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Exercise Can Help Ease the Discomfort of Fibromyalgia: Up to 10 million Americans suffer widespread pain from the condition, along with other symptoms.

Fibromyalgia affects up to 10 million Americans, according to the National Fibromyalgia Association. Widespread pain is a characteristic of the condition, along with tender points that hurt if pressure is applied, fatigue, and headaches. Fibromyalgia also is associated with depression, poor sleep, problems with thinking and memory, and digestive conditions such as irritable bowel syndrome. If you suffer from fibromyalgia, exercise may help--and recent research points to tai chi as particularly effective.

Women More Susceptible It isn't clear what causes fibromyalgia, but research suggests it may result from an imbalance of brain chemicals that causes the brain to experience pain more intensely. "Over time, this phenomenon renders the brain more sensitive to pain that most people would consider relatively minor," says David Thomas, MD, PhD, professor of medicine and rehabilitation medicine at Mount Sinai.

Fibromyalgia tends to be more prevalent in women, though men can also develop it. "There seems to be a genetic predisposition to the condition," Dr. Thomas notes. "It also is more likely in people with sleep disorders like restless legs syndrome, and in those with autoimmune conditions like rheumatoid arthritis and systemic lupus erythematosus, although fibromyalgia itself is not classified as an autoimmune condition." Traumatic emotional events (for example, a car accident), repetitive joint injuries, illness, and obesity are also believed to raise the risk of fibromyalgia.

Difficult to Diagnose Fibromyalgia symptoms typically appear first in middle age, but the incidence of the disorder increases with age--about 8 percent of people aged 80 and older meet the American College of Rheumatology classification of fibromyalgia. Since the symptoms of fibromyalgia are vague and occur with other health conditions, it often takes a long time for fibromyalgia to be diagnosed. At one point, doctors relied on the presence of tender points to guide their diagnosis, but the American College of Rheumatology now recommends consideration of three criteria:

* Pain and symptoms over the previous week, based on the total number of painful areas out of 19 parts of the body, plus the level of severity of fatigue, waking feeling unrefreshed, cognitive (memory or thought) problems, and the number of other general physical symptoms.

* Symptoms having lasted for at least three months at a similar level.

* No other health problem that might explain the symptoms.

Tai Chi Helpful Although you may not feel like doing exercise if you have fibromyalgia, it is one of the best therapies for easing symptoms. The study we reference (BMJ, March 21) evaluated how effective tai chi was at helping fibromyalgia patients cope. The study included 226 participants who had suffered from fibromyalgia for an average of nine years. They were randomized to take part in twice-weekly supervised aerobics sessions or tai chi (one session each week for a period of 12 weeks, or two sessions per week for 24 weeks). At the end of follow-up, participants completed a standard questionnaire that assesses fibromyalgia patient status. Those who had practiced tai chi had better pain scores than those who had taken part in the aerobics sessions, but their scores didn't reach the estimated minimal clinically important difference of 8.1 points when compared with aerobics. However, those who had done tai chi twice a week for 24 weeks had the lowest pain scores: a 16.2 difference from the aerobics group. Another follow-up, at one year, found an 11-point difference in scores between the high-intensity tai chi group and the aerobics group. Medication usage (including opioids) declined in both groups during the study.

Dr. Thomas says that tai chi is the perfect form of exercise for fibromyalgia sufferers because it is low-impact, meaning it shouldn't aggravate muscle discomfort in the way that high-impact exercise might. "Tai chi involves slow, controlled movements that build muscle strength and flexibility," he explains. "Plus, tai chi is a 'mind-body exercise that focuses on deep breathing and relaxation. Its meditative component means that it may help alleviate the stress and anxiety that typically accompany fibromyalgia."

Other Therapies Other non-drug therapies that may ease the discomfort of fibromyalgia include cognitive behavioral therapy and mindfulness, which can help you learn how to manage pain. "Many people also gain relief from acupuncture and gentle massage," Dr. Thomas adds. When it comes to drug treatment, anti-seizure medications such as gabapentin (Neurontin) and pregabalin (Lyrica) inhibit the activity of nerve cells involved in the transmission of pain. Antidepressants also can help, and may result in better sleep. "If you think you have depression due to fibromyalgia, don't suffer in silence," Dr. Thomas adds. "Seek help from your doctor. Depression can cause potentially severe complications, but is a treatable illness."

WHAT YOU CAN DO

* Reduce your stress levels by avoiding stressful situations as much as you can, and practicing stress-management techniques like deep breathing and meditation.

* Get enough sleep to counteract the fatigue that characterizes fibromyalgia.

* Exercise regularly Stick to low-impact exercise, like walking, cycling and swimming.

* Maintain an overall healthy lifestyle by eating a nutritious diet.

Caption: Fibromyalgia causes widespread pain that can affect your emotional as well as physical wellbeing.
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Title Annotation:PAIN MANAGEMENT
Publication:Focus on Healthy Aging
Date:Sep 1, 2018
Words:836
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