Bend and Stretch – Brazilian Style

Exercise is an important part of managing fibromyalgia symptoms. Studies since the 1970s have shown that exercise can benefit patients. Staying physically active can relieve pain, stress, and anxiety. A key question left unanswered was the benefits of specific types of exercise.

Researchers at the University of São Paulo show that stretching improves patients’ physical functioning and quality of life, while resistance training helps combat depression, “Muscle stretching exercises and resistance training in fibromyalgia: which is better? A three-arm randomized controlled trial” published in the European Journal of Physical and Rehabilitation Medicine.

Because movement can increase fibromyalgia’s pain, many patients develop an inactive lifestyle. But in the long run, this can lead to both physical injury and emotional distress.

The study consisted of 44 women, aged 30 to 55. Researchers randomly assigned them to a stretching group, a resistance training group; or, a control group.

The stretching group went through a 12-week supervised training program. Twice a week they would take 40-minute stretching sessions without a therapist’s assistance. The trainers increased the intensity of the workouts over time.

Trainers put the resistance group through a similar 12-week, twice-a-week program. The patients did eight repetitions of resistance exercises, adding more weight each week.

The control group received standard fibromyalgia treatment but no exercise.

At the end of the 12 weeks, those in the stretching group were able to endure pain better and showed significant improvement in symptoms and quality of life. The resistance training group showed both physical and symptom improvements.

Analysis indicated that stretching significantly improved patients’ ability to deal with pain and to function better physically, while the biggest of resistance training was reducing patients’ depression.

The controls had the highest morning-fatigue and stiffness scores of the three groups, and the lowest score for vitality.

Researchers concluded that stretching had the biggest impact on patients’ quality of life, while resistance training had the biggest impact on fibromyalgia symptoms and on patients’ physical functioning, vitality, social interaction, and mental health.

“The muscle stretching exercise program was the most effective modality in improving quality of life, especially physical functioning and pain, and resistance training was the most effective modality in reducing depression,” the team wrote.

The key is to start slowly.

Round 2 – It’s a Knock Out.


boxing-pills-supplements-sports-05102011Remember I just wrote about a current study run by Daiichi Sankyo, a Japanese drug company?

Have another look – see that I wrote about the drug trial underway in the U.S and Canada?

Guess what? I found out some more information!

The study is also recruiting in:

  • Campse and Coffs Harbour, NSW, Australia;
  • Maroochydore, Sherwood and Southport, Queensland, Australia;
  • Hobart, Tasmania, Australia;
  • Malvern East, Victoria, Australia;
  • Tallin and Tartu, Estonia;
  • Baldone, Jekabpils, Liepaja, Ogre and Riga, Latvia;
  • Auckland, Hamilton, Nelson, Tauranga and Wellington, New Zealand;
  • Banska Bystrica, Bratislava and Dubnica Nad Vahom, Slovakia; and,
  • Reading, Berkshire; Chesterfield, Derbyshire; Wellingborough, Northamptonshire: Atherstone, Warwickshire; and
    Belfast, United Kingdom.

Good luck, if you’ll be trying to get in.


It Can’t Hurt to Ask

The Australian Parliament is asking for public submissions into chronic disease prevention and management in primary health care.  This is our opportunity to write to them and ask them to fund research into Fibromyalgia and cater for patients who require home care, visits and support from medical professionals.

Despite an estimated one million Australians living with Fibromyalgia, there is limited services, support and information available. The gaps between research and daily care are unacceptable.

Now is the time to ask the Federal Government to provide:

  1. Leadership and coordination of a national approach to provide integrated management of Fibromyalgia services, building on the work of state governments, private sector providers, Medicare Locals and Local Hospital Networks.
  2. Access to quality services for all Fibromyalgia sufferers including people in rural, regional and remote areas, indigenous and socio-economically disadvantaged communities, children, and older Australians.
  3. Access to education and training for health professionals in particular as it relates to early intervention, multidisciplinary team practice and the early identification of Fibromyalgia.
  4. A public awareness campaign to address discrimination, misunderstanding and stigmatisation of people with pain within the community, including in the workplace and in welfare and compensation systems.
  5. Funding to provide community support services including consumer information, self-management education and telephone support (crisis help line).
  6. The development of a national research agenda to address gaps in knowledge about Fibromyalgia and improve clinical practice in pain management.

The deadline for submissions is Friday, 31 July 2015.

Please make a submission if you can.




No-No to Nana Naps

According to a study published in BMC Musculoskeletal Disorders, when patients with FM nap during the day to cope with their symptoms, their symptom severity may actually increase. 75. good in bedA team of researchers from New Zealand, United Kingdom, The Netherlands, and Germany gathered data from an online questionnaire and noticed that frequent and longer naps taken during the day corresponded to greater symptom severity.

“Given the common use of daytime napping in people with fibromyalgia, evidence-based guidelines on the use of daytime napping in people with chronic pain are urgently needed,” stated the authors.

198. tiredThe questionnaire gathered data on age, sex, and other population descriptors, as well as measures to assess daytime napping behaviour. From this data, the researchers divided the patients into two categories: those who regularly napped and those who napped less frequently than once a day. The majority of daily nappers did so during the afternoon without meaning to take a nap. Only 22.5% of participants indicated that they plan their daytime naps. Generally, patients nap because they are tired or exhausted, do not feel well, need to make up for a bad night’s sleep, have a headache, or are experiencing pain.

FYI: Younger patients napped more than older patients during the day, both in frequency and in duration.

Although napping makes patients feel better at the time, this study suggests that overall symptom severity may worsen as naps become longer and more frequent.


You Could Have Asked Me…

New findings published in Arthritis & Rheumatology, a journal of the American College of Rheumatology (ACR), suggest that brain abnormalities in response to non-painful sensory stimulation may cause the hypersensitivity (increased unpleasantness) that patients experience in response to (‘normally’ non-painful) daily visual, auditory and tactile stimulation.

According to the study, patients reported increased unpleasantness in response to multi-sensory stimulation in daily life activities. Furthermore, the fMRI images displayed reduced activation of both the primary and secondary visual and auditory areas of the brain, and increased activation to visual, auditory and tactile stimulation that patients reported to experience in daily life.

191. broken wing

Lead study author, Dr Marina López-Solà from the Institute of Cognitive Science, University of Colorado Boulder said, “Our study provides new evidence that fibromyalgia patients display altered central processing in response to multi-sensory stimulation, which are linked to core fibromyalgia symptoms and may be part of the disease pathology. The finding of reduced cortical activation in the visual and auditory brain areas that were associated with patient pain complaints may offer novel targets for neuro-stimulation treatments in fibromyalgia patients.”


Did the Earth Move for You, Too?

According to recent study findings by Anthony S. Kaleth, PhD, associate professor at the School of Physical Education and Tourism Management, Indiana University-Purdue University Indianapolis, whole-body vibration exercise effectively reduced the severity of pain in patients with fibromyalgia.

146. best exerciseBUT it is not entirely clear whether these improvements were the result of added vibration or just the effects of being more active.

24 women with FM were randomly assigned to either 8 weeks of twice-weekly, lower-body, progressive-resistance exercise with whole-body vibration or an attention control group. Whole-body vibration involved patients standing, sitting or laying on a vibrating platform to induce alternating muscle contraction and relaxation.

Patients were assessed at baseline and at 8-week follow-up for fibromyalgia-related physical function, pain severity and muscle strength.

The researchers found a significant improvement in pain severity among patients in the whole-body vibration group compared with controls, but the magnitude of muscular strength improvement was not different between groups.


Music is the Strongest Form of Magic

musicA music therapist will use music to facilitate behavioural changes, by allowing patients to use a variety of musical instruments. Then, the therapist will engage in discussions about the patient’s musical interaction, allowing the patient to express his/her feelings with the aid of musical interaction. The main aim of music therapy is to determine how patients respond emotionally to music, and improve cognitive functioning and quality of life.

How Does This Apply to Fibromyalgia

Researchers examined the effects of music therapy on fibromyalgia, and found that music therapy, combined with relaxation techniques, reduced pain and depression, along with improving sleep for fibromyalgia patients.

music 2If music is able to reduce muscle tension, then possibly the muscle pain experienced in fibromyalgia may decrease. Additionally, if music interventions do decrease the release of stress hormones, then most of the emotional and anxiety symptoms of fibromyalgia may decrease. There is also evidence that music improves mood and stress, and it may also increase one’s immunity.

Sixty FM patients were assigned to either a music group or a control group. The participants of the music group listened to music (duh!) daily for 4 weeks, and were assigned to listen to two types of music. They were also taught relaxation techniques, and the combination of relaxation techniques and music therapy significantly decreased pain intensity and improved quality of life. After 4 weeks, participants of the music intervention group reported a significant decrease in their pain levels, while participants of the control group experienced no change in pain and/or quality of life.

Researchers state that musical interventions decrease cortisol and endorphins, which are markers of the hypothalamic-pituitary-adrenal axis (responsible for release of stress hormones), along with decreasing levels of cortisol, prolactin, ACTH, growth hormone, and norepinephrine levels. Music initiates brain responses that reduce muscle tension, heart rate, and skin conductance.

The researchers greatly recommend the combination of music and relaxation for FM patients. However, the efficacy of this combination depends on the patient’s dedication and willpower to be involved in the treatment.

BUT what if our overly sensitized brains can’t even handle music? (Personally) Give me silence any day…ssshhhh!

from Effects of Music Therapy on Fibromyalgia

Fibromyalgia: The Stigma and the Truth

Printed from Washington Post Communities Digital News
Written by Paul Mountjoy

WASHINGTON- January 24, 2014—Those suffering from fibromyalgia syndrome (FMS) now have undeniable proof that their illness is not psychogenic or psychosomatic (in the mind), thanks to a plethora of new and current findings from the most respected medical research facilities in the U.S.A.

After years of being ignored and told that it was all in their minds, like individuals suffering from obesity before them, FMS sufferers are finally getting the acknowledgment they deserve.

Denied the recognition, compassion and disability benefits they so desperately needed, until recent research emerged, FMS sufferers were subjected to skepticism by family members, employers, friends and the legal profession. Even many primary care physicians turned a deaf ear to FMS sufferers.

Isolated and trapped into forced silence by negative reactions to their ailment, FMS victims were often overcome by fear of asking medical practitioners to address their symptoms and fear of asking family members for help in their day-to-day lives.

The disdain suffered by many with FMS exacerbated the depression they were already experiencing as a result of the condition.

The general confusion surrounding FMS among the medical and other professions may lie in the syndrome’s etiology, the cause or set of causes that gives rise to a disease or condition. Currently, research has been unable to identify a single, specific cause that leads to FMS; instead, FMS appears to have multiple sources of causation.

FMS and Obesity: A Comparison

The attitudes toward FMS are analogous to traditional attitudes toward obesity.

Historically, it was believed that those who were overweight were lazy overeaters with poor self-control. Friends, family and healthcare professionals advised more exercise and less food.  While poor diet and inadequate exercise are the predominant reasons for body weight issues, hundreds of thousands of overweight people are as active as their slimmer counterparts, and in many cases eat less.

Fortunately for some with ‘metabolic syndrome’ —the medical term used to describe patients with weight problems—medical research has finally produced answers.  The good news is that in many cases weight problems and obesity arise form a genetic disorder that makes the condition difficult if not impossible to overcome. Dr. Jeremy Cooke maintains there are individuals so genetically predisposed to obesity that they may never lose or keep weight off.

The bad news is that obesity may not be closely linked to individual lifestyle and dietary choices, which can make many individuals’ life-long battle with weight issues a war without victory.  Even for those who do not have a genetic predisposition to having weight problems, being overweight may be attributed to factors other than laziness and overeating. Prolonged increased levels of stress, which cause the release of certain hormones from the hypothalamic-pituitary-adrenal axis, for example, can cause metabolic syndrome.

Aging, genetics, accumulation of stress hormones, sleep issues and several other factors not related to activity or diet can also cause metabolic syndrome. These in turn may lead to diabetes, coronary issues, high blood pressure, chronic pain, depression, stress and a host of other related health problems.

Thanks to the identification of metabolic syndrome as a disease, however, sufferers are no longer called lazy, inactive or just plain “fat” by friends, family, and the medical profession.

Before obesity was identified as a legitimate disease, the emotionally pervasive level of frustration felt by those suffering from it was similar to what victims of FMS are currently experiencing.

There are a number of other similarities between FMS and metabolic syndrome. A single cause has not been identified for either FMS or metabolic syndrome, and it is believed that there are several if not many causes that lead to both syndromes. The resulting symptoms of both are extensive and varied, and the effect of both on health is severe, undeniable and not psychogenic.

FMS as a Syndrome

”Syndrome” is defined as a group of symptoms that consistently occur together or a condition characterized by a set of associated symptoms that cause an abnormal physiological condition. This definition is the hallmark of FMS.

The causes of FMS range from sleep issues, to central nervous system damage, peripheral nervous system problems, hormonal imbalances and serotonin concerns, all of which may have serious implications.

For example, central nervous system damage may arise from injury, causing disrupted pain processing. Peripheral nervous system problems such as blocked AV shunts can cause an array of pain and body temperature problems. Hormonal imbalances involve hypothalamus-pituitary and thyroid gland functions, and serotonin problems include poor production and inhibited serotonin reuptake.

A variety of treatments are available for FMS, yet each treatment must be individualized to address its particular causes. For example, serotonin may be a primary factor for some patients’ FMS, while endocrine system imbalance or injury may the primary cause for others. For this reason, one single specific treatment is not appropriate to treat all forms of FMS.

Int Fibro

Fibromyalgia Mystery Solved (Again!?!)

So, I was sent a link to an article which once again extolled the virtues of the FM mystery’s latest research:

66. Invisible IllnessResearchers have found the main source of pain in FM patients, and contrary to what many believe, it does not stem from the brain. The findings mark the end of a decades-old mystery about the disease, which many doctors believed was conjured in patients’ imaginations. Up until recently, many physicians thought that the disease was “imaginary” or psychological, but scientists have now revealed that the main source of pain stems from a most unlikely place – excess blood vessels in the hand.

The discovery may lead to new treatments and perhaps even a total cure in the future (?) To solve the mystery, researchers zeroed in on the skin from the hand of one patient who had a lack of the sensory nerve fibres, causing a reduced reaction to pain. They then took skin samples from the hands of FM patients and were surprised to find an extremely excessive amount of a particular type of nerve fibre called arteriole-venule (AV) shunts.

Up until this point scientists had thought that these fibres were only responsible for regulating blood flow, and did not play any role in pain sensation, but now they’ve discovered that there is a direct link between these nerves and the widespread body pain that we feel.

The breakthrough also could solve the lingering question of why many sufferers have extremely painful hands as well as other “tender points” throughout the body, and why cold weather seems to aggravate the symptoms.

In addition to feeling widespread deep tissue pain, most of us also suffer from debilitating fatigue.

Neuroscientist Dr Frank L. Rice explained: “We previously thought that these nerve endings were only involved in regulating blood flow at a subconscious level, yet here we had evidences that the blood vessel endings could also contribute to our conscious sense of touch… and also pain,” Rice said. “This mismanaged blood flow could be the source of muscular pain and achiness, and the sense of fatigue which are thought to be due to a build-up of lactic acid and low levels of inflammation. This, in turn, could contribute to the hyperactivity in the brain.”

216. capsulesCurrent treatments for the disease have not brought complete relief to the millions of sufferers. Therapies include narcotic pain medicines; anti-seizure drugs, anti-depressants and even simple advice such as “get more sleep and exercise regularly.”

Now that the cause has been pinpointed, patients are looking forward to an eventual cure. Others expressed frustration about how much they had suffered already: “When are they ever going to figure out that things are never “all in your head?” said one commenter.

“Whenever something doesn’t fit in their tiny little understanding, they belittle the patient and tell them they are crazy. People have suffered through this since they were invented. Prescribing SSRIs for everything is not the answer any more than a lobotomy or hysterectomy was.”

The announcement has the potential to unlock better future treatments and undoubtedly has patients all over the world rejoicing that the mystery of Fibromyalgia has finally been solved.

So…how many times have they solved(?) this mystery so far?

A Fine Line Between Pleasure and Pain

New research indicates that a disruption of brain signals for pleasure and pain contributes to increased pain sensitivity, known as hyperalgesia, in FM patients.

Results published in Arthritis & Rheumatism, a journal of the American College of Rheumatology, suggest that this altered brain processing might contribute to widespread pain and lack of response to opioid therapy in such patients.

“In patients with fibromyalgia there is an alteration in the central nervous system pain processing and a poor response to topical pain treatments, trigger point injections and opioids,” said lead author Dr Marco Loggia from Massachusetts General Hospital and Harvard Medical School in Boston. “Our study examines the disruption of brain function involved in the individual experience of pain anticipation and pain relief.”

For this study, the research team enrolled 31 patients with fibromyalgia and 14 healthy controls. Functional magnetic resonance imaging (MRI) and cuff pressure pain stimuli on the leg were performed on all subjects. During the MRI, participants received visual cues alerting them of impending pain onset (pain anticipation) and pain offset (relief anticipation).

brain_3Results show that during pain anticipation and relief, FM patients displayed less robust response within brain regions involved in sensory, affective, cognitive and pain regulating processes. The ventral tegmental area (VTA)—a group of neurons in the centre of the brain involved in the processing of reward and punishment—displayed activation during pain anticipation and stimulation, but deactivation during anticipation of relief in healthy controls. In contrast, VTA responses during periods of pain, and anticipation of pain and relief, in FM patients were significantly reduced or inhibited.

Dr Loggia concludes, “Our findings suggest that fibromyalgia patients exhibit altered brain responses to punishing and rewarding events, such as expectancy of pain and relief of pain. These observations may contribute to explain the heightened sensitivity to pain, as well as the lack of effectiveness of pain medications such as opioids, observed in these patients. Future studies should further investigate the neurochemical basis underlying these dysfunctions.”