The following is an expanded excerpt from the book, Taking Charge of Fibromyalgia
The course of fibromyalgia varies from one person to another and is characterized by remissions and flare-ups of symptoms. A remission is defined as a period when one's symptoms are greatly diminished or even absent. Remissions can last for days, weeks, months; . snd even years, often differing from one time to another. A flareup of symptoms can -often be associated with weather changes, stress, interrupted sleep; depresssions, postural strain, illnesses, or even catching the flu. Sometimes a flare-up can't be attributed to anything we're able to identify and can contribute to a feeling of frustration and lack of control over our health.
It is extremely important for the patient to feel in control of flare-ups, as the increase in pain, cognitive symptoms, and overall symptoms of ill health can cause an increase in anxiety, depression, and hopelessness, and a vicious cycle may develop. When this occurs, some patients may try to cope by frantically calling their physician for help. Others may feel it is useless to try to help themselves and will succumb to the flare by isolating themselves. Once you find yourself in this position, it is often too late and too difficult to decrease flare symptoms once you are well into it. It is much more effective to have a plan to deal with flare-ups before they begin so you can initiate your flare-up management techniques immediately without having to feel anxious, depressed, or hopeless about your symptoms.
You may find it helpful to work with your physician or health care provider to develop options which you can utilize quickly. You and your physician can determine which steps you can take to reduce symptoms or shorten the length of a flare. If you determine that extra medication is needed for a short time until symptoms subside, maybe a phone call to the nurse will be all that is needed to get a prescription filled. Or perhaps a few visits to your physical therapist could be issued, if that works for you. It is important for you, as the patient, to be able to verbalize to your health care professional what works for you as each patient responds differently to different therapies. There are certain options which work for many patients, and you can explore these with your health care professional.
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Remove or-change a modulating factor, if possible.
Eliminate or reduce repetitive stress (i.e., typing at a keyboard, sitting/standing in one position for extended periods of time, continuous repetition of any muscular movement).
Treat other illnesses as they occur; not all symptoms are related to fibromyalgia.
Correct posture; change your work height at your desk; consider getting a lumbar pillow.
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Evaluate sleep and discuss other medication options with your physician.
A different medication may be used or the dosage of a current medication may be increased.
A sleeping medication may be added.
Pain medication may be. used for a short time to improve sleep quality.
Improve sleep environment; snoring spouses, crying babies, even pets, can interfere with sleep.
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Relaxation/Biofeedback
Use relaxation techniques which can be easily learned from commercially available audiotapes. Some of these tapes include guided imagery which transports you to a peaceful area such as a beach or garden and then guides you through images which are designed to produce muscular and mind relaxation.
Use/learn biofeedback techniques to help you to relax more quickly, decrease muscle tension, and reduce pain.
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Rest and be gentle to yourself.
Take frequent breaks from activity.
Cancel unnecessary appointments.
Give yourself permission to take care of your health.
Try to make activities of daily living as easy as possible.
Take a nap and/or try to get more sleep at night.
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Reduce stress level.
Identify major stressors and eliminate or modify them where you can.
Alter your perception of the stress whether it is emotional or physical.
Journal your thoughts. By writing down your thoughts, feelings, hopes, fears, and concerns, you may develop a greater insight, gain a new direction, solve a problem, get in touch with your feelings, and/or engage in a rich dialogue with yourself.
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Heat/Analgesics
Utilize warm baths, whirlpools, or cold packs. Use topical creams, such as those containing eapsaicin (i.e., Zostrix) or those containing prescription pain relievers. Short-term use of over-the-counter pain relievers can be helpful.
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Massage/Acupressure/Acupuncture
Use self-massage tools which you should already have at home. Several sessions of physical therapy may be prescribed.
See a massage therapist.
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Gentle stretching
Increase stretching to ease those kinks and knots. (Try applying heat beforehand.)
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Decrease duration and intensity of exercise.
This is not a time to increase exercise; listen to your body for signals.
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Positive messages
It's easy to feel discouraged, but try repeating these self-affirming messages: "I'm doing everything necessary to feel better."
"This flare will be over soon." "I can cope, I can cope."
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Get extra support during these times from a friend or counselor who understands your illness and will listen to you.
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Flare-ups are part of living with fibromyalgia. Though they can be frustrating, discouraging, and uncomfortable, remember you can help yourself through them by utilizing these strategies. It is important to keep telling yourself that this, too, will pass as flares always do.
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