Behavioral measures
To treat some symptoms of fibromyalgia, such as sleep disorders, the first rule is to adequately educate the patient to avoid wrong behaviors, both in the dietary field (caffeine intake) and habitual (sleeping in the afternoon).
- Reduce stress. The patient suffering from fibromyalgia should, as far as possible, avoid or limit excessive efforts, too burdensome activities and emotional stress, allowing himself daily time to relax, without resorting to drastic changes to the usual routine.
- Improve the quality of sleep. Debilitating fatigue and easy fatigue are some of the symptoms that characterize the clinical presentation of fibromyalgia. In addition to meeting a sufficient time for night rest, it could be useful to practice habits, which allow you to optimize sleep quality, such as limiting any daytime nap, going to bed and getting up at the same time. To learn more: remedies for insomnia
- The role of physical activity. Fibromyalgia patients should be encouraged to practice regular low-impact and aerobic exercise, such as walking, swimming or cycling. About 45 minutes is enough, three times a week, to get benefits. Activity in the gym, on the other hand, has not proved to be very tolerated by patients. Initially, exercise could increase pain and fatigue, but a gradual and regular approach often decreases symptoms and progressively increases functional capacity. In general, the recommendation is to keep moving without reaching the muscle fatigue limit; in this way a counterproductive effect is avoided. A physiotherapist can support and help develop an appropriate home exercise program dedicated to the individual subject. For those who have the possibility, physical activity in thermal water is recommended, which helps a lot to relax the muscles.
- Maintain a healthy lifestyle. There is no specific diet to comply with in fibromyalgia, as there are no dietary supplements that are recommended for all patients; this does not take away from the fact that in order to combat pain and fatigue, food plays an important role. Many fibromyalgia patients have reported improvement in symptoms during low-fat diets. The food councils can therefore be summarized as follows:
- Reduce sugar, especially when refined;
- Limit consumption of red meat and prefer other sources of animal protein (fish, poultry, eggs and dairy products).
- Eat plenty of fresh seasonal fruits and vegetables, with the addition of mineral salts and vitamins.
- When patients have irritable bowel syndrome (in association with fibromyalgia), the diet must be adjusted accordingly, in order not to aggravate the symptoms.
- Reduce the use of salt and drink plenty of water.
- Limit the use of coffee and tea. Avoid spirits.
Alternative therapies
Many fibromyalgia patients resort to alternative or complementary therapies. In some cases the results on pain and muscle stiffness seem to be good, even if there are no studies evaluating their effects. Alternative therapies to reduce pain and relieve stress are not new approaches (example: meditation and yoga), but their use has become more popular in recent years, especially among people with chronic diseases, such as fibromyalgia. Many of these treatments seem to be safe, but many practices so far have not been adequately studied and their real effectiveness has yet to be demonstrated.
- Acupuncture. It consists of inserting very thin needles through the skin at various depths, in order to promote the health and well-being of the individual. According to Western theories, this practice can cause changes in blood flow and alter the levels of neurotransmitters in the brain and spinal cord, helping to increase pain tolerance. Some studies indicate that acupuncture helps alleviate the symptoms of fibromyalgia, while others show no benefit.
- Massage therapy. It involves the use of various manipulative techniques that help reduce chronic pain in the muscle or myofascial (soft tissues). Massage can reduce heart rate, relax muscles and improve range of motion in the joints. It often helps relieve stress and anxiety, while in other cases it can make the symptoms worse.
- Muscle relaxation therapy. They are techniques of psychological derivation: they act on the causes of muscular tension, reducing the neurovegetative hyperactivity at the base of fibromyalgia. The therapy is based on Schultz's autogenic training or relaxation therapy (Ericksonian techniques).
- Yoga and Tai Chi. These practices combine meditation, slow movements, deep breathing and relaxation. Both seem to be useful in controlling the symptoms of fibromyalgia.
- Meditation. It produces brain waves consistent with serenity and happiness, which help relieve anxiety.
- Electromyographic biofeedback . Using electronics to measure the body's responses to stress, biofeedback helps people control chronic pain. At least two studies have documented its effectiveness, but this method has the limit of being not very widespread, therefore mostly unknown to patients.
- Herbal remedies. Regarding the contribution of phytotherapy in the treatment of fibromyalgia, the most appropriate medicinal plants will have to be chosen from time to time, in consideration of the variability of the symptoms associated with the disease: gingko biloba (circulation activator), eleuterococco (adaptogen), hypericum and valerian (sedatives and antidepressants), boswellia, willow and devil's claw (analgesics). Ginseng, on the other hand, is not very suitable: it is an effective tonic, but in fibromyalgia it can increase muscle contractility and pain level, as well as making night rest difficult. Although there are few studies on the relationship between herbal remedies and fibromyalgia, some patients report an improvement in sleep or energy.
- Food supplements. Additional components have useful properties to reduce pain, improve the depressive state and increase the quality of sleep: 5-HTP (5-hydroxytryptophan), melatonin, L-carnitine, SAM-e (s-adenosylmethionine), B-complex vitamins, vitamin D3, malic acid and magnesium etc.
Final considerations
Fibromyalgia itself is not degenerative or fatal, but the chronic pain associated with it is persistent and debilitating. Most patients report that the symptoms do not seem to improve with time.
Although no treatment is currently defined for fibromyalgia, diagnostic criteria and treatment options for chronic pain management continue to be developed. There are also many research activities aimed at defining the disease. In recent years, much progress has been made and clinical studies have shown that patients can try to control their symptoms through various therapeutic possibilities; nevertheless, fibromyalgia remains a difficult pathological condition to sustain. Working in collaboration with competent health professions and motivated and informed fibromyalgia patients, it is desirable to continue to find a significant improvement in symptom management and quality of life.
