Exercises Can Alleviate Fibromyalgia Pain

exercise fibromyalgia.Research out of Spain confirmed the belief that exercise and physical fitness can help relieve symptoms due to chronic pain and fibromyalgia.

To conduct their experiment, researchers asked participants to refrain from using pain medications for at least 24 hours, then they measured their pain levels using a number of different scales, including the Visual Analog Scale (VAS), the Pain Catastrophizing Scale (PCS) and the Chronic Pain Self-Efficacy Scale. After pain was measured, researchers surveyed patients about their exercise habits. Although the findings don’t prove causation, researchers uncovered:

  • Patients with higher physical activity exhibited lower levels of pain.
  • Those who exercised more had a lower psychological overreaction to pain.
  • Fitness appeared to decrease negative thoughts about chronic pain.

“These results might have implications for future intervention studies in this population,” the investigators wrote in Arthritis Care and Research. “In general, there was a linear (dose-response) relationship so that higher levels of fitness were associated with lower levels of pain and catastrophizing and higher self-efficacy.”

The team concluded that fitness helped improve overall agility, flexibility and mobility. They believe strength conditioning can help increase pain tolerance, while aerobic exercises can help a person with some of the mental aspects of chronic pain and fibromyalgia.

“Our exploratory analyses suggest that muscle strength and flexibility could be the fitness components most strongly associated with pain levels, while aerobic fitness and flexibility could be the fitness components most strongly associated with the psychological experience (i.e. catastrophizing and self-efficacy) of pain,” wrote the authors.

Dr. Cohn Comments

The benefits of exercise for chronic pain have been well documented, so it should come as no surprise that regular exercise can help alleviate problems associated with fibromyalgia.

I’ve even written about how exercise has helped me control my pain condition. If you’re suffering from chronic pain, try to squeeze in some regular exercise. Even 15 minutes of walking can do wonders for your mind and body. If some exercises are too trying, try to find an activity that works for your condition. Whether it’s running, walking or swimming find an activity that works for you!

Working Through Chronic Pain

Living with chronic pain isn’t easy. Some people are awarded full or partial disability, but for many people, those benefits eventually run out or their claim is denied altogether. Because of this, many people are forced to work, even with debilitating chronic pain. Today, we share some tips for getting through the work day with chronic pain.

1. Move Around

You might think you’re making your pain problem worse by moving around, but staying sedentary for long periods can actually trigger chronic pain. For example, if you’re dealing with chronic back pain, staying seated in one position can actually put more strain on your back. Moving around helps build muscle and helps regulate blood flow to affected areas. Try to get up and walk around for five minutes every hour. This doesn’t necessarily mean you need to take a break every 60 minutes – just find an excuse to walk around. Deliver those memos to accounting by hand or walk around while you’re talking on the phone.

2. Don’t Overdo It

While you want to move around, you don’t want to overdo it at work. It may sound obvious, but a lot of workers want to prove to themselves and their coworkers that their pain condition won’t hold them back at work. Lifting heavy boxes or equipment can exacerbate a previous pain condition. Talk to your boss about your condition so there are no surprises when you return to work. If you can’t preform all the typical duties, talk with your boss or your coworkers about other ways you can contribute. For example, instead of loading boxes onto the truck every Friday, maybe you can compile the weekly productivity reports. Being open and honest about your limitations means there will be no confusion about your job duties.

Pain at work

3. Tell Your Boss

As we mentioned above, it’s important to talk to your work superiors about any limitations you might have because of your chronic pain. Lying or trying to hide your pain can be extremely problematic. First, it can affect your disability benefits. If you tell your insurance company that your injury is preventing you from completing all your tasks, but you attempt to push through the pain and complete them anyway, your insurance can deny your claim. On the other hand, if you don’t open up about your condition to your boss, he or she might not be as open to hearing why you didn’t finish a certain task.

4. Adjust Your Schedule

This one again goes hand in hand with the above point. If possible, try to adjust your schedule to accommodate your pain. For example, if you are supposed to take water therapy classes to alleviate your back pain, and the classes are only offered at 8am on weekdays, but you normally work 8am-5pm, ask your boss if you can work from 9am-6pm on Tuesdays and Thursdays so you can get to your treatment. If you can’t adjust your work schedule, do your best to adjust your personal schedule so you can best manage your pain condition.

Insomniacs More Prone to Chronic Pain

Findings out of the Norwegian Institute of Public Health suggest that people who have trouble sleeping are more likely to have an increased sensitivity to pain.

Although the study didn’t show a cause-and-effect relationship, researchers said insomniacs were more likely to be sensitive to pain. For the study, researchers asked more than 10,000 adults to dip their hands in cold water for 1 minute and 46 seconds. If they felt the cold water was causing too much pain, participants could remove their hands from the water prior to the completion of the timer.

Insomnia

After their reading was recorded, researchers asked participants a bunch of questions about their sleeping habits, including how long they typically sleep, how long it takes them to fall asleep, and if they suffer from insomnia. Researchers also asked questions about related issues that can make it hard to fall asleep, like anxiety, stress and depression.

Study Results

After looking at the findings, researchers uncovered:

  • Nearly 1/3 of participants were able to keep their hands in the water for the entire test.
  • 42 percent of people with insomnia pulled their hands out of the water early.
  • 31 percent of people without the sleep disorder pulled their hands out of the water early.
  • Participants with frequent insomnia were more likely to remove their hands from the water than people who have insomnia once a month.
  • People with insomnia and chronic pain were twice as likely to have a reduced pain tolerance than participants without those conditions.

“While there is clearly a strong relationship between pain and sleep, such that insomnia increases both the likelihood and severity of clinical pain,” researchers wrote, “it is not clear exactly why this is the case.”

Dr. Cohn Comments

Although the findings are interesting, they are hardly revolutionary. In fact, it’s more of a chicken-and-the-egg type argument. People who have chronic pain are more likely to be plagued by nagging pain, which can make it difficult to fall asleep and stay asleep, and if you don’t get a full night’s sleep, your body can fully recover from the activities of the day, contributing to more pain. So what came first, the chronic pain or the insomnia?

Related source: Health.com

Dopamine May Be Key To Unlocking Chronic Pain

DopamineMedical researchers at the University of Texas say dopamine – the mechanism in your brain responsible for movement, memory and reward – could provide the key to unlocking the problem of chronic pain.

Dopamine is vital for several different brain functions, but its contributions to the problem of chronic pain are not well known. To better understand dopamine’s role in chronic pain transmission, researchers began studying its effect in mice. Researchers noted that removing a specific collection of neurons -known as A11 – helped diminish the perception of chronic pain. The cluster of A11 neurons contained high levels of dopamine.

“These findings demonstrate a novel role for how dopamine contributes to maintaining chronic pain states,” said associate professor Dr. Ted Price.

How it Works

When a person gets injured, neurons inside the body send pain signals to the brain. In someone with chronic pain, these neurons send pain signals to the brain even when an injury isn’t present. A physical medicine pain specialist’s job is to determine what is causing these neurons to fire, and how to stop them from incorrectly firing.

The A11 cluster might be causing some of these neurons to fire. In fact, when removed, mice were still able to feel acute pain (an actual physical injury), but they exhibited a lesser response to chronic pain.

“We used a toxin that affected A11 neurons, and that’s when we found that acute pain signals were still normal, but chronic pain was absent,” said Dr. Price. “This may open up new opportunities to target medicines that could reverse chronic pain,” said Dr. Price.

Dr. Price and colleagues want to continue studying dopamine receptors in relation to chronic pain perception.

“In future studies, we would like to gain a better understanding of how stress interacts with A11. And we’d like to know more about the interaction between molecular mechanisms that promote chronic pain and dopamine.”

Spinal Cord Stimulation For Pain Management

Spinal Cord StimulationUsing electrical stimulation for the control of pain with an implanted device onto the spinal cord and in the epidural space was done for the first time in 1971. This began after the publishing of Melzack and Wall’s renown work on the “gate control theory” of pain. The theory proposed that nerves carrying painful peripheral stimuli travel into the dorsal horn of the spinal cord. Further, the “gate” may be manipulated or closed by other electrical impulses to the area. Since the initial device in 1971, technology and understanding of neuromodulation has greatly changed, and there are new developments coming to the field.

Spinal cord stimulation (SCS) is an advanced form of pain management. It is an implantable system that uses electrical signals to the spine to modulate pain signals traveling through the spine. The exact mechanism is unknown, but somehow the signal generated by the stimulator modifies pain signals such that one does not perceive their normal pain quality. In the simplest terms, it is a pacemaker for the spine, pacing out pain signals. Since it is an implantable device, versus a simple form of treatment like physical therapy or medication, it is not considered a first line of treatment, but something to consider if other treatments have failed. For pain management professionals, it is a treatment that should be considered before less successful treatments like multilevel spine decompressions or fusions. The cost effectiveness of this treatment is far superior to most lumbar surgeries and is typically more successful in controlling pain.

Spinal cord stimulation is used for a variety of painful conditions. In the United States, the most common use is for pain that continues after back surgery. It is also used for neuropathic (nerve damage) type pain in the extremities, complex regional pain syndrome, and extremity pain that is unlikely to be managed with back surgery. In Europe, it is also often used for ischemic vascular pain in the legs and also for angina. Occasionally it is used for peripheral nerve pain, especially for migraines caused by occipital nerve irritation.

Advantages of Spinal Cord Stimulation

The advantage of SCS is that it often can control pain that no other treatment has been able to impact. When performed by an experienced interventional pain physician, the pain relief success rate should be above 60% with a complication rate less than 5%. Problems that may occur range from stimulator lead movement, damage from the needle used to insert the electrodes and infections. That said, complications are rare. The newer units have long lasting batteries, and one company makes units that are MRI compatible. Further, before any implant, a trial is done to see if the technology is helpful and to ensure it does not change the anatomy in the body.

As the technology has improved, there have been some new techniques discovered on spinal cord stimulation. The first technique is high frequency and high density stimulation. The unit is programmed at a very high rate, and the patient does not actually feel the stimulation to the spine. The electrical impulses block the pain signals at the spinal level and there may be some indication that it may also begin changing the central brain perception of pain signals. Several different brands of stimulators can perform this type of function; whether one brand is better than another is not clear.

The second new development is a very specific burst pattern of stimulation. This pattern is thought to mimic the transmission of certain pain signals and may be more effective in some individuals in blocking pain with less actual sensation of the electrical signals from the stimulator unit. Again, it is thought to also change the brain’s ability to perceive excessive pain signals in chronic pain patients, resetting the brain to a more normal pain sensitivity. The last new technique is for a special electrode that allows for specific nerve root ganglion positioning of the electrode to block an isolated nerve pain generator.

Spinal cord stimulation is an excellent technology to block pain signals. Our knowledge and ability to use these techniques to help diminish pain is expanding rapidly. Government and insurance approval has slowed some of the new technology and proven techniques, but hopefully these will be approved in the future to treat pain. The future for these technologies is bright and these provide a good option when simpler methods do not work.