Where, oh Where…?

So, I’ve spent most of the day looking at current research and trying to find something to write about; BUT it’s all so BLAH!

203. acupunctureYes, acupuncture has been found to help those suffering from FM – where’s the new information in that?

Yes, marijuana has been shown to help those suffering from FM – where’s the new information in that?

Yes, dysmenorrhea is especially common in FM – where’s the new information in that?

Obesity, tai-chi, hydrotherapy,  shiatsu, reflexology, yoga – it’s all the same…there is nothing new!

I’ve kept reading, checking Facebook, watching tweets and I can’t find anything! And, obviously, I have done nothing else to tell you about. So, I’m setting you a mission: can you find (somewhere, anywhere) something new about FM?

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Related Articles:

Good Vibrations

Vibration can help reduce some types of pain, including pain from FM, by more than 40 per cent, according to a new study published online in the European Journal of Pain.


When high-frequency vibrations from an instrument were applied to painful areas, pain signals may have been prevented from travelling to the central nervous system, explains Roland Staud, MD, professor of rheumatology and clinical immunology in the University of Florida College of Medicine in Gainesville.

If you think of a pain impulse having to travel through a gate to cause discomfort, the vibrations are closing that gate. “When the gate is open, you feel the pain from the stimulus. It goes to the spinal cord. When you apply vibration you close the gate partially,” says Dr Staud. You can still feel some pain, but less than you would have felt without the vibrations, he adds.

Subjects were split into 3 groups: 29 had FM, 19 had chronic neck and back pain and 28 didn’t have any pain at all. Dr Staud and his research team applied about five seconds of heat to introduce pain to each participant’s arms and followed that with five seconds of vibrations from an electric instrument that emits high-frequency vibrations that are absorbed by skin and deep tissue.

A biothesiometer

A biothesiometer

Dr Staud used a biothesiometer, an electric vibrator (not THAT kind of vibrator – get your mind out of the gutter!) with a plastic foot plate that can be brought into contact with the patient’s skin.

Compact TENS

Compact TENS

Similarly, you could buy/borrow a Transcutaneous Electrical Nerve Stimulator (TENS), which is a medical device, designed specifically for the purpose of assisting in the treatment and management of chronic and acute pain; and it does exactly what Dr Staud is suggesting. I am currently borrowing a compact TENS machine. The pulse rate is adjustable from 1-200 Hz.

Following the use of heat and vibration, patients were asked to rate the intensity of their pain on a 0-to-10 scale and found that the experimental pain, as opposed to their chronic pain, was reduced by more than 40 per cent with the use of vibration. What was of particular interest was that the patients in the study with FM appeared to have the same mechanisms in their body to block or inhibit pain through the use of vibration as those in the pain-free group.

“Fibromyalgia patients are often said to have insufficient pain mechanisms, which means they can’t regulate their pain as well as regular individuals. This study showed that in comparison to normal controls, they could control their pain as well,” Dr Staud explains.

What they don’t know is how long the pain relieving effects will last.

I used the TENS on my arms two days ago and the pain has not returned (yet! Knock on wood!) If I choose to buy it, it will cost me $175.00 from www.tensaustralia.com.au

Dr Howard, a rheumatologist and director of Arthritis Health in Scottsdale, Ariz., says this study is still very interesting. “Vibration is another way of minimizing pain, and it sounded like it would be more helpful for regional or local pain rather than widespread pain,” he says.

Dr Staud says this theory is still very much in the testing stages and the vibrating instrument used in this study isn’t available to the public. “Although we didn’t test it, I think that the size of the foot plate of the biothesiometer is relevant. I wouldn’t suggest that everybody should go out and by any vibrator to use for pain relief. But pending a commercial product this is entirely feasible,” he explains.

Until then, Dr Staud’s message for patients is that vibration involves touch, and that can provide pain relief.

Dr Howard agrees that this study reinforces the importance of touch therapy, like massage, and even movement therapy, like gentle exercise, for people with chronic pain.

“When you have pain, you want to stop what you’re doing and protect the area. But for some types of pain that’s not the right thing to do,” Dr Howard says.

You do, however, need to know what types of pain touch is good for and for which ones it isn’t. Dr Howard says his general rule is to baby your joints and bully your muscles.

“Fibromyalgia patients often shrink away from touch therapy and movement. The foundation of treatment is to use movement and touch and stimulus to help with their pain, but their natural reaction is to withdraw and avoid tactile activity. Don’t be afraid. Don’t avoid it,” Dr Howard says.

Good forms of touch therapy include massage and the use of temperature – both hot and cold. Good forms of movement therapy include tai chi, yoga and swimming/warm water exercising.

 

Risk Free Tai Chi

I have previously told you about my experience with Tai Chi – I go to a modified class for Arthritis, held by the Arthritis Foundation. We practice a modified Sun tai chi, which has 12 forms (this info is just so you can understand the next part).

Clinical Rheumatology reported, on May 13 2012, that the Oregon Health & Science University’s Fibromyalgia Research Unit held a randomized controlled trial of 8-form Tai chi to gauge any improvement in symptoms and functional mobility in fibromyalgia patients.

Previous researchers have found that 10-form Tai chi yields symptomatic benefit in patients with FM. The purpose of this study was to further investigate earlier findings and add a focus on functional mobility.

Participants met in small groups twice weekly for 90 minutes over 12 weeks.

Of the 101 randomly assigned subjects, clinically and statistically significant improvements were seen in:

  • pain severity
  • pain interference
  • sleep, and
  • self-efficacy for pain control

No adverse events were noted.

Accordingly, the study reported that tai chi appears to be a safe and an acceptable exercise modality that may be useful as adjunctive therapy in the management of FM patients. Yippee! Tai chi class on Wednesday is still on!

A Balanced Body

Ahh…BodyBalance:

BODYBALANCE™ is the Yoga, Tai Chi, Pilates workout that builds flexibility and strength and leaves you feeling centred and calm. Controlled breathing, concentration and a carefully structured series of stretches, moves and poses to music create a holistic workout that brings the body into a state of harmony and balance.

The class started with a tai-chi warm-up…cool – I can handle that! Then, into some of the yoga moves that I had done previously. When we hit the downward dog,

I had to dodge Mommy’s dirty looks – what the hell have you gotten me into? Down into the plank – if looks could kill!

The Plank!

And onto the mat for the yucky part – pilates core workout! Guess what? I still haven’t developed any stomach muscles (ummm…and it seems neither has Mommy!) More yoga, some flowing tai chi and finishing with a 10 minute meditation to clear the mind.

(I haven’t gone into great detail because the class was definitely, as promised, a fusion of all three other classes: yoga, pilates and tai-chi as described in previous posts).

I must say that the final meditation was very much appreciated, as I dripped sweat onto my mat and waited to be scraped from the floor.

Earlier in the day, Mommy and I went to visit the doctor (rheumatologist #3). I tried to motivate him with the promise of fame, fortune and untold riches (He could be the One! The One who could show empathy! The One who could publish numerous journal articles! The One that all FM patients would seek!) Erm…it seems he wasn’t interested.

So, the plan is:

  1. maintain Lyrica dosage – 150 mg am & pm (til step 6);
  2. stop taking the Prednisolone (no weaning as I was only on it for a week);
  3. visit GP on Friday to start weaning off Sertraline (anti-depressant actually being used for depression) over the week;
  4. no anti-depressant for one week (should be some interesting posts that week!);
  5. start Cymbalta (until we find correct dose for my depression);
  6. reduce morning dose Lyrica;
  7. reduce evening dose Lyrica.

Of course, steps 6 and 7 will only be attempted if necessary; and step 5 may take quite a while. If at any stage, I find that everything feels better, then I’ll be leaving it as is. I have a follow-up appointment with Rheumatologist #3 in 3 months.

So it looks like it’s up to me and Mommy (and my poor GP – she doesn’t know yet! with as much input from you guys as you feel like giving) to discover the secret (at least, the one that works for me) behind managing the pain, fatigue and fog and returning to work.

Moving Meditation

Alarm had to wake me today –three times. Ankles and wrists feel like they’ve swollen to about 5 times their size (that’s another thing I hate – I feel swollen without any visible swollen-ness!) with really, really tight manacles holding me down on the bed.

But I had to get up as it was my first class of Tai Chi for Arthritis (beginners).  Tai Chi is an ancient practice proven to reduce pain and improve your mental and physical well-being. In 1997, Dr Paul Lam, a family physician and tai chi expert, worked with a team of tai chi and medical specialists to create the Tai Chi for Arthritis program. The special features of this unique program are that it is easy to learn, enjoyable, and provides many health benefits in a relatively short period of time.

So lesson one: Tai Chi for Arthritis is based on Sun style tai chi (pronounced “soon” as in– I will soon be learning tai chi!). This style was chosen because of its healing component, its unique Qigong (an exercise which improves relaxation and vital energy), and its ability to improve mobility and balance. The program contains a carefully constructed set of warming-up and cooling-down exercises, Qigong breathing exercises, a Basic Core six movements, an Advanced Extension six movements, and adaptations of the movements so you can use a chair for balance, or even sit on the chair for the entire class. Also incorporated into the program is a safe and effective teaching system.

Medical studies have shown that practicing this program reduces pain significantly, prevents falls for the elderly, and improves many aspects of health. For these reasons, Arthritis Foundations around the world have supported the program. And that’s why I’m at Arthritis Victoria today…they also provide the cheapest classes (and I received an added discount due to hardship!)

Supposedly, tai chi will help you:

  • Reduce stress
  • Increase balance and flexibility
  • Feel relaxed
  • Improve your overall mind, body and spirit

Tai Chi for Arthritis involves 12 movements or positions that are designed to be safe and beneficial for people with arthritis. Instructors of the program are trained to understand arthritis and ensure the movements are safe for participants. Tai Chi for Arthritis classes begins with warm-up exercises (lasting about 10 minutes) where you start at your head and move all the way down to your ankles. Each joint has two exercises, to reduce the chance of injury during the movements.

The leader then demonstrates and teaches one or two movements per lesson, encouraging us to learn the movements properly and slowly, working within your comfort limits. This week, we started with the Single Whip and Wave Hand in Cloud.

Single Whip

I start with my feet in a duck position (outward facing) and my hands by my side. Slowly lift your wrists, straight out and up, like two helium balloons are attached, up to shoulder height. the slowly lower them.  Then, while stepping forward with your right leg (heel first the toe), push your hands forward like you’re handing a ball to someone. Bring the ‘ball’ back (and your foot at the same time) to hold in front of you – then spread your arms by opening up your elbows. Allow your left hand to keep moving outwards (and slightly back) and watch it by twisting your head as far as you can go. Your right hand sort of just sits in mid-air waiting for something to do.

Ta Da! We’ve learnt our first form.

Wave Hand in the Cloud

From the position we left above, now move your left hand forward again, until it looks like you are trying to say stop. Your right hand moves beneath your left elbow – now you look like a traditional policeman trying to stop traffic. Take a step to the right, landing with your toe first followed by your heel – then wipe your right hand in front of your face, while your left hand moves to your right elbow. Remember Karate Kid? Wax on. Let your left leg move across to join your other leg (remember toe then heel) and wax off with your left hand. We do that 3 times, moving across the room. Then do it the opposite way. This is where we all get tangled up and obviously need to practice. My head doesn’t change direction that fast!

But hey! we’re doing tai chi! I think that was all the movements – at least, what I can remember from my first one hour session. It is all very slow, controlled and relaxing – just like in the movies – sort of like a moving meditation, as you’re concentrating so hard on breathing, moving hands and feet that you can’t think about anything stressful.

The lesson ends with cool-down exercises, lasting about three minutes.

I feel very calm and relaxed. But my wrists and ankles still hurt!