Fibromyalgia doesn’t have to rule your life. Coordinated care from a team of experts can help you take charge of this chronic pain condition.
“People often think, ‘the more I hurt, the sicker I am.’ But the pain is caused by an increased sensitivity to pain signals, and today there is much we can do to help control that kind of pain,” says Cleveland Clinic rheumatologist Carmen Gota, MD, who heads the Fibromyalgia Clinic.
Shared symptoms vary for each person
The pain associated with fibromyalgia varies widely — both on a day-to-day basis and among patients. These symptoms are shared by millions of people with fibromyalgia to varying degree:
- Pain all over, sometimes targeting the neck and shoulders, at night, in the morning and with prolonged inactivity
- Insomnia and restless sleep
- Stiffness on awakening
In addition, fibromyalgia patients often have other chronic conditions, including:
- Mood disorders such as depression or anxiety
- Medical problems such as irritable bowel syndrome, headache or urinary difficulties
The cause of fibromyalgia is unknown. Often a traumatic stressful event, such as loss of a loved one, can trigger the condition. Women develop fibromyalgia much more often than men.
“Psychologists can empower people to control their pain, instead of letting pain control their day and their lives.”
Addressing the whole person
“At Cleveland Clinic, we try to look at the whole patient and tailor treatment to the individual,” says Dr. Gota. Coordinated care by a team, including a rheumatologist, behavioral therapist, physical therapist and, if needed, an occupational therapist, is most effective. Care involves:
Medications. Rheumatologists can prescribe medications to lessen pain. These drugs, often called antidepressants, have been in use for decades — not only for the treatment of depression, but also for conditions such as neuropathic pain and sleep disorders.
“While three drugs are now approved by the U.S. Food and Drug Administration for the treatment of fibromyalgia, rheumatologists use many others in the same category with similar benefits,” notes Dr. Gota.
Physical therapy. Patients are often afraid to exercise because they hurt more after they move. But exercise raises the level of endorphins, which improve sleep, memory and mood. Exercise also improves brain function and gives patients control over their own bodies. Physical therapists will tailor an exercise program for each patient.
“Fibromyalgia pain can worsen when people try to do too much. Guidance from a physical therapist can show them how to gradually increase their exercise levels,” says Dr. Gota.
Behavioral therapy. Because emotional stress and emotional responses to pain tend to worsen symptoms, it’s important to include a behavioral health specialist on the team. Cleveland Clinic psychologists from the Pain Management Program also work with Fibromyalgia Clinic patients. They understand what triggers each patient’s stress and can identify the pattern of response to pain.
“Psychologists can empower people to control their pain, instead of letting pain control their day and their lives,” says Dr. Gota. They help patients:
- Learn to put pain in its proper perspective
- Practice mindful meditation
- Use relaxation techniques in times of stress
If pain begins to interfere with work, patients can see an occupational therapist to improve manual skills. “This helps them feel better and more productive at work,” says Dr. Gota.
The bottom line: There is hope if you have fibromyalgia — especially with a team of experts behind you.