Fibromyalgia (FM) is a chronic disorder that causes widespread pain throughout the entire body. It wasn’t until the 1990s that the World Health Organization and other medical organizations recognized Fibromyalgia as a disease. It was also at this time that the American College of Rheumatology (ACR) classification criteria, used to diagnose FM, differentiated FM from other forms of chronic musculoskeletal pain.
People who suffer from FM complain of pain, fatigue, sleep disorders, headaches, cognitive problems, anxiety, depression, and digestive problems. FM impacts quality of life and patients find it difficult to carry on the normal activities of daily living and these activities that once were easy become more difficult, time consuming, and sometimes impossible. Unfortunately, there is no known cure for FM, making disease management the standard approach to treatment. It is important for individuals to incorporate healthier lifestyle choices into their daily lives to help reduce symptoms related to FM. Five key puzzle pieces that relate to lifestyle modifications that can help manage FM include diet change, exercise, better sleep, stress reduction, and mental health management.
Best services for writing your paper according to Trustpilot
FM nonprogressive and nondegenerative disease that is commonly observed in people who are 30–55 years old (Goldenberg, 2008). Pain is the primary symptom and can occur in many forms including, muscle aches, burning, tingling, throbbing, and persistent pain throughout body. This pain associated with FM can start abruptly following a physical or emotional trauma, or could progressively develop over the years (Sumpton, ; Moulin, 2014).
As previously mentioned, the ACR defined official diagnostic criteria for FM in 1990. This criterion includes more than three months of pain throughout the body (left side, right side, below waist, and above waist), fatigue, cognition and other somatic symptoms (Sumpton, ; Moulin, 2014). Other assessment measures used in research studies include the Fibromyalgia Impact Questionnaire (FIQ), pain and fatigue scales, and quality of life measures. Because FM has a negative impact on the entire body, the goal of management is to decrease overall pain, amend sleep, and restore physical and mental function, to improve the patient’s overall quality of life.
The first piece of the puzzle as it relates to lifestyle modifications is diet change. Due to digestive problems, those suffering from FM benefit from altering their diet to relieve symptoms. One study found that 42% of FM patients reported their symptoms got worse after eating certain foods (Haugen, Kjeldsen-Kragh, Nordvåg, & Førre, 1991). Some of the trigger foods that caused their pain included those that contained gluten and although these patients may have a gluten sensitivity, it doesn’t mean they have Celiac Disease.
This means that an individual can have a gluten allergy that can be causing chronic musculoskeletal pain, asthenia, and irritable bowel syndrome (Isasi, et al., 2014). Due to this sensitivity, abstaining from gluten can be extremely beneficial for reducing overall pain.
One way to see if gluten is causing increased pain and digestive problems is to keep a food diary to track what foods were eaten and the reactions to that food. By keeping a food journal for a few weeks, patients with FM can identify the exact foods that are causing pain and eliminate those foods from their diet. Once these patients begin to eliminate trigger foods that cause inflammation and pain, they can focus on maintain a healthy and balanced diet full of fruits, vegetables, and heathy fats. In addition to diet modifications it can also be beneficial to incorporate natural supplements into a patient’s diet. Coenzyme Q10 (CoQ10), is a natural vitamin found within our cells that functions like an antioxidant.
Patients with FM tend to have lower concentrations of CoQ10 in the blood, and this deficiency has been detected in depression and chronic fatigue which are two typical symptoms found in FM patients (Cordero, et al., 2012). A small study found that giving 300 mg of CoQ10 supplementation to FM patients daily for three months increased CoQ10 levels back to normal and decreased pain, fatigue, and joint stiffness (Cordero, et al.
, 2012). When looking at the overall problems that FM causes, diet appears to be a crucial piece of the puzzle. Based on these studies, eliminating foods that trigger pain and digestive problems, such as gluten, and adding natural supplements, like CoQ10, into one’s diet is recommended.
Another piece of the puzzle is exercise. Exercise involves repetitive body movements that improve and maintain physical fitness. The purpose of physical activity for those suffering from FM, is to reduce pain, improve health-related quality of life, and improve physical fitness (Busch et al., 2011). Because a sedentary lifestyle may place those with FM at an increased risk for developing a chronic disease, optimizing overall health is crucial. FM can be presented differently between individuals so it is important to note that one specific exercise approach won’t be beneficial for everyone with FM.
As learned in class, it is important to talk to a primary health care provider and find a fitness professional who can provide expert advice about how to individualize an exercise program based on individual need. A gradual intensity progression for individuals with fibromyalgia with moderate intensity is recommended and clinicians should ensure that their clients with FM are supported in developing active lifestyles that include regular exercise whether it be aerobic, stretching, or holistic approaches. Aerobic exercises like walking and water aerobics are extremely beneficial for those with FM. However, research has explored the effects of physical activity that extends beyond conventional aerobic exercise training. Mind-body approaches that are used in Asian countries are being explored including Tai Chi, Yoga, Breathing exercises, and Pilates. These holistic approaches encompass the physical, emotional, psychosocial, behavioral, and spiritual elements that could be beneficial for those with FM. Wang et al.
(2010) looked at the effects of twice weekly tai chi sessions, delivered for 12 weeks, for men and women with fibromyalgia. In this study, the sessions included a warm-up, review of tai chi principles, practice with tai chi movements, breathing techniques, and relaxation. Participants demonstrated large improvements in their health-related quality of life which was measured by the Fibromyalgia Impact Questionnaire (FIQ) and Short Form–36 health survey questionnaire (SF-36). In addition to tai chi, another fast- growing and popular form of exercise that is recommended to both healthy individuals and for those in rehabilitation is Pilates. Pilates combines Asian and Western techniques by focusing on strengthening the core, posture, and breathing while moving. In 2009, Altan et al. (2009) looked at the effects of Pilates in 49 women with fibromyalgia.
The FIQ revealed that they demonstrated improvements when compared to the control group who performed home-based relaxation and stretching exercises (Altan, et al., 2009). Overall, exercise is important for maintaining good health in all individuals and can help with pain, fatigue, and depression in individuals with FM. While a mind-body integrative approach may be promising, further research comparing mind-body techniques to conventional approaches are needed. Sleep is another piece of the puzzle that plays an integral role in maintaining good physical health.
Sleep is essential because it allows the mind and body to rest and recuperate. Disturbed sleep can involve having a difficult time falling asleep, waking up and being unable to fall back asleep, waking up after six hours or so and feeling extremely tired, and sleeping inconsistently. Nonrestorative sleep has been reported in more than 90% of FM patients (Sumpton, & Moulin, 2014). A small study by Lentz et al. (1999), showed that disrupting sleep for many consecutive nights was associated with increased discomfort, fatigue, and a decrease in pain threshold (Lentz et al., 1999). While there are FDA approved medication for FM that may improve sleep, it is best to focus on natural ways of improving sleep quality.
One way to compensate for the lack of sleep is by engaging in relaxation or meditation during the day. Restoring some degree of relaxation to your body can improve night-time sleep (Sheridan, &Waugh, 1999). Another way to improve sleep is to avoid stimulating foods, especially right before going to bed. Foods that are high in sugars or starches cause fluctuations in blood sugar levels and cause you to wake up during the night due to a decrease in blood sugar levels. Instead, Sheridan and Waugh (1999) discuss that eating more fruits and vegetables can help to promote sleep. By adhering to some of these modifications, patients with FM can improve their overall quality of sleep which will in turn help manage their overall pain and improve their quality of life.Stress is a puzzle piece that can be defined as a stressor that disrupts one’s homeostasis.
This stressor activates the stress response system that works to preserve and/or restore equilibrium. When the threat has diminished, the stress response is weakened by a negative feedback system (Van Houdenhove, Egle, ; Luyten, 2005). In a recent study, Kivimaki et al. (2004), looked at the association between occupational stress and the incidence of FM. The results of this study showed that increased workload, lack of decision making, and the potential experience of being bullied at work, greatly impacted the risk of developing FM. Bullying at work includes someone who is socially isolated and excluded, whose work and efforts are not valued, is threatened, where demeaning comments are made in their absence, or is involved with other negative actions that cause torment and frustration (Kivimaki et al., 2004).
When some individuals with FM are exposed to an immense mental load or emotional burden, they tend to fall prey to pain.The American Heart Association provides some great techniques to reduce stress. When stress builds up over time is can limit performance and create problems physically, mentally, and emotionally. One of their techniques is to engage in positive self-talk.
Because negative self-talk increases stress, it is important to incorporate positive self-talk to control stress and calm down. The American Heart Association also provides some stress reduction activities that can help someone find their happy place in a natural way. Some of these activities include going for a walk, reading a book, meeting a friend, playing a sport, and working on a hobby. These activities can provide individuals with FM tangible ways to reduce their stress while doing something that they enjoy and take their mind off of stressful events that might occur in the work environment. It can take practice to incorporate positive self-talk and work a stress reduction activity into a weekly routine, but disrupting the stress cycle can produce amazing results in overall quality of life in patients with FM. The final piece to the puzzle is working through depression and anxiety which are common in patients with FM. According to Our World in Data, 322 million people around the world live with depression.
Although there is a high rate of depression among these individuals, only thirty percent of patients had actually spoken to their doctor about mental health issues (Fuller-Thomson, Nimigon-Young, ; Brennenstuhl, 2012). One option for people with FM who are struggling with depression is group therapy where individuals with similar challenges meet together with a facilitator. Those who attend can benefit from either a structured group-therapy session or a more informal support-group meeting.
In a structured session, the facilitator will share information with the group and then engage the group in discussions. In less structured group meetings, the participants decide which topics will be discussed with the guidance of the facilitator (Fuller-Thomson, Nimigon-Young, ; Brennenstuhl, 2012). People who attend group therapy usually benefit from exchanging thoughts and experiences related to their condition and are able to problem solve with other individuals. When looking at the combination of sleep, stress, and mental health related problems in patients with FM, cognitive behavioral therapy (CBT) may be beneficial. CBT is a psychological intervention that has burgeoned over the past few decades and is beneficial for those suffering from FM (Lumley, 2011).
Moreover, research has identi?ed five processes that are positively impacted by CBT. These five processes include: understanding a problem and learning how to change it, learning self-management skills, learning how to process emotions and memories that were previously avoided, encouraging avoided behaviors that were caused by a negative emotion like fear or guilt, and providing a supportive therapeutic relationship (Lumley, 2011). The main focus of CBT for FM patients is to help develop cognitive and behavioral skills for managing symptoms. Overall, CBT has been shown to decrease pain, fatigue, and improve mood, stress management and physical functioning in patients with FM (Goldenberg, 2008). It allows patients to deal with and think differently about their symptoms.
Fibromyalgia is a multifaceted disorder that is continually challenging healthcare providers and patients. Successful FM management relies on comprehensive education with the patient playing an active role in their own heath care. FM reduces the quality of life of many people all over the world and is an important current public health issue. Currently, there is no effective treatment for this disorder, but research points to a multidimensional approach. This includes using some pharmacological remedies with lifestyle modifications.
Those with FM should make sure to monitor their diets, incorporate exercise into their weekly routines, get better sleep, manage stress, and seek help to maintain good mental health.
