Teaching fibromyalgia sufferers to take control

Management helps people take their life back

To control the symptoms of fibromyalgia, sufferers must take control of their disease. That means getting the upper hand on pain, fatigue, and emotion. "A lot of fibromyalgia patients get into this mode where the disease is taking over their lives. They no longer have control. Fibro-myalgia is controlling them, and they have to reverse that," says John Klippel, MD, medical director of the Arthritis Foundation in Atlanta.

The term fibromyalgia means pain in the muscles, ligaments, and tendons, according to the foundation. Pain is the most prominent symptom.

About 90% of people with fibromyalgia experience fatigue and sleep disturbances. Some also have cognitive dysfunction where they can’t think clearly or become forgetful. This condition is called "fibro fog," according to the Arthritis Foundation.

Fibromyalgia is diagnosed by a set of criteria established by the American College of Rheumatology in Atlanta. Symptoms that indicate a person has the disease include:

A history of widespread pain on both sides of the body and above and below the waist for at least three months.

Pain in at least 11 of 18 tender-point sites. These points are located in front and back of shoulders, at the shoulder blades, top of the buttocks, crook of the elbow, knees, and upper back of the thighs. These areas are considered tender points if they are sensitive to pressure. However, people with fibromyalgia often describe their pain as tenderness all over the body.

The first step in gaining control of the pain, fatigue, and emotional swings caused by this disease is to reduce the amount of stress in one’s life, because the severity of the disease often fluctuates with the amount of stress a person is experiencing. To reduce stress, fibromyalgia sufferers must identify the stressors, says Klippel.

Those who cannot do this on their own should seek professional help. A psychologist or psychotherapist can help people with fibromyalgia not only determine the cause of stress in their lives but also develop coping strategies.

Emotions, such as depression, that frequently plague those with fibromyalgia are intertwined with the stress. "The feeling that the disease is taking over their life contributes to the stress, so there is this spiral effect where things just keep getting worse and worse," says Klippel. Stress reduction helps people gain control and reduces the negative emotions, such as depression, that accompany fibromyalgia.

Stress also intensifies the pain of fibromyalgia, and because medications do not help reduce the type of pain caused by this disease, stress reduction is vital. For most arthritis sufferers, the source of pain is clear. For example, they have pain in their knee, so they take an analgesic to control the pain. "Analgesics are generally not effective in fibromyalgia pain. For most people, the pain is generalized, and they can’t be quite as specific about it," he says.

The role of exercise

Another important factor in taking back control is a regular exercise regimen. "What is quite clear is that people with fibromyalgia can benefit enormously by paying attention to fitness," says Klippel. A daily exercise routine helps anyone feel better, yet because of their pain, many fibromyalgia sufferers do not exercise. It also helps people sleep more soundly so they are less fatigued, and exercise is widely used to combat stress.

The Arthritis Foundation recommends a walking regimen for those just starting to exercise. Recently, the foundation launched a tai chi program, which Klippel says is very helpful for people with fibromyalgia. They also are doing some exploratory work in developing yoga programs. "Yoga combines mental discipline with attention to awareness and body, and there is a clear exercise component to it. All those things should be valuable to someone with fibromyalgia," he says.

Although exercise helps with the problem of fatigue, often medications also are used to help with sleep disturbance. Generally, these are medications that are used to treat depression, but they are used in lower doses for fibromyalgia sufferers who have trouble sleeping.

While no two people experience exactly the same symptoms or can manage the disease in the exact same way, it does help when people share coping strategies, says Klippel. Therefore, a support group is a good disease-management tool for people with arthritis. "People can be very creative in coming up with ways to make their lives better," he says.

Managing symptoms through stress reduction and regular exercise can help fibromyalgia sufferers take back their lives, says Klippel. "Many people who get into effective treatment programs find their symptoms are substantially relieved or completely go away."


For more information about controlling the symptoms of fibromyalgia, contact:

  • John Klippel, MD, Medical Director, Arthritis Foundation, P.O. Box 7669, Atlanta, GA 30357-0669. Telephone: (800) 283-7800.