure. Fibromyalgia symptoms can come and go in “flares” and often include pain, stiffness, fatigue, “fibro fog,” and mental health issues. If you have fibromyalgia, you know it can feel debilitating and cause a lot of distress for you, and even those you love.
Researchers don’t know exactly what causes fibromyalgia, and there’s no evidence it’s the result of physical damage to the bones, joints, or muscles. We do know, however, fibromyalgia pain may be triggered and worsened by infections, injury, inflammation, or emotional stress and tends to occur in families, but so far, no specific genes have yet been found that predispose someone to getting it. And while low levels of oestrogen have been linked to pain perception in perimenopause and menopause, research so far hasn’t found a connection between oestrogen deficit and the development of fibromyalgia.
Common fibromyalgia symptoms.
Some of the common symptoms of fibromyalgia include
- Pain or tenderness in the muscles, soft tissues, and/or bones throughout the body, including the arms, legs, head, chest, abdomen, back, and buttocks
- Numbness or tingling in the arms and legs
- Fatigue, inability to get a good night’s sleep, restless leg syndrome, feeling stiff on waking
- “Fibro fog” (memory problems, confusion, inability to pay close attention or concentrate)
- Headaches
- Pain in the face or jaw, TMJ syndrome
- Increased sensitivity to light, odors, noise, and temperature
- Mental health issues (anxiety, depression)
- Digestive issues (bloating, constipation, IBS, GORD, difficulty swallowing)
- Painful menstrual periods
- Overactive bladder, pelvic pain
The risk for fibromyalgia is higher in people who experience other conditions such as chronic back pain, lupus, polymyalgia rheumatica, spondyloarthritis, osteoarthritis, hypothyroidism, endometriosis, and IBS (irritable bowel syndrome). Because it’s possible to experience several of these at the same time, your doctor will try to determine which of these you may be experiencing
Supporting fibromyalgia with exercise and nutrition.
While there currently isn’t a cure, there are ways to manage symptoms and reduce the impact fibromyalgia has on your life and self-care plays an important role. The first thing is to know that even though fibromyalgia is difficult to diagnose and doesn’t have a definitive test, it is a real condition and research is being done to try to better understand it and eventually find a cure.
Physical Exercise. While more research is underway, physical exercise is currently considered to be the most effective treatment for fibromyalgia. Cardiovascular fitness training (“cardio”) can ease symptoms by helping with pain and improving sleep. Ideally, doing 30 minutes of cardio three times each week is recommended. Low-impact exercises like walking, biking, stretching, yoga, tai chi, and water-based exercises are helpful. If regular exercise is new for you or feels like a lot, simply start low and go slow to create a comfortable routine. It may take time to build up your endurance and the intensity of physical activity that you can do.
Nutrition. Eating a healthy and nutritious diet is also highly recommended. While there currently isn’t a huge amount of strong evidence to recommend any one dietary strategy to help with fibromyalgia symptoms, a few small studies show promising results for the following nutrition recommendations:
- Different types of elimination diets have helped different people– the vegetarian diet (eliminates meat, poultry, and fish), vegan diet (eliminates all animal products including dairy and eggs), the low FODMAP diet (reduces intake of short-chain carbohydrates that are fermentable oligo-di-mono-saccharides and polyols), gluten-free diet, a diet free from both MSG (monosodium glutamate) and aspartame (an artificial sweetener).
- The Mediterranean diet has been shown to decrease fatigue and improve moods.
- The replacement of some foods may also help, including replacing non-olive oil fats with olive oil and replacing non-ancient grains with ancient grains such as Khorasan wheat.
- If you are low in vitamin D, taking a supplement can help reduce fibromyalgia pain.
- Additional supplements that may help include Chlorella green algae, Coenzyme Q10, acetyl-L-carnitine, magnesium, iron, vitamins C and E, probiotics, and Nigella sativa (Black cumin) seeds Note: My clinical approach to fibromyalgia often includes supplementation shown to help modulate pain and inflammatory pathways and is discussed as part of an individual’s treatment strategy.
This is a long list of potential dietary strategies and more research is needed. Working with a degree-qualified nutritionist will help ensure you find the best path forward with a dietary approach that’s right for you as an individual.
Lifestyle strategies to support fibromyalgia symptoms
Practices that support the natural circadian rhythm and your sleep/wake cycle may be beneficial if you’re experiencing fibromyalgia symptoms. One of my favourite practices to sync the circadian rhythm is to begin the day by getting 15-30 minutes of natural, morning light on waking—before exposing myself to artificial indoor lights and the blue lights of electronics. This is based on the scientific work of Dr Samer Hattar (credited with co-discovering the neurons in the eye that set our circadian clocks), on how viewing light at particular times of the day adjusts our mood, ability to learn, stress and hormone levels, appetite/feeding cycles, and our mental health. Additional practices include:
- Go to bed and wake at the same time each day.
- Limit stimulants like caffeine and nicotine as much as possible, especially in the evenings. Establish a relaxing nightly routine that includes reduced screen time, dimmed lights, soft music, meditation, and a warm bath.
- Keep your bedroom comfortable for sleeping by keeping it dark, quiet, and cool. If you suspect you may have a sleep disorder such as sleep apnea, reach out to your healthcare provider.
Managing stress and moods can also help you relieve symptoms. Pace yourself and balance your need to work and rest by taking breaks when necessary. Also, make time to relax each day and try deep breathing, progressive muscle relaxation, mindfulness, and stress reduction techniques. If you feel lonely or isolated, consider joining a support group that you find to be positive and encouraging—one that shares helpful coping techniques. Cognitive behavioral therapy (with a qualified therapist or counselor) may help you by focusing on how your thoughts and behaviors affect pain and other symptoms. If you have any mental health concerns such as anxiety or depression, seek out professional help.
If necessary, consider reaching out to your healthcare provider about prescription medications that may help with fibromyalgia.
The Bottom Line.
Fibromyalgia is a complex condition of chronic widespread pain—you’re not making it up and it’s not “all in your head”. Self-care is the mainstay for improving symptoms of fibromyalgia and current research suggests that the most effective treatment is physical activity. In addition to that, there are several dietary and lifestyle strategies that can help, including certain diets and supplements, improving sleep, and managing stress. While there may not be a cure for the condition yet, you don’t have to suffer in silence.
Need support to best implement these strategies into your life in the safest and most effective way? Book an appointment with me to find out how I can help you.