Is it all in my head?

[kazadela]

I was diagnosed with FM seven years ago by a rheumatologist. My pain has gradually got worse and my gp has sent me to a new type of pain clinic. The first meeting didnt go well , the doctor told me I don't have FM it doesn't exist. He said its my body is craving opiates so turns up the pain signals when it needs a fix. He said throw away all my meds and go cold turkey as they are poisoning my body. Even though bits of what he said makes sense I'm in pain and its real. I've managed to cut down to just 1 tramadol aday but my life is awful I can hardly do a thing. I am a cardiac nurse on restricted duties coz of FM but if I don't get help soon I'm gonna have to quit. Any suggestions what to do ?

[Wendy Green]

Hi Kazadela,

To go to a pain clinic because you have fibromyalgia, only to be told by the doctor that it doesn't exist must have been upsetting to say the least! I don't know where this doctor has been for the past few years because fibromyalgia has been recognised as a legitimate condition for quite some time!

Although I disagree that you should go 'cold turkey' I think it's not a good idea not to take too many painkillers - so perhaps the doctor had a point there. However, you can't be expected to just throw away your painkillers if you are still in pain.

I would recommend trying to manage your symptoms through lifestyle changes - namely by taking regular moderate aerobic exercise such as walking, yoga and swimming and by following a healthy balanced diet; focus on eating oily fish, lean proteins, low-fat dairy foods, whole grains, nuts and seeds and fresh fruit and vegetables to improve your overall health.

You might also consider taking one or two supplements. The supplements that have been shown to help fibromyalgia the most are vitamin B complex, vitamin D, 5-HTP, magnesium and malic acid and red Montmorency cherries.

Taking vitamin B complex has been shown to cut homocysteine levels - high levels of which have been associated with fibromyalgia. Vitamin B complex is believed to help reduce pain, fatigue and insomnia as well as boost mood.

Too little vitamin D has been linked to chronic pain conditions like fibromyalgia. Many people in the UK are short of vitamin D because our main source is sunlight on the skin. The recommended daily dose is around 30mcg (1,200IU).

5-HTP is thought to ease pain and improve mood by increasing serotonin levels (Tramadol is thought to do the same thing, but with side effects), it's also thought to clear 'fibro-fog'. Low levels of serotonin have been associated with fibromyalgia.

200mg of magnesium twice daily, combined with 1,200mg of malic acid once daily, is claimed to help to ease pain, tenderness and fatigue. BioCare Magnesium Malate would be a good supplement to try. You can buy it here http://www.biocare.co.uk/default.aspx?G ... Guid=26190

Studies suggest Red Montmorency cherries, grown in North America can help ease fibromyalgia pain and improve sleep. They are rich in antioxidants which have an anti-inflammatory pain-relieving effect, as well as the 'sleep hormone' melatonin. You can buy CherryActive Concentrate (juice) at most large supermarkets; CherryActive Capsules and CherryActive Dried Montmorency Cherries are also available.
For more details go to http://www.cherryactive.co.uk

You may also want to try capsaicin gel, a topical treatment made from chillis which has been shown to reduce tenderness and improve grip strength. I know it's available on prescription for arthritis, so I'd assume your GP could prescribe it for fibromyalgia.

To check whether or not it's worth continuing a supplement rate your pain and other symptoms from 0-10 before starting to take it, then rate them again after three months, to see if there's an improvement.

Finally, whilst it's good to remain active with fibromyalgia, try not to overdo things; make sure you pace yourself when doing physical tasks and always try to rest whenever you feel tired. Also, you may benefit from practising meditation, deep breathing, or muscle relaxation exercises, to help you relieve tension and relax.

I hope these tips help you to reduce the amount of pain you suffer, so that at some point you CAN cope without painkillers.

Best wishes,

Wendy

[Adam Eason]

Whether an issue is in someone's head or not, they are still experiencing it and it is real for you. I can understand that this would be frustrating to hear.

There is potentially some value in looking at psychological interventions too. Many sufferers have a firm, and 'invested-in' belief system that can fuel many of the symptoms being experienced. Likewise ongoing problematic cognitions can advance suffering in a number of ways.

I think in addition to the valuable advice already given, you may like to consider how your ongoing psychology may help you advance and enhance your current and future treatment.

Best wishes, Adam.