What you need to know about fibromyalgia treatment
Fibromyalgia is one of the most common chronic pain conditions, and in general, fibromyalgia treatment is incredibly personalized and it takes a whole person approach. Fibromyalgia feels like pain or tenderness that is very sensitive to the touch, can happen just about anywhere throughout the body, and lasts days, weeks, months, or longer. Fibromyalgia is considered to be a “pain regulation” or “neurosensory” disorder because people with fibromyalgia seem to experience more pain and a higher intensity of pain than others, even under gentle pressure. This is thought to be because the brain becomes more sensitive to pain. Fibromyalgia pain can come and go throughout the body in “flares” and it often occurs along with stiffness, fatigue, “fibro fog,” and mental health issues. It can sometimes feel debilitating and cause a lot of distress.
In the U.S., it’s estimated that up to 7.7 percent of women and 4.9 percent of men experience fibromyalgia. These rates are higher than in Europe or South America.
Researchers still don’t know exactly what causes fibromyalgia, but it does not seem to be the result of physical damage to the bones, joints, or muscles. The pain may be triggered and worsened by infections, injury, inflammation, or emotional stress. Fibromyalgia tends to occur in families, however no specific genes have yet been found that predispose someone to getting it. There are many potential underlying factors that contribute to fibromyalgia, including trauma (both physical and emotional), previous infections, gut dysbiosis (imbalance in the gut bacteria), chronic infections, mycotoxin or heavy metal exposures, SIBO, other chronic or autoimmune conditions, and more. Again, fibromyalgia is not a one-size-fits-all and the underlying cause is dependent on the person. It’s usually an accumulation of many things that lead to the onset.
TYPICAL SYMPTOMS OF FIBROMYALGIA
Some of the most common symptoms of fibromyalgia include:
Pain or tenderness in the muscles, soft tissues, and/or bones throughout the body (muscle pain, joint pain), including the arms, legs, head, chest, abdomen, back, and buttocks
Numbness or tingling in the arms and legs
Fatigue, inability to get a good night’s sleep, restless leg syndrome, feeling stiff upon waking up
“Fibro fog” (memory problems, confusion, inability to pay close attention or concentrate)
Headaches (migraines, tension headaches)
Pain in the face or jaw, temporomandibular joint (TMJ) syndrome
Increased sensitivity to light, odors, noise, and temperature
Mental health issues (anxiety, depression)
Gut/GI/Gastrointestinal issues (bloating, constipation, IBS, GERD, difficulty swallowing)
Painful menstrual periods
Overactive bladder, pelvic pain
The risk for fibromyalgia is higher in people who experience other conditions such as chronic back pain, lupus, polymyalgia rheumatica, spondyloarthritis, osteoarthritis, inflammatory myopathy, systemic inflammatory arthropathies, hypothyroidism, endometriosis, and IBS (irritable bowel syndrome). It is also possible to experience several of these at the same time. Fibromyalgia is difficult to diagnose because there isn’t a definitive test for it, however your doctor will likely do a physical exam and medical tests to try to determine which of these you may be experiencing.
NUTRITION AND FITNESS STRATEGIES TO AID FIBROMYALGIA TREATMENT
There are many things that you can do to help alleviate these symptoms and reduce the impact of fibromyalgia on your life. The first thing is to know that even though it’s difficult to diagnose and doesn’t have a definitive test, fibromyalgia is a real disease and research is being done to try to better understand and eventually cure it.
While there isn’t a cure just yet, there are ways to manage fibromyalgia symptoms and self-care plays an important role in reducing its impact. According to the American College of Rheumatology, “patient self-care is vital to improving symptoms and daily function. In concert with medical treatment, healthy lifestyle behaviors can reduce pain, increase sleep quality, lessen fatigue, and help you cope better with fibromyalgia.”
While more research is underway, physical exercise is currently considered to be the most effective treatment for fibromyalgia. Cardiovascular fitness training (“cardio”) can ease symptoms by helping with pain and improving sleep. Ideally, doing 30 minutes of cardio three times each week is recommended. Low-impact exercises like walking, biking, stretching, yoga, tai chi, and water-based exercises are helpful. If regular exercise is new for you or feels like a lot, simply start low and go slow to create a comfortable routine. It may take time to build up your endurance and the intensity of physical activity that you can do.
Eating a healthy and nutritious diet is also highly recommended. While there currently isn’t a huge amount of strong evidence to recommend one specific dietary strategy to help with fibromyalgia symptoms, a few small studies show promising results for the following nutrition recommendations:
If you are low in vitamin D, taking a supplement can help reduce fibromyalgia pain. A quality vitamin D3 supplement is crucial, but specific amounts will depend on the individual
Additional supplements that may help include Chlorella green algae, Coenzyme Q10, acetyl-L-carnitine, magnesium, iron, vitamins C and E, probiotics, N-acetyl Cysteine or liposomal glutathione, and Nigella sativa (Black cumin) seeds.
Different types of elimination diets have helped different people, such as the vegetarian diet (eliminates meat, poultry, and fish), vegan diet (eliminates all animal products including dairy and eggs), the low FODMAP diet (reduces intake of short-chain carbohydrates that are fermentable oligo-di-mono-saccharides and polyols), a low calorie diet (reduces calorie intake), gluten-free diet (eliminates the protein gluten), or a diet free from both MSG (monosodium glutamate) and aspartame (an artificial sweetener). A more tailored/specific elimination diet can be extremely beneficial for those struggling with fibromyalgia. An example of a more tailored elimination diet is the MRT/LEAP test and protocol. This is lab test that I am specifically trained in and it can help pinpoint specific food sensitivities that many general elimination diets cannot. Schedule a free consultation with me to learn more CLICK HERE!
The Mediterranean diet has been shown to decrease fatigue and improve moods.
The replacement of some foods may also help, including replacing non-olive oil fats with olive oil and replacing non-ancient grains with ancient grains such as Khorasan wheat.
Utilizing specific testing to strategize a nutrition plan such as:
Comprehensive Stool Analysis
Organic Acids test
MRT Food Sensitivity test
This is a long list of potential dietary strategies and more research is needed. Because many of these should not be combined together, it’s wise to approach these dietary changes cautiously and work with a credentialed, master’s level dietitian that also specializes in integrative and functional nutrition. You want a healthcare professional who is knowledgeable in dealing with your symptoms and can work with you to choose the best path forward.
LIFESTYLE STRATEGIES TO AID FIBROMYALGIA TREATMENT
Improving sleep patterns and sleep hygiene can also be very helpful if you’re dealing with fibromyalgia. For example, try to go to bed and wake up at the same time each day and limit stimulants like caffeine and nicotine as much as possible, especially in the evenings. Establish a relaxing nightly routine that may include reduced screen time, dimmed lights, soft music, meditation, and a warm bath. Also, keep your bedroom comfortable for sleeping by keeping it dark, quiet, and cool. If you suspect you may have a sleep disorder such as sleep apnea, reach out to your healthcare provider.
Managing stress and moods can also help relieve symptoms. If you experience symptoms of fibromyalgia, pace yourself and balance your need to work and rest by taking breaks when necessary. Also, make time to relax each day and try deep breathing, progressive muscle relaxation, mindfulness, and stress reduction techniques. If you feel lonely or isolated, consider joining a support group that you find to be positive and encouraging—one that shares helpful coping techniques. Cognitive behavioral therapy (with a therapist or counselor) may help by focusing on how thoughts and behaviors affect pain and other symptoms. If you have any mental health concerns such as anxiety or depression, seek out professional help.
If necessary, consider reaching out to your healthcare provider about prescription medications that can help with fibromyalgia.
FINAL THOUGHTS
Fibromyalgia is a complex condition of chronic widespread pain. It’s thought to result from the brain becoming more sensitive to pain signals, as if even a small signal becomes amplified and feels much stronger. In addition to the pain, people with fibromyalgia tend to also have difficulty sleeping and experience fatigue, stiffness, changing moods, and “fibro fog.”
The American College of Rheumatology recommends that you “look forward, not backward. Focus on what you need to do to get better, not what caused your illness.” Self-care is the mainstay for improving symptoms of fibromyalgia. Current research suggests that the most effective treatment is physical activity. In addition to that, there are several dietary and lifestyle strategies that can help, including certain diets and supplements, improving sleep, and managing stress.
Now that you know there are fitness, nutrition, and lifestyle strategies you can use to help manage fibromyalgia symptoms, if you’re looking for support in making these changes, schedule a free consultation with me by CLICKING HERE.
Not only am I a registered dietitian who specializes in integrative and functional nutrition, but I am also fibromyalgia warrior myself. I was diagnosed with fibromyalgia at 19 years old and am aware of just how debilitating flares can be. It’s my mission to help others along in their fibromyalgia journey reduce their flares and help them thrive and truly live and enjoy life again.
REFERENCES
American College of Rheumatology. (2021, December). Fibromyalgia fast facts. https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Fibromyalgia
Bhargava, J. & Hurley, J. A. (2021, October 13). Fibromyalgia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. https://www.ncbi.nlm.nih.gov/books/NBK540974/
Lowry, E., Marley, J., McVeigh, J. G., McSorley, E., Allsopp, P., & Kerr, D. (2020). Dietary Interventions in the Management of Fibromyalgia: A Systematic Review and Best-Evidence Synthesis. Nutrients, 12(9), 2664. https://doi.org/10.3390/nu12092664
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551150/
Mayo Clinic. (2020, February 18). Fibromyalgia pain: Options for coping. https://www.mayoclinic.org/diseases-conditions/fibromyalgia/in-depth/fibromyalgia-pain/ART-20047867?p=1
MedlinePlus. (2021, October 20). Fibromyalgia. https://medlineplus.gov/fibromyalgia.html
National Center for Complementary and Integrative Health. (2016, May). Fibromyalgia: In depth. https://www.nccih.nih.gov/health/fibromyalgia-in-depth
National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2021, June). Fibromyalgia. https://www.niams.nih.gov/health-topics/fibromyalgia
National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2021, June). Fibromyalgia: Diagnosis, treatment, & steps to take. https://www.niams.nih.gov/health-topics/fibromyalgia/diagnosis-treatment-and-steps-to-take
Pagliai, G., Giangrandi, I., Dinu, M., Sofi, F., & Colombini, B. (2020). Nutritional Interventions in the Management of Fibromyalgia Syndrome. Nutrients, 12(9), 2525. https://doi.org/10.3390/nu12092525
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551285/
Silva, A. R., Bernardo, A., Costa, J., Cardoso, A., Santos, P., de Mesquita, M. F., Vaz Patto, J., Moreira, P., Silva, M. L., & Padrão, P. (2019). Dietary interventions in fibromyalgia: a systematic review. Annals of medicine, 51(sup1), 2–14.
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