Fibromyalgia, more than a physical pain

back woman with fibromyalgia pain

Does she have fibromyalgia? Antonia is a 52 year old woman. She has a life without too many limitations: she works in a box, cleans the building and looks after her own home. She is a nice person, she talks with her friends and neighbors, and always with a smile . She almost never complains because she always has to go ahead, at any cost, and no matter how she feels.

But she alone knows the sacrifices she has to make on a daily basis to lead an apparently normal life. She has pain in the body, in different places, in a diffuse way. She has a lot of trouble activating in the morning because she does not rest well at night . Sometimes she gets so bad that she can not finish the dishes; she leaves the dishes full of dishwashing liquid and launches them later. Other times, she feels like she has a wooden sword stuck in her back …  Does she have fibromyalgia?

People like Antonia, who have constant pain sensations that appear for no apparent reason, may suffer from fibromyalgia. Normally, fibromyalgia syndrome is difficult to understand because the symptoms are not perceived externally. One can even believe that these people invent these pains or complain for no reason, seeking excuses not to do what they have to do. But this is not the case because their pain is real and they suffer from it.

What is fibromyalgia?

On the one hand, fibromyalgia is generally described as  chronic pain in muscles and fibrous tissue  (ligaments and tendons), that is, in the muscular and skeletal system. On the other hand, it can also be defined as  hypersensitivity to pain. Faced with stimuli that produce pain, the cerebral response gives more information, as if there is more pain than the actual pain. When the stimulus that produces pain disappears, the pain may even continue to persist.

Thus, instead of leaning for  muscle damage, research thinks it is an alteration of the central process, medullary and cerebral. This may be due to a lack of analgesic activity (fewer endogenous opiates) and changes in the main neurotransmitters associated with central sensitization (less serotonin, norepinephrine and dopamine).

In addition to pain, patients also experience other symptoms such as fatigue, sleep disturbances, paresthesia in the extremities, lack of concentration and, sometimes, emotional symptoms such as depression or anxiety. .

A stone above the body that represents the weight of fibromyalgia

woman with back pain

Fibromyalgia is a very difficult symptom to describe. No specific cause, whether biological or psychological, gave any real explanation to these pains. In any case, and fortunately, it was recognized by the World Health Organization (WHO) in 1992.

The criteria for diagnosing fibromyalgia are that the patient has generalized pain on 11 (out of 13) tender points of the body (especially in the cervical, back and joints such as elbows and knees), for more than 3 consecutive months. And it is not necessary that another pathology explains this pain.

This is how this ignored pain ended up being recognized, gaining a little more voice. This evaluation was a first step and it is very important for these people to feel more supported and able to cope better with the disease.

Fibromyalgia, is it chronic pain?

Antonia, like so many others, faced with doubts about the reason that made her feel such pain for a long time, consulted many doctors to find the cause and relieve her suffering. For a long time, despair invaded him until he was diagnosed with fibromyalgia. But that was not all: she had a hard time accepting that this pain would be chronic and that she would accompany it throughout her life.

Unfortunately, there is no specific treatment to calm the pain of fibromyalgia. Anti-inflammatories, usually used, are not effective because they do not eliminate the pain or only reduce it. It always reappears. It is important to note that  fibromyalgia is not a degenerative disease, it does not destroy the joints and does not cause irreversible damage or deformities. It is therefore necessary to demystify the false belief that suffering from this disease can lead to serious mobility problems or involve the use of a wheelchair.

Even if no specific cause or medication is found for fibromyalgia syndrome, a better quality of life can be achieved. The person can learn to take care of her so that the pain does not increase; it can, at a minimum, reduce it, or even succeed in reducing it. Change is possible.

Is it safe to continue activities or is it better to rest?

Normally, people with fibromyalgia feel the need to do a lot of activities and do not rest very much. So much so that they end up totally exhausted. They need to rest for hours and sometimes even days, because the pain they feel is so intense that it does not allow them to move.

Thus, it is not a question of linking activities or always resting. It is essential to find an intermediate point, which would change according to the person. It is very important that people who suffer from fibromyalgia learn to regulate their pace of activity and rest.

To regulate their pace of activity and rest, the first thing to do is to observe and listen to their body  to avoid reaching the maximum level of pain (the 10, on a scale of 0 to 10). They must learn to be aware of when they are at level 5 and allow themselves a moment of rest. In this way,  they will avoid the critical point of pain and fatigue, the  one that will make them feel that they can not take it anymore and that they have to stop completely.

It should be noted that even if more time is spent on rest,  it is also necessary to perform a minimum of daily physical activity, with a moderate intensity,  to avoid that impairment of the musculoskeletal system occurs by no. -use. Not doing any physical activity could make the pain, fatigue, stiffness worse, not only physically, but also psychologically.

“The art of rest is part of the art of working.”

-John Steinbeck-

woman with fibromyalgia

The importance of dedicating more time to rest so as not to reach the maximum sensation of pain means  reducing one’s expectations . This means not trying to do too much work in the same day, setting more accessible goals, or dividing big tasks into smaller, more manageable tasks.

It is also beneficial for these people to  learn to be more flexible and less demanding with themselves. For example, when one day they can not do all that they had planned because they have even more pain, they must avoid tormenting themselves and punishing themselves because that will only increase their pain. be.

Can psychological treatment relieve pain?

It has been proven that better regulation of emotional and relational levels helps to relieve physical pain. Thus, psychotherapy allows these people to obtain a better quality of life and improve on many points such as:

  • Accept the pain and live with
  • Restore the emotional balance
  • Increase the quality of sleep
  • Improve relationships with others, especially with the family (who is experiencing more closely the suffering and pain effects of fibromyalgia syndrome)

People who suffer from fibromyalgia have, in general  (not all, because we have not defined a concrete personality),  tend to take more care and help others. They must learn to say “no”. Of course, helping others is positive but to a certain extent; it must not involve neglecting oneself.

In this way, the psychological treatment aims, among other things, that people learn to take care of themselves and to respect themselves. This goal implies being able to say “no” in certain circumstances and to bond with others in a more assertive way .

As is often the case, it is always easier to say it than to do it. These people may know, for example, that resting would help them feel better. The problem is that normally people with fibromyalgia are not used to rest and, when they do, feel a great sense of guilt:  they feel the need to respect “their obligations”. They must learn to spend time with themselves, without feeling bad.

Although resting seems to be a simple goal, for many people this rest challenges their identity and in a sense removes their value. Based on studies based on Kelly’s “theory of personal constructs” , we have found various “constructs” (adjectives) that are related to the “dilemmas” (obstacles) faced by these people to achieve the changes they need, as for example the “constructs” generous versus selfish.

Normally, people with fibromyalgia  are seen as hard-working and generous people  and, unconsciously,  if they relegate their activities and “obligations”, feel that they are no longer like that  and turn into weak and selfish people. It is for this reason that one of the goals of psychotherapy is to make them realize that resting or asking others for help does not mean stopping oneself.

It is important that the changes are consistent with their identity so that they can actually be meaningful.

woman with her head down

What more can they do to take care of them?

It seems that the pain of fibromyalgia is uncontrollable, that we can not predict when it will intensify. Nothing can reduce it. However, according to the ” Gate Control Theory “, one can successfully  identify certain situations that “open” the barrier of pain or the “ferment”.

For example, it has been observed that many people with fibromyalgia agree that they feel  less pain when they are more relaxed and distracted,  in the presence of friends or relatives. On the other hand, the aspects that increase the pain are: feeling tense, stressed, anxious or preoccupied, for example after having worked, after having exercised too much or after having quarreled. with somebody.

Once these people are aware that these situations affect the perception of pain,  it will be necessary to decrease those aspects that intensify the pain and increase those that reduce it, such as rewarding activities. It’s easy to say, of course, but hard to achieve for people who have spent their whole lives taking a sacrifice that often tortures them more than their own illness.


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