Five little words we women hope we'll never hear again in a doctor's office: It's all in your head. Yet that's exactly what was heard for decades when women reported experiencing widespread pain lasting months and accompanied by sleep disturbances, headache, even mood and memory issues.
Angela Roberts, who saw her share of doctors over the years as she desperately sought a diagnosis for her chronic pain and fatigue, is one of 540,000 adults in Canada trying to cope with this complex yet invisible disability. Chances are, when their doctors did not know what to say or do, some of these people felt defeated and dismissed. Today, that chronic pain condition has not only been given a name but is finally recognized as a legitimate medical condition: Fibromyalgia.
The chronic pain syndrome increases with age and is considerably higher among women than men. Although it is not yet entirely understood, experts now believe that it may be linked to stressful or traumatic physical events such as car accidents or repetitive injuries. Other research is examining its genetic components, potential environmental triggers, and how deficiencies in the hypothalaic-pituitary axis contribute to its development.
Fibromyalgia affects mood and research has also focused on the link between fibromyalgia and depression and fatigue. These affect not only those suffering with the condition but also those around them. One study done by researchers at the University of Missouri found that individuals with fibromyalgia were almost three times more depressed than their spouses. The healthy spouses reported increased levels of marriage instability and said that it was difficult to watch their spouses experience chronic pain.
There is no apparent cure, but there are treatment strategies. For instance, women who exercise regularly have less of a risk of fibromyalgia, and among those who have the condition, regular everyday exercise such as walking, taking the stairs, or even gardening can bring some relief. The problem is that when you have fibromyalgia you can hardly get up off the couch to move. The I-must-exercise-but-am-too-tired-and-in-pain cycle can be a vicious one.
But Angela Roberts found help through a unique program run by Southlake Regional Health Centre in Newmarket, Ontario. That program run by an inter-professional team including rheumatologists, physiotherapists, and social workers covered exercise techniques, medication options, and problem-solving skills to help sufferers attain empowerment and increased emotional well-being -- things that Roberts felt she lost over the years of trying to understand and cope with her illness.
Roberts got the support she needed to re-gain her confidence. Now a patient ambassador for the program, she hopes to raise awareness so that people living with the illness won't feel so isolated: "We have to get over this negative stigma attached to fibromyalgia and just realize that everybody has a bag of hammers, and this is just ours," she concludes.
Toronto naturopath Dr. Louise McCrindle says that fibromyalgia overlaps with various fields including sleep dysfunction, chronic pain and depression. In her view, however, depression does not cause fibromyalgia because "it's normal to be depressed when you have such an isolating and debilitating condition."
Dr. McCrindle, together with Dr. Alison Bested, medical director of the Complex Chronic Diseases Program at BC Women's Hospital in Vancouver, British Columbia, offer common-sense tools to help fibromyalgia patients to improve their quality of life in their book The Complete Fibromyalgia Health, Diet Guide & Cookbook.
Why diet? Diet can have a definite impact, says Dr. McCrindle: "Most of our patients also present with digestive symptoms. A lot of them are not absorbing their nutrients well, so it is important to try to improve their nutrient status." Fibromyalgia is also an inflammatory condition, she says: "In the blood of fibromyalgia patients, inflammation markers are elevated. If you eat more regularly and in a balanced way, if you eat protein and anti-inflammatory foods, you are stabilizing your blood sugars." The anti-fibromyalgia anti-inflammatory diet is balanced, high in protein, low in carbs, organic and Omega-3 rich.
Fibromyalgia cannot be diagnosed by any lab test, but simple blood tests can rule out other possibilities such as hypothyroidism or autoimmune disease. "One of the most debilitating aspects of the condition outside the pain is brain fog," says Dr. McCrindle. "There is often cognitive impairment, memory loss, trouble concentrating, problems in completing tasks." The difference between fibromyalgia and chronic fatigue can be confusing, she admits: "But chronic fatigue is a pathological fatigue with a viral history. Chronic fatigue does not have the pain associated with fibromyalgia."
But just how is it diagnosed? Because not all fibromyalgia patients will see specialists such as a rheumatologist, primary care physicians can now consult the 2012 Canadian Fibromyalgia Guidelines at www.fmguidelines.ca, written to help patients and their health care providers navigate fibromyalgia's murky waters. But according to Montreal Dr. Mary-Ann Fitzcharles, in the absence of abnormal results from laboratory tests, "clinicians must rely on the time-honoured art of medicine to diagnose fibromyalgia."
In a review published last spring in the Canadian Medical Association Journal, Dr. Fitzcharles, Research Institute of the McGill University Health Centre, and her co-authors note that until we know more, "skepticism about the condition will remain." Adds Dr. McCrindle: "There is no magic bullet. It's a slow and steady approach to return to wellness. Regardless of conventional or alternative medicine, you have to go one step at a time to let your body heal."
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The beginner-friendly cat pose is a great way to relieve tension in the spine, shoulders and neck, and to boost circulation in the upper body. Begin with your hands and knees on the floor in a tabletop position, and gently round the spine up as you exhale. On the inhale, return to a neutral spine. "You're moving up all the way through the spine and spreading the disks, which can get compressed from all the sitting that we do at computers and driving," Anderson said. "Compression can put pressure on the nerves that go up through the spine."
Try "eagle arms" when you feel a tension headache coming on -- this modified version of the Eagle Pose, performed either standing in Mountain Pose or sitting cross-legged, relieves upper body tension without the difficulty level of the full pose. "This is really good for releasing tension in the shoulders," says Anderson. "When we twist the arms, there's a flexibility. By holding it, we're stabilizing the whole shoulder area."
Take a load off and boost circulation with a calming forward bend. Recommended by Yoga Journal for helping a distracted mind unwind, the pose is performed by sitting on the floor with the legs straight in front of you and feet flexed. Bend forward at the waist and reach the arms straight ahead, relaxing into the pose while keeping the knees straight. "The reason for the forward bend is that we take a lot of pressure of the heart," says Anderson. "The heart has to work very hard to pump blood and oxygen into the brain and upper body. When you do a forward bend, the blood that tends to pool is going in the opposite direction and it moves up towards the brain." Anderson notes that if you have glaucoma, a herniated disk or heart problems, consult your doctor before doing forward bends.
In yoga, we're often told to return to child's pose when we need a break, and this pose can be just as helpful outside the studio. Child's pose -- the fundamental resting pose of many yoga practices -- can also be a powerful remedy for stress, anxiety and headaches. It helps to quiet the mind while releasing tension from the back and shoulders. "In this pose, we drop the shoulders and release the tension," says Anderson. "The breath is directed towards the back, so the back is expanding. That's driving the oxygen up the spine, and into the back of the neck and the shoulders."
Legs Up The Wall, a restorative inversion posture, also tops our list of the best yoga poses for anxiety. The feel-good pose helps to quiet the mind and reduce fatigue -- two factors which can make a big difference in preventing and reducing the impact of headaches, says Anderson. "The legs are going up, and again what we're doing is reversing gravity," says Anderson.
You can try this restorative pose by bringing the knees up to the chest and holding the shins about two inches under the knee. Relax in the pose for 30-60 seconds, and then release down. Repeat as needed. "In a tuck pose... you're loosening the muscles up the back," says Anderson. "Then when you let go, there's a rush of blood throughout the body."
Spinal twists are dynamic poses that awaken many parts of the body, stimulating the digestive system and energizing the spine, according to Yoga Journal. Performed with the bottom leg either bent or straight, the top knee is bent and crossed over. Extend the opposite arm to the outside of the leg and gently twist the back. Repeat on the other side. "Anything with a lower back twist is good because it's kind of releasing," says Anderson.
The Head to Knee Pose is a forward bend variation that can help boost blood flow and release tension. Bend the left leg in a 90-degree angle and extend the right leg. Lift the arms up and then bend over the extended leg and reach for the toes. Hold for 60 seconds and then repeat with the left leg extended. "When you're in the forward bend, if you can also be very quiet and breathe and feel the energy flow, you can feel the flush to your face and your skin and neck," says Anderson.
Savasana, the final pose of most yoga practices, is all about quieting the mind and completely relaxing the body -- which can be hugely helpful in easing tension headaches. You can completely let go in this pose if you close your eyes, says Anderson. "The individual has an opportunity to really come back in and focus on relieving the tension in the body through breathing,"she says
Try a calming breathing exercise to release tension in the shoulders and bring more oxygen into the brain. Sitting cross-legged, draw the shoulders up as high as you can towards your ears as you take a long inhale. And on the exhale, drop the shoulders all the way down. Repeat three to five times, or more if needed. "If you do that for about a minute, you're really going to feel a real release of tension," says Anderson. "There's a tightening of the muscles pulling that fresh blood and oxygen up, and then a release with the breath that pushes it all away and releases it up into the head and neck area."
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