Article on Managing Chronic Pain by Karen Lee Richards

How I Manage My Chronic Pain, by Patient Expert Karen Lee Richards ProHealth.com by Karen Lee Richards July 14, 2010 Karen Lee Richards is Lead Expert specializing in Fibromyalgia and ME/CFS, for HealthCentral's ChronicPainConnection.com. She is a co-founder of the National Fibromyalgia Association, a former Executive Editor of the NFA's FibromyalgiaAWARE magazine, and a long-time contributing writer for ProHealth.com. ____________________ “Over the years, I have gradually found a number of things that have helped improve many of my symptoms. The key is, I don't stop trying.” -Karen Lee Richards I am often asked, “What is the best treatment for fibromyalgia?” or “What is the best pain medication?” I wish there was an easy answer. The truth is, we are all very different, particularly when it comes to medications and alternative treatments. What works very well for me may not work at all for you – or may even cause adverse reactions. Each of us has to embark on our own personal journey to discover what works best for us. One thing I can tell you is that I've never talked with anyone who has successfully managed fibromyalgia or any other chronic pain condition just by taking medication. It pretty much always takes a combination of medication, complementary therapies and lifestyle adjustments. Even though we each have to find our own individualized treatment plan, there is value in learning what has worked for someone else because it just might work for you, too. Generally speaking, treatments that are considered to be effective will usually work for about 30% to 40% of the people who have that particular condition. I know firsthand how frustrating it is to try one treatment after another and nothing seems to work. But don't give up. Eventually you will begin to find things that will help. In the end, it's worth going through some trial and error to find the treatment combination that works best for you. What Works for Me I have lived with chronic pain from fibromyalgia and ME/CFS for more than 20 years. Over those years, I have gradually found a number of things that have helped improve many of my symptoms. The key is, I don't stop trying. In fact, in just the last few months I've discovered two new weapons to add to my treatment arsenal. Following are the medications, therapies and lifestyle changes that have made a difference for me. 1.  Medication For the first seven years, I lived with ever-increasing pain while doctors told me it was stress and I was “just getting older.” During that period of time, I took massive doses of ibuprofen, which we now know to be very dangerous. Once I was finally diagnosed with fibromyalgia, my doctor suggested I try tramadol. That turned out to be a huge blessing for me. For the first time in years, my pain levels were down enough that I could function fairly well most of the time - and I even had some periods of time that were pain free! Since that time, three new medications have been approved for the treatment of fibromyalgia, but I have continued to take the tramadol. My philosophy has been, “If it ain't broke, don't fix it.” Tramadol still works well for me and I see no reason to take a chance on something new that may not work as well and may have unpleasant side effects. For the past couple of years, my doctor has also been giving me a prescription of Lortab® to have on hand for breakthrough pain. I generally only take it once or twice a month, when my pain level is up and I have to go somewhere or have a project due. 2.  Complementary Therapies A wide range of complementary therapies may help improve pain and other symptoms of fibromyalgia and ME/CFS. I've heard from people who have found things like massage therapy, yoga, biofeedback, hypnosis, and even bee-sting therapy to be helpful. For me, three complementary treatments have been the most effective: Myofascial Release Therapy – I learned about MRT about 12 years ago. It is similar to massage therapy but much more gentle. Basically, the therapist gently manipulates and loosens your body's constricted fascia, which helps release muscle spasms and ease pain. When I first started MRT, I was walking with a cane. Two months later, I laid my cane down and haven't picked it up since. MRT did a lot to reduce my pain and help my body move and function better. You can read more about MRT here:  “Myofascial Release Therapy” Acupuncture – Acupuncture came into my life about eight years ago when my MRT therapist decided to go back to school to study it. While acupuncture is certainly beneficial for pain, the two areas where I noticed the greatest differences were irritable bowel syndrome and sleep. Except for an occasional flare, my IBS is pretty much under control. Prior to acupuncture, I could never sleep more than an hour and a half to two hours at a time without medication. After starting acupuncture, I could usually sleep for one four-hour stretch, followed by two or three two-hour segments without medication. Here is more information on acupuncture: “Acupuncture” Supplements – I've only been taking supplements on a regular basis for about a year. My most recent find in the supplement world is CoQ10. I've been amazed at how much my energy level has increased since starting it. I take three 100 mg softgels of Ubiquinol (the most usable form of CoQ10) each day. Other supplements I've found helpful for FM and ME/CFS symptoms are vitamin D3 for pain, vitamin B-12 for energy, and acidophilus pearls for digestive health. I'm still experimenting with one new supplement at a time to see what else might prove to be beneficial.   3.  Move/Stretch One of the most important things I've learned is that I need to move as much as possible. Sitting or lying in one position for too long will cause my muscles to stiffen and significantly increase my pain. I try to do a few simple stretches several times a day. If I'm having a particularly bad day, just standing up and doing a few full-body stretches can make a big difference. Exercise can be a tricky thing for FM and ME/CFS patients – especially for those like me who have both illnesses. Fibromyalgia patients are taught that exercise is an essential component of any treatment program, but overexertion can send ME/CFS patients into a tailspin. It's hard to know what you should do. For me, short walks - even just walking through my house - and frequent stretches with plenty of rest breaks in between seems to work best. 4.  Breathe Breathing may sound like an odd “treatment” but I've found that most of us who have FM and/or ME/CFS tend to hold our breath a lot without even realizing it.  I'm not sure why. Perhaps because it's somewhat natural to hold your breath when you feel pain. The problem is, shallow breathing and holding your breath will actually cause your body to be more tense and increase your pain. As strange as it may sound, I try to remind myself to breathe several times a day. I've found that taking several good, deep breaths can help relax me and ease the pain a little. You can learn more about how to breathe properly here: “The Importance of Breathing Properly” 5.  Distraction I learned a long time ago that the more I think about and focus on my pain, the worse it seems to get. So I try to always keep my mind occupied with something else. Following are some of my favorite distractions: Help Others – The more I focus on trying to help others with their problems, the less I think about my own. I spend quite a bit of time each day answering questions and writing articles trying to help others find ways to better cope with their health problems. ProHealth's Message Board is a good place to connect with, help and encourage others: http://www.prohealth.com/blog/index.cfm Laugh – The old saying, “Laughter is the best medicine” has a lot of truth to it. Research has shown that laughter has positive physiological effects on us like reducing pain, stimulating the immune system and improving brain function. Because of that, I regularly record a variety of comedy shows and movies so I always have something funny to watch if I'm having a rough day. Mental Activities – Since I enjoy working with words, I spend some of my free time each day doing crossword puzzles or playing electronic games like Scrabble. Not only do they keep my mind occupied, but I feel like they help improve my cognitive functioning and keep fibro fog at bay. 6.  Sleepwear Three months ago I would never have dreamed that I would be listing sleepwear as a method for coping with chronic pain. But then Goodnighties came into my life. I was invited to become a “Jammie Tester” for a new product line of what was called “recovery sleepwear.” The fabric is infused with negative ions, which are known to have many positive effects like increasing serotonin and melatonin levels, increasing blood flow and oxygen to the brain, and helping us reach REM sleep more quickly. Much to my surprise, I find that since I began wearing Goodnighties to bed every night, I fall asleep more quickly, sleep for five to six hour stretches and awake feeling refreshed – something I hadn't experienced for more than 20 years. On top of sleeping better, the hip and low-back pain I have been plagued with for years is gone. Needless to say, this new sleepwear has become a key component of my treatment protocol. You can read my full review of Goodnighties here: “Goodnighties Recovery Sleepwear: A Product Review” In Summary It's taken me 20 years to put together what I feel is a pretty effective treatment plan for myself. No, I'm not “cured,” and I still have some bad days. But I have a good life and many more good days than bad, which is a drastic improvement. I hope at least a few of the things that have helped me will help you as well. ___ Note: This information has not been evaluated by the FDA. It is general and anecdotal, and is not intended to prevent, diagnose, treat or cure any illness, condition, or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.