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Fibromyalgia and Sleep — Is There a Connection?

18 Feb

Is there a connection between fibromyalgia (FM) and sleep disturbance? Let’s take a look!

FM is a condition that causes widespread pain and stiffness in muscles and joints. Patients with FM often experience chronic daytime fatigue and some type of sleep problems like getting to sleep, staying asleep, and/or feeling restored in the morning upon waking. The National Institutes of Health estimates between 80-90% of those diagnosed with FM are middle-aged women, although it can affect men and happen at any age. As little as 10-20 years ago, it was hard to find a doctor who “believed” in FM, and it was common for the patient to be told that their pain “was all in their head.” FM has now been studied to the point that we know it is a real condition, and it affects between 2-6% of the general population around the world.

It is well established that sleep disturbance frequently occurs after surgery, which usually normalizes as time passes. One study used a group of healthy women who were deprived of sleep (particularly slow wave sleep) for three days to see if there was a link between sleep disturbance and pain. Results confirmed that the women experienced a decrease in pain tolerance and increased levels of discomfort and fatigue after three days—the same symptoms found among FM sufferers!

Fibromyalgia may have NO known cause, or it can be triggered by other conditions such as repetitive stress injuries, car crash injuries, and other forms of trauma. FM also appears to run in families though it’s still NOT clear if this is a true genetic link or caused by shared environmental factors. Some feel FM is a rheumatoid condition, and though FM is NOT a true form of arthritis, it has been found that people with arthritis are more likely to have FM.

FM sufferers frequently suffer from conditions such as irritable bowel syndrome, chronic fatigue syndrome, migraine headaches, arthritis, lupus, and major depressive disorders. Approximately 20% of FM patients have depression and/or anxiety disorders, and a link between chronic pain and depression exists and seems to play a role in people’s perception of pain.

Because conditions such as sleep apnea can result in symptoms similar to FM, it’s recommended that patients suspected of FM keep a sleep/sleepiness diary in order to rule out sleep apnea as a cause for their condition.

There are many “tips” for improving sleep quality, which we will dive into next month, as these may prove VERY HELPFUL in the management of FM!

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR FIBROMYALGIA! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

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Fibromyalgia “Diet” – Is There Such a Thing?

21 Jan

Folks suffering with fibromyalgia (FM) commonly complain that certain foods can make their symptoms worse. How common is this? One study reported 42% of FM patients found that certain foods worsened their symptoms!

Because FM affects each person differently, there is no ONE FM diet or, “…one size fits all” when it comes to eating “right” for FM. Patients with FM usually find out by trial and error which foods work vs. those that consistently don’t. However, remembering which foods do what can be a challenge so FIRST, make a three column FOOD LOG with the following headings: BETTER, NO CHANGE, WORSE. This will allow you to QUICKLY review the list as a memory refresher.

According to Dr. Ginevra Liptan, medical director of the Frida Center for Fibromyalgia (Portland, OR) and author of Figuring Out Fibromyalgia: Current Science and the Most Effective Treatments, there are some common trends she’s observed through treating FM patients. Here are some of her recommendations:

PAY ATTENTION TO HOW FOOD MAKES YOU FEEL: It is quite common to have “sensitivities” to certain foods, but this is highly variable from person to person. Examples of problematic foods/ingredients include: MSG (commonly used in Chinese food), other preservatives, eggs, gluten, and dairy. Dr. Liptan HIGHLY recommends the food journal approach! She also recommends including a note about the type of symptoms noticed with each “WORSE” food, as symptoms can vary significantly.

ELIMINATE CERTAIN FOODS: If you suspect a certain food may be problematic, try an elimination challenge diet. That means STOP eating that food for six to eight weeks and then ADD it back into your diet and see how you feel. Remember, FM sufferers frequently have irritable bowel syndrome, also known as IBS, and this approach can be REALLY HELPFUL! Food allergies may be part of the problem, and your doctor may refer you for a consult with an allergist and/or a dietician. They will also discuss the “anti-inflammatory diet” with you.

EAT HEALTHY: In general, your diet should emphasize fruits and vegetables and lean protein. Pre-prepare food so you have something “healthy” to reach for rather than a less healthy snack when you’re hungry and tired. Consider “pre-washed” and pre-cut up vegetables; try quinoa rather than pasta. Consume anti-fatigue foods and eat multiple small meals daily vs. one to two large meals. Protein snacks (like a hardboiled egg or oatmeal – GLUTEN FREE) help a lot! Eat breakfast and include protein. Also, GET ENOUGH SLEEP (at least seven to eight hours and be consistent)!

SUPPLEMENTS: Consider a good general multi-vitamin, calcium and magnesium, omega-3 fatty acids, vitamin D3, and Co-Enzyme Q10. There are others, but this represents a great place to start. Remember to check any medication you may be taking with these/any suggestions before taking supplements!

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR FIBROMYALGIA! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dietary Strategies to Treat Fibromyalgia

21 Dec

Fibromyalgia (FM) is a common condition that affects about five million Americans, often between ages 20 and 45 years old. FM is very difficult to diagnose primarily because there is no definitive test like there is for heart, liver, or kidney disease. Equally challenging is the ability to effectively treat FM as there are frequently other conditions that co-exist with FM that require special treatment considerations. Typically, each FM case is unique with a different group of symptoms and therefore, each person requires individualized care.

Fibromyalgia symptoms can include generalized pain throughout the body that can vary from mild to severely disabling, extreme fatigue, nausea/flu-like symptoms, brain “fog” (“fibro-fog”), depression and/or anxiety, sleeping problems and feeling un-refreshed in the mornings, headaches, irritable bowel syndrome, morning stiffness, painful menstrual cramps, numbness or tingling (arms/hands, legs/feet), tender points, urinary pain or burning, and more!

So, let’s talk about ways to improve your FM-related symptoms through dietary approaches. When the FM symptom group includes gut trouble (bad/painful gas, bloating, and/or constipation), it’s not uncommon to have an imbalance between the “good” vs. the “bad” bacteria, yeast, and problems with digestion or absorption. Think of management as a “Four Step” process for the digestive system:

  1. REMOVE HARMFUL TOXINS: Consider food allergy testing to determine any foods the FM patient has a sensitivity for. Frequently, removing gluten, dairy, eggs, bananas, potatoes, corn, and red meat can benefit the FM patient. The use of anti-fungal and / or anti-bacterial botanicals (as opposed to drug approaches such as antibiotics) can be highly effective. A low allergy-potential diet consisting of fish, poultry, certain vegetables, legumes, fruits, rice, and olive and coconut oil is usually a good choice.
  2. IMPROVE DIGESTIVE FUNCTION: The presence of bloating and gas is usually indicative of poor digestion, and the use of a digestive enzyme with every meal can be highly effective!
  3. RESTORE THE “GOOD” BACTERIA: Probiotics (with at least 20-30 billion live organisms) at each meal are often necessary to improve the “good” gut bacteria population, which will likely also improve immune function.
  4. REPAIR THE GUT: If the gut wall is damaged, nutrients like l-glutamine, fish oils, and n-acetyl-d-glucosamine may help repair it.

This process will take several months, and some of these approaches may have to be continued over the long term. Doctors of chiropractic are trained in nutritional counseling and can help you in this process. As an added benefit, many FM sufferers find the inclusion of chiropractic adjustments to be both symptomatically relieving and energy producing.

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR FIBROMYALGIA! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Can I PREVENT Fibromyalgia?

19 Nov

Fibromyalgia (FM) is a common cause for chronic pain (pain that lasts three or more months) and afflicts 4% of the general population in the United States! FM commonly affects the muscles and soft tissues – not the joints (like arthritis); however, many FM sufferers are mistakenly diagnosed with arthritis, so it may take years before they get an accurate diagnosis. There are NO known accurate diagnostic tests for FM, which is another reason for a delayed diagnosis.

In order to answer the question, “Can fibromyalgia be prevented?” we must first find the cause of FM. There are two types of FM: PRIMARY and SECONDARY. Primary FM occurs for no known reason, while secondary FM can be triggered by a physical event such as a trauma (e.g., car accident), an emotional event or a stressful situation (e.g., loss of a child), and/or a medical event such as a condition like irritable bowel syndrome, rheumatoid arthritis, or systemic lupus erythymatosus (SLE). Any condition that carries chronic or long-lasting symptoms can trigger FM, and some argue that the lack of being able to get into the deep sleep stage may be at the core of triggering FM since sleep disorders are a common finding in FM sufferers!

The “KEY” to managing FM has consistently been and probably always will be EXERCISE and SLEEP. So, if FM is preventable, daily exercise and getting the “right kind” of sleep are very important ways that may reduce the likelihood for developing the condition! Since emotions play a KEY ROLE in the cause and/or effect of FM, applying skills that keep life’s stressors in check is also important. This list can include hobbies like reading a good book, playing and/or listening to music, or meditation. The combination of exercise with mindful meditation using approaches like Tai Chi, Yoga, Qi Gong, and others has had positive impacts on FM patients such as improved balance and stability, reduced pain, enhanced mental clarity, and generally improved quality of life. Managing physical conditions that are associated with FM (such as irritable bowel syndrome, rheumatoid arthritis, or systemic lupus erythymatosus) is also important in managing and/or preventing FM.

Another management strategy of FM is diet. As most patients with FM will agree, certain foods help and others make the FM symptoms worse. In a survey published in the Journal of Cinlical Rheumatology, 42% of FM patients reported certain foods exacerbated their symptoms. Of course, each individual case is unique, so keeping a food log or journal can be very helpful to determine dietary “friends” vs. “enemies.” The first step is to eliminate certain foods for four to six weeks, such as dairy and/or gluten. Most patients report a significant improvement in energy (less fatigue) while some report less pain when problem foods are elimated from their diet. Generally, a diet rich in fruits, vegetables, and lean proteins can have a positive impact on the FM patient. Consider eating multiple small meals vs. two or three large meals during the day, as this can keep blood sugar levels more stable and reduce fatigue.

So back to the question, can fibromyalgia be prevented? Maybe…maybe not. Since the medical community doesn’t know the exact cause, it’s hard to answer this question. However, being proactive and implementing the strategies used to better manage FM may help in preventing it as well!

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR FIBROMYALGIA! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

How Are Fibromyalgia Exercises Different?

29 Oct

For some people, fibromyalgia (FM) can make life miserable. In some cases, it can be so bad a person will spend the majority of the day in bed! When FM is this intense, exercises MUST be tailored accordingly – like starting out with exercises that can be done in bed! Initially, you may only be able to exercise for one to two minutes, but slowly, your tolerance will improve! Here are some “steps” that one may consider for implementing exercise into the FM sufferer’s lifestyle.

 

STEP 1: POSITIVE ATTITUDE: It’s easier said than done to have a “positive attitude” about anything, much less exercise when FM has its grip on you! In fact, depression is a BIG problem with most FM patients. Both studies and experience have shown that exercise is one of the most effective ways to treat FM. This is because exercise benefits ALL of our bodily functions from the brain to the heart, lungs, muscle/joints, and gut! It even benefits symptoms like fatigue, depression, and sleep problems. It helps bone density, improves balance, increases strength, controls weight, and reduces stress! As one FM patient said, “…this may be the last thing you feel like doing, but you have to believe that it really does help.”

 

STEP 2: START SLOWLY: Just like training for a marathon, you DON’T begin with a ten-mile run! You have to increase the distance and pace gradually. With FM, a person needs to steadily work into exercise because the post-exercise pain (that you should expect initially) may scare them away from continuing and/or make them even more hesitant about trying it again. Consider an initial one-to-two minute routine and gradually add more time and distance to that, ramping up the intensity and duration of exercise over time! Remember, it may take 15 weeks to reach a 30-minute goal of treadmill walking, elliptical use, or swimming. Consider taking stairs, doing household chores, grocery shopping, and gardening/yard work as part of your fitness routine. It doesn’t have to be a formal exercise program!

 

STEP 3: LISTEN TO YOUR BODY: Even if you were very active before FM entered your life, you must learn not push it beyond the “reasonable boundaries” of your usual activity tolerance. Take breaks when necessary and closely monitor how you feel. Your goal is to AVOID FRUSTRATION by NOT over-exercising! Keep track of what you do and how you feel so that you can refer back to such information when needed.

 

STEP 4: EXERCISE DAILY: Make it a point to walk. Walk the dog (or your neighbor’s), take the stairs, park further away from stores, and INCLUDE these activities as part of your workout! When you say, “I worked out today,” you don’t have to explain yourself to everyone! Consider cycling, walking/running, low-impact yoga or Palates classes, or light weight-lifting. A local gym or class may be a perfect match for what you are looking for!

 

STEP 5: MODIFY THE WORKOUT: Mix it up so it’s not boring! Figure out when you feel best and exercise then. For many FM patients, this is between 10am and 3pm. Include some stretches, balance tasks, vary the stride and/or speed, ease into strength training, pace yourself, and rest when needed.

 

STEP 6: BE PATIENT: This cannot be overemphasized as it’s easy to get frustrated. It can take up to six months before the FM patient may start to feel a change in their symptoms! Patiently work towards realistic goals – Exercise is the #1 best long-term FM treatment method!

 

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

 

YOU MAY BE A CANDIDATE FOR CHIROPRACTIC CARE FOR FIBROMYALGIA! FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

The “TOP 10” FACTS of Fibromyalgia!

29 Sep

What are the ten most important attributes of fibromyalgia (FM)? Let’s take a look!

  1. FM definition: It’s characterized by widespread muscular pain and tenderness (in all four of the body’s quadrants) that’s NOT caused by inflammation or joint damage.
  2. FM can be primary or secondary: Secondary FM is caused by something else (often after trauma) in association with another disorder like rheumatoid arthritis (RA), irritable bowel syndrome (IBS), lupus, chronic fatigue syndrome, and more. Primary FM has no known association with another condition.
  3. FM is OFTEN chronic: Because FM is diagnosed by EXCLUDING other conditions, it’s often left undiagnosed for years! To further complicate this, when a person has a diagnosed condition such as Lyme disease, RA, etc., those conditions get all the attention and FM is left undiagnosed. In fact, the National Fibromyalgia Association reports that it takes about an average of five years to get an accurate diagnosis of FM!
  4. Sleep & Chronic Fatigue: A reported 90% of FM patients suffer from severe fatigue or a sleep disorder. Non-restorative sleep contributes significantly to fatigue and poor cognitive function, and is a hallmark of FM making it an important problem to address in treatment.
  5. FM Symptoms are many: Headache, IBS, memory problems, TMD (jaw pain), pelvic pain, noise-light-temperature sensitivities, restless leg syndrome (RLS), depression, and anxiety are ALL associated issues with FM (more reasons for a delayed diagnosis and treatment challenges)!
  6. FM includes both physical and psychological aspects: One study of 307 FM patients followed over an eleven-year time frame found that 33% had severe physical and psychological problems, another 1/3 had mild issues with both, and the last third had only mild physical symptoms.
  7. FM is HIGHLY VARIABLE: With the widespread pain, variable disability rates, variable physical and psychological aspects (see #6 above), and symptom/condition variability (see #5 above), a treatment approach to manage FM must be individualized! There is no “recipe” for managing FM!
  8. FM Tests: There are none! Diagnosing FM relies on the patient’s history of widespread pain and associated disabilities more than the physical exam, blood tests, and x-rays which are used to help “rule-out” other disorders.
  9. FM Treatment: The “best” management strategies for FM include a multi-disciplinary “team” of providers including primary care (medications), chiropractic (manual therapy, nutrition, exercise training), clinical psychology (depression/anxiety management), and other forms of treatment such as massage therapy, acupuncture, and meditation / relaxation therapy. Programs that are individualized work the best! The patient MUST BE an active participant who is willing to do the work!
  10. “Stats” about FM: First of all, it’s common! It affects women more than men, and about 2-4% of the population overall. What is left out of the stats is the intensity of symptoms, how well each patient responds to the different management strategies, and the patient’s coping skills with this chronic, sometimes totally disabling condition (see #6 above). Other “facts” about FM include: increased “substance P” (a chemical that increases nerve sensitivity), decreased blood flow to the thalamus (brain), hormone imbalances, low levels of serotonin and tryptophan, and abnormal cytokine function….and more!

REMEMBER as stated in #9, the “team” approach yields the BEST RESULTS!

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!