Massage for Fibromyalgia: A Complete Guide to Getting the Most Out of this Healing Therapy

Massage for Fibromyalgia_A Complete Guide

If you have fibromyalgia, could massage be the effective, natural and drug-free treatment you have been looking for to treat your muscle pain?

If there is one hallmark symptom of fibromyalgia, it has to be sore, aching muscles. Chronic body-wide pain is one of the most limiting features of this chronic illness, because it reduces our ability to participate in the activities we love. Unfortunately, muscle pain is also one of the more difficult symptoms to treat. Medications for fibromyalgia offer only partial relief from pain. So with no magic bullet available, many patients consider alternative treatments. I don’t know about you, but painful muscles often lead me to think about massage. But is massage therapy an effective treatment for fibromyalgia?

For someone who doesn’t have fibromyalgia, that might seem like an odd question. The reason people with fibromyalgia are cautious about massage is because of another common symptom called ‘allodynia’ – painful sensitivity to pressure or touch on the skin. If putting on a blanket hurts you or wearing clothing feels like sandpaper on your skin, then you probably experience  allodynia. In cases where this is severe, massage is probably not the best treatment option.

However, a common misconception is that when it comes to massage, the attitude should be ‘no pain, no gain’. This is untrue. It is entirely possible to have a therapeutic massage that is also gentle. In fact, research shows that “Manual therapy, and any exercises prescribed as part of it, should … take into account the fact that our bodies react strongly to sensation. Basically, they should be gentle and appropriate to what we can handle without increased symptoms.”[i] If you can tolerate light pressure, then massage might well be the effective, natural and drug-free treatment you have been looking for to treat your muscle pain.

Personally, once I found the right therapist, massage became one of my go-to treatments for muscle pain. It’s crucial that you find a practitioner who has the right training and experience. In this article, I’m going to share the different types of massage and the essential questions you need to ask in order to get the most out of your treatment session.

Infographic on massage for fibromyalgia

What are the Different Types of Massage Therapy for Fibromyalgia?

 Swedish massage: is the most common type of massage therapy. It is based on Western medical concepts of anatomy (compared to the focus on energy therapy in Asian forms of massage). Swedish massage uses techniques like ‘effleurage’ (long smooth strokes), as well as kneading, rolling, circular and rocking motions.

Shiatsu massage: this Japanese form of massage incorporates acupressure points from traditional Chinese medicine.[ii] Essential life energy, called ‘qi’ (chee) is believed to flow along channels in the body called meridians. Acu points are mapped along meridians. Stimulating acupressure points restores the flow of qi along the meridians, improving the health of the individual.

Deep tissue massage: this type of massage focuses on knots, or adhesions,  in the deeper layers of muscles, which are associated with chronic pain or injury. Techniques include deliberate strokes or friction across the grain of the muscle. As the name implies, this form of massage uses a greater degree of pressure, so fibromyalgia patients should communicate closely with their therapist to ensure that the massage is not painful.

Myofascial release massage: focuses on muscles and fascia – the connective tissue membrane that encompasses your muscles like a sheath. When the therapist feels that myofascial tissue is tight and constricted, including finding trigger points (painful contractions of muscle tissue), they use techniques to lengthen and restore elasticity using stretching and manual pressure.[iii] In my personal experience, this kind of therapy can be intensely painful if the practitioner applies direct pressure to trigger points. However, finding a practitioner experienced in treating fibromyalgia makes all the difference – in my case, the therapist used gentler, more indirect techniques, making the massage much less painful.

What are the Benefits of Massage for Fibromyalgia?

In general, massage increases blood circulation, encourages cell oxygenation and nutrition, relieves muscle tension, and releases natural painkillers like serotonin.[iv]

Massage has been found to improve pain levels, sleep and mood in people living with fibromyalgia.[v] One study found that levels of a neurotransmitter, called substance P, which stimulates pain receptors in the body, were reduced after twice-weekly massage therapy sessions over five weeks. As a result, the “patients’ physicians assigned lower disease and pain ratings and rated fewer tender points in the massage therapy group.”[vi]

Another study investigated the effects of shiatsu massage for managing fibromyalgia symptoms. It found that participants who received a twice-weekly 40 minute shiatsu massage for eight weeks had reduced pain intensity and decreased sensitivity to pressure, as well as improved sleep, compared to a control group .[vii]

Researchers have also investigated whether myofascial release massage improves fibromyalgia symptoms. A randomized, placebo-controlled study found that the experimental group (who received massage) had improved anxiety levels, quality of sleep, pain levels and quality of life, as compared to the control group (who did not have myofascial massage). However, six months after the study concluded, only sleep quality remained significantly better for the experimental group than the control group. This suggests that massage needs to be continued on an ongoing basis to see the full benefits of the treatment.[viii]

 How Do I Find a Qualified and Experienced Massage Therapist?

Finding the right massage therapist is the key to getting the most benefit from this treatment for fibromyalgia. I have had healing, therapeutic massages and painful, flare-inducing massages. Through trial and error I learned that the primary difference was the training and experience of the massage therapist. Training matters because regulations for massage therapy vary across states in the US and provinces in Canada. Unfortunately, some massage practitioners have very little training or clinical experience and could do more harm than good if they treat you.

However, in order to increase standards and build consumer confidence, a number of professional massage therapy organizations have created certifications with a higher standard of training and clinical experience. In order to receive this certification, therapists voluntarily meet these standards. Before seeing a potential massage therapist, make sure you ask:

  • (In the US) Are you board certified by the National Certification Board for Therapeutic Massage and Bodywork?  The NCBTMB is the regulatory authority for massage therapy professionals in the USA, and responsible for ensuring that massage therapists follow best practices and uphold the codes of ethics, quality and legality. A helpful website is NCBTMB.com, where you can locate a Nationally Certified Massage Therapist in your zip code.
  • (In Canada) are you a member in good standing of your provincial massage therapy professional organization? Massage therapy Association self-regulate standards of practice in six Canadian provinces, while four have established massage therapy as a regulated health profession. You can utilize provincial massage therapy association websites to find a therapist near you.

Broadly speaking, I have found that massage therapists often focus on either relaxation, sports medicine or injury rehabilitation/chronic pain. Spas often employ a ‘masseuse’ for relaxation massage, who are typically poorly trained in therapeutic massage techniques. Sports or athletic focused massage therapists often use more aggressive techniques. This makes sense, given that athletes are anxious to get back on the field, but it is not appropriate for fibromyalgia patients who have a high sensitivity to pressure or touch and a low threshold for pain. This makes massage therapists who have experience in rehabilitation and treating chronic pain the best choice for people living with fibromyalgia. Always ask:

  • What is your experience treating clients with fibromyalgia?
  • What type of massage do you practice?
  • Inform them that you are looking for a gentle therapeutic massage, not a painful or intense massage

As we have discussed throughout this article, each individual with fibromyalgia has a different level of sensitivity to touch. It is critical that your massage therapist asks for your continual feedback to ensure that they use the right intensity and amount of pressure for you. Once you’ve selected a therapist,

  • Ask that they use light pressure during your first appointment
  • Tell them that it is important that you have an ongoing dialogue about whether the pressure or technique is comfortable for you
  • Don’t be afraid to speak up if something feels painful or uncomfortable!

References:

[i] https://www.verywell.com/fibromyalgia-chiropractors-massage-therapists-715646

[ii] http://www.prevention.com/health/health-concerns/fight-fibromyalgia-shiatsu

[iii] http://www.mayoclinic.org/diseases-conditions/back-pain/expert-answers/myofascial-release/faq-20058136

[iv] http://www.prevention.com/health/health-concerns/fight-fibromyalgia-shiatsu

[v]http://journals.lww.com/jclinrheum/Fulltext/2002/04000/Fibromyalgia_Pain_and_Substance_P_Decrease_and.2.aspx

[vi] http://journals.lww.com/jclinrheum/Fulltext/2002/04000/Fibromyalgia_Pain_and_Substance_P_Decrease_and.2.aspx

[vii] https://www.massagemag.com/shiatsu-improves-fibromyalgia-symptoms-2-13210/

[viii] https://www.hindawi.com/journals/ecam/2011/561753/abs/

Retrain Your Brain: My Experience in the Gupta Fibromyalgia Recovery Program

I have been given this product as part of a product review through the Chronic Illness Bloggers network. Although the product was a gift, all opinions in this review remain my own and I was in no way influenced by the company.

brain

Causes of FM/CFS: Scientific Basis for the Gupta Program

The premise of the Gupta program is that fibromyalgia (FM) and chronic fatigue syndrome (CFS/ME) are caused by abnormalities in the functioning of brain structures that process physical and emotional threats to the body. However, connections in the brain are not fixed and can be rewired. Neuroscientists call this process “neuroplasticity”. The program was created by Ashok Gupta, who suffered from ME/CFS himself, but has since recovered.

The primary region in the brain involved is called the amygdala, a small almond shaped structure in the brain. The amygdala interprets sensory information in order to detect potential threats to the body. If the amygdala determines that there is a threat, it triggers a response from other brain regions in order to protect the body .

However, in certain people, the amygdala may overprotect the body. Many patients with CFS/FM experience  a viral infection and/or a period of heightened stress at the beginning of their illness. These circumstances put the amygdala on ‘high alert’. The amygdala begins to interpret sensations in the body as dangerous (like back pain or fatigue after a virus), triggering negative thoughts in the conscious mind about these symptoms, and causing a constant, unremitting stress response in the body. This stress response causes further negative symptoms (sleep disturbance, pain, digestive issues, etc.) – setting the stage for a vicious cycle in the body, which we call fibromyalgia.

I can completely relate to this hypothesis. In the year before I developed FM, I had mumps, bronchitis and gastroenteritis, as well as back pain. Then I began an intensive graduate studies program, which caused a lot of anxiety. I quickly developed a cascade of FM symptoms, including body-wide pain, fatigue and insomnia.

How it Works: Brain Retraining

At the core of the Gupta program is an amygdala retraining technique. This technique involves a series of steps that focus on changing your relationship to your symptoms. Retraining includes recognizing and interrupting the flow of negative thoughts about your symptoms; changing your self-talk in a compassionate and positive direction; and visualizing health and happiness in your body.

In addition to the amygdala retraining technique, the program includes a daily meditation component, as part of the larger brain retraining focus. Meditation is, essentially, a way to practice being present. According to Jon Kabat-Zinn, a pioneer in the field of meditation and medicine, meditation is a practice of learning to “pay attention, on purpose, in the present moment, non-judgmentally.” Researchers have investigated the effect of meditation programs for patients with chronic pain conditions and found overall improvements in bodily pain, quality of life and psychological symptoms (Rosenzweig et al., 2010). I have personally benefited from regular meditation practice by learning that most anxiety comes from worrying about the future or re-living difficult moments from the past, rather than from anything going on directly in this moment. Learning to be more present has helped me reduce stress and anxiety by reinforcing what my grandma used to say –– worry about crossing that bridge when you get there!

The goal of brain retraining is to substantially improve FM/CFS symptoms, and even recover from these devastating conditions. Is it really possible? A small clinical audit found substantial improvements in 90% of patients with CFS who attended Ashok Gupta’s clinic in London. The Gupta program website is full of success stories and positive testimonials. The program is designed for patients no matter how long they have suffered from the condition.

What it Includes: Gupta Program Coaching and Learning Materials

The Gupta program consists of a DVD program and Webinar series which includes:

  • a fully interactive DVD programme of 14 Training Modules with clinical director Ashok Gupta;
  • a comprehensive manual (which is a transcript of the DVDs), as well as worksheets and handouts
  • 2 Audio CDs with Meditative and Breathing Techniques
  • a large floor chart mind map to help you “retrain your amygdala”
  • a Follow-up 3 Month Group Coaching Webinar Series: 12 Interactive Sessions with Ashok Gupta in the form of a weekly webinar on a weekday evening, 6pm UK time, with the opportunity to ask questions and see feedback from others

The Gupta program also incorporates a free app called ‘The Meaning of Life Experiment‘ with 30 days of free meditations. This is an excellent meditation app. Ashok Gupta guides 10 or 20 minute meditations on topics like dealing with difficult emotions, gratitude and inner peace. This app has helped me to deepen my meditation practice and I can’t recommend it highly enough.

My Experience: How the Gupta Program Helped Me

Before I share my personal experience with the Gupta program, I should mention an important caveat. During the five months since I began the program, I have undergone surgery and experienced complications from an unrelated chronic pain condition (endometriosis). For this reason, I do not expect to see improvements in my physical fibromyalgia symptoms at this time. (As an example, my unrelated chronic pain condition often keeps me awake at night, so it’s not surprising that I experience fatigue and brain fog after a bad night’s sleep). However, I have been surprised that my fibromyalgia symptoms have not flared or worsened despite the pain and disruption of my endometriosis.

Instead, the benefits that I have experienced are primarily in mentally and emotionally coping with chronic pain and illness. The daily meditation component has helped me to be more self-aware. What I really like about the Meaning of Life Experiment app and the meditation and breathing technique CD is that the guided meditations go beyond practicing being present. The ‘soften and flow’ and ‘surrender’ meditations have provided me with invaluable techniques for handling difficult emotions, like anxiety, that can accompany life with chronic illness. On the flip side, meditations on gratitude and cultivating inner contentment have helped me to take in the positives of small moments of enjoyment throughout my day. Finally, meditations on self-compassion have helped me to better understand patterns of negative self talk or self judgment. In the same vein, the amygdala retraining technique has helped me to interrupt unhelpful thought patterns like hyper-vigilance over symptoms or catastrophizing negative experiences, like having to cancel plans at the last minute. Since these negative thoughts are associated with an amygdala on high alert, I’m hopeful that breaking these cycles will help improve my physical fibromyalgia symptoms over time. Overall, I can say that I feel more positive and in control since I began the Gupta program.

How much does it cost?

The Gupta program costs $299 in the US/CANADA. One aspect I like is that if you aren’t  satisfied with the DVD Home Study course, you can return it for a full refund after 6 months, and for up to a year from purchase (minus the cost of postage and packing). You can learn more at the Gupta Program website by clicking here.

Real Life with Chronic Illness: Inspirational Blog Posts from Spring 2017

Real Life with Chronic Illness: Inspirational Blog Posts from Spring 2017

How reading chronic illness blogs helps me navigate life with chronic illness

Living with a chronic illness can feel isolating. How many people do you know who even have a chronic illness? Our daily challenges are unique, and it can be difficult to find someone who really understands.. Even when it comes to positive changes, I find that friends and family can have a difficult time relating to the treatments or lifestyle changes that I’ve made in order to improve my health and well-being. For example, starting a meditation practice or taking supplements was considered equivalent to fraudulent ‘snake-oil treatments’  by some of my more skeptical relatives. Even more broadly, living with chronic illness changes your perspective on life and your priorities. While you might see working towards acceptance as part of healing, other people around you might see it as ‘giving up’ on getting better. For all of these reasons, it can be difficult to find your way through the realities of life with a chronic illness

This is where the community of chronic illness bloggers comes in. Reading about shared experiences can help reduce that sense of isolation –– knowing other people out there can relate to what you are going through. Chronic illness blogs can help to suggest treatments or self-care strategies, which is important given the lack of research, medical treatments or adequate pain management supports out there. Most importantly, chronic illness blogs can inspire their readers with the wisdom of experience and the power of insight.

Here, I wanted to share a few of the inspiring posts I read this spring about navigating real life with chronic illness:

Inspiring blog posts from Spring, 2017

 

You are miracle.
You are harmony.
You are 90 trillion cells weaving new tapestry.
Each one testifies to the mystery
That even on the worst day
Even at your worst
You are still your best
You are miracle

  • The Beauty of the Story Your Life Is Telling by Stacey from Chronically Whole An inspiring take on the narrative of being a person living with chronic illness. My favourite lines: “Some may say it’s telling a story of failing by not getting better faster [but]… Let your life keep telling the story of adapting, overcoming, loving in spite of loss, being unafraid  to face the uncertain future head on…”

 

  • What can fairy tales teach us about living with chronic illness? That we have to be our own heroes, for one.  Rhiann, from My Brain Lesion and Me, writes:  “My experience of living with a permanent neurological condition has also taught me that we all have the power to rescue ourselves from our own battles in whatever form that they take.” Read more at Life is Anything But a Fairy Tale. 

 

Breathe Safe: A Review of Enviroklenz Everyday Odor Eliminator

I have been given this product as part of a product review through the Chronic Illness Bloggers network. Although this product was a gift, all opinions in this review remain my own and I was in no way influenced by the company. This post contains affiliate links.

What are the health concerns about indoor air pollution?

A few years ago, I learned that there was formaldehyde in my conditioner (DMDM hydantoin). My jaw dropped open for a good 30 seconds. How was this possible? I used to think that government safety regulation prevented anything too harmful from being used in personal care products. That was before I began reading ‘There’s Lead in your Lipstick’ by Gillian Deacon. Apparently there is virtually no industry regulation on what ingredients companies can put in their products.

Over time, I also learned that the same lack of health safety regulation is true for scents, fragrances and chemical air pollutants. I bought a new area rug and the smell gave me a serious headache. I did some research and learned that unhealthy odours are caused by “Volatile Organic Compounds” (VOCs), which are gases emitted from indoor materials. VOCs are emitted from furniture, drapes, carpets, foam insulation, particle board, and other common items. Other VOC sources include personal care products like hair spray or perfume, as well as paints, lacquers, and cleaning supplies. Health concerns caused by VOCs include: “eye, nose and throat irritation, shortness of breath, headaches, fatigue, nausea, dizziness, and skin problems. Higher concentrations may cause irritation of the lungs, as well as damage to the liver, kidney, or central nervous system. Some VOCs are suspected to cause cancer in humans and have been shown to cause cancer in animals.”[1]

VOCs are of particular concern to many people with chronic illness, who may have fragrance allergies and sensitivities. For people with a condition called Multiple Chemical Sensitivities (MCS), in particular, VOCs pose a daily threat to health and well-being.

How can Enviroklenz products help you breathe safer?

Even though I knew about the health concerns associated with VOCs, I didn’t know if there was much I could do about these risks. That’s why I was excited to have the opportunity to review a product by a company called Enviroklenz. This company is focused on producing a range of products that improve the indoor air quality of people who live with fragrance allergies/sensitivities, MCS, and environmental allergies/sensitivities, as well as anyone concerned about reducing their daily toxin exposure.

Enviroklenz

Since I was buying a new mattress protector, I decided to review the Everyday Odor Eliminator. This product deodorizes and cleans carpets, upholstery, furniture and flooring. The ingredients include water, magnesium oxide, zinc oxide and titanium dioxide. These earth minerals, which are non-toxic, attach to pollutants and either neutralize or destroy them. There are no fragrances or masking agents.

My experience testing the Everyday Odor Eliminator:

Applying the Everyday Odor Eliminator is easy enough – directly apply it to the fabric or flooring, undiluted, or spray with a pump sprayer. I used a spray bottle. Test it on an inconspicuous spot first. A white residue forms after application. Removing the product is a little more difficult. After leaving it for 15 minutes, the liquid can be removed by wet extraction, wet vacuum, spot extraction or carpet shampooing (but don’t use it in place of soap or detergent). I used a shop vacuum. If any white residue remains, it can be removed by brushing, vacuuming, wiping or washing.

The Everyday Odour Eliminator worked well. There wasn’t any remaining “new mattress smell”, meaning a reduction in VOCs emitted after the treatment. The white residue was removed after two vacuuming sessions. Overall, I was happy with this product and I would recommend it for anyone worried about unhealthy odours coming from furniture, carpets or flooring.

I am interested in trying other Enviroklenz products like the laundry enhancer, odor neutralizing granules, and the odor neutralizing hand soap. Although beyond my personal needs, for people severely affected by multiple chemical sensitivities, Enviroklenz also retails a medical grade HEPA filter air purifier. You can find the Everyday Odor Eliminator and other products here. 

Here are a few additional tips for reducing exposure to VOCs in your home[2]:

  • Make sure you get enough fresh, clean air into your home.
  • Increase ventilation by opening windows and doors after you bring new VOC sources into your house, such as new carpets, furniture, or drapes
  • Do not allow smoking in or near your home; smoking is a source of many pollutants, including VOCs.
  • If it is not possible to remove the source of VOCs, reduce exposure by sealing surfaces like particle board or paneling with an impermeable sealant, such as polyurethane varnish or latex paint.
  • Allow gases from new furnishings and building materials to be given off in storage for at least a few weeks before you bring them into your home. If this is not possible, increase the ventilation by opening windows and doors in your home for a few weeks.
  • Buy only enough paints, cleaners and solvents for immediate use to prevent the need to store these products in your home. Follow instructions on the product label. Keep lids on tightly. Store products in a separate room; preferably an outdoor shed, or in areas with proper ventilation.
  • Do not bring recently dry-cleaned clothing into your home if it still has a strong smell. Leave the clothing at the shop, or take it out of the plastic wrapping and hang it in a ventilated area until it is properly dried.

[1] https://www.healthlinkbc.ca/healthlinkbc-files/air-quality-VOCs

[2] https://www.healthlinkbc.ca/healthlinkbc-files/air-quality-VOCs

Real Health News: A Review of the New Life Outlook Browser Extension

Although I am a paid contributor for New Life Outlook, the views expressed in this review are entirely my own.

For the past six months I have written articles about fibromyalgia and chronic pain for the health website New Life Outlook. NLO is an online hub for people living with chronic conditions, featuring informative articles and online discussion communities.  Now they’re launching a Chrome browser extension, called NewTab, to help connect patients to online health resources.

HomeScreenGrab

I recently tried out this browser extension.  Based on my experience, I think it is a useful tool for people who want to be better informed about their specific chronic condition, as well as knowledgeable about how improve their overall health.

NewsScreenGrab

The NLO browser extension has several features, which you can customize for your specific illness. When you click on the NLO icon, you are taken to a web navigation tool with three functions.

  • First, you can scroll through recent NLO articles about your specific health condition and share them to Facebook, Pinterest, and by e-mail. You can also ‘like’ an article if you want to be able to find it later.
  • Second, after selecting your favorite health news sites (like Medical News Today, WebMD and Healthline) and mainstream media websites (like CNN, Fox and NBC), you can scroll through recent headlines in a news feed. When you customize these sites, you will be offered health sites that have specific pages for you chronic condition (ex. Science Daily Fibromyalgia News).
  • Third, NLO shares a stream of Pinterest-worthy inspirational quotes and memes about living with chronic illness. This function helps patients share humor and daily truths about the realities of life with a chronic condition.

MemeScreenGrab

The NLO browser extension has a search function that uses Yahoo search capabilities.  It also has a to-do list function, where you can list upcoming tasks you need to remember. If you are interested, here is a walk-through of how to set-up the browser extension:

Taken altogether I think that the NLO browser extension can help people living with chronic illness find “Real News” from reliable sources about their health and other general topics.  This is important in the wild west of the internet, where there are so many “Fake News” sites.  Reliable information is especially important when it comes to your health – inaccurate information is not only potentially harmful, but could be part of a treatment scam.

This browser extension is also a great resource for health bloggers looking for articles and inspiration to share with their followers. It can be overwhelming to individually search out dozens of websites to find recent articles, trending topics or funny memes.

The NLO browser extension is available in on Chrome web store. I encourage you to check it out!

My Fibromyalgia Story: Learning How to Manage One Day at a Time

my story

Part I: From Onset to Diagnosis

For Fibromyalgia Awarenss Month, I wanted to share my illness journey here on the the blog. My story starts eight years ago. It wasn’t a climactic beginning. It was just achey low back pain that got worse the longer I sat writing my M.A. thesis. It seemed like a common enough problem to have, except for the fact that I was 23. The nurse told me to take ibuprophen 24/7 and stretch. Spoiler alert: it didn’t work. About a year later, my body gradually began to fall apart, limb by limb. My back pain worsened. My knee gave out. My shoulders become too painful to allow me to type. This is what the doctors call “gradual onset”.

I thought I was losing my mind.

My doctor at the time told me all she could do was suggest Robaxacet. At this point I was starting my PhD. The physical demands of reading and writing 24/7 began to take their toll, exacerbating my pain. Daily functioning on my own became increasingly difficult. My fiancé (now husband), who was living 4 hours away,  had to come every weekend to help me with the chores (groceries, cleaning, etc.) that I could no longer do.  In retrospect, I think the stress of the program and my fear about not being able to meet expectations, as well as not being able to understand what was happening to me, pushed my body past the point of no return. After that I developed more of the classic fibromyalgia symptoms, like insomnia, fatigue and digestive problems.

I was fortunate to have been referred previously to a pain clinic for pelvic pain. This meant I was able to see a pain specialist for my musculoskeletal pain within the same year all my fibro symptoms exploded. In March 2012 he diagnosed me with fibromyalgia.

Part II: Change, Anxiety and Trying to Cope

I was so relieved after my diagnosis that my symptoms had been validated – and given better medication than NSAIDs. I was given tramadol, which reduced my pain, and doxepin, which helped me to sleep. But I still hadn’t absorbed yet what this diagnosis would mean for my future. After my diagnosis, it became obvious that even with treatment, no amount of accommodations would allow me to continue my PhD. I had tried everything I could think of so I could stay – withdrawn from my TA position, put in place disability accommodations to allow me to submit work late, bought expensive adaptive devices and installed voice recognition software.

Feeling like my life was spinning out of control, I started having panic attacks on campus. When the spring term ended, I went back home to move in with my fiancé, and decided to withdraw from the PhD program.

With huge relief, I  went on medical leave from my studies. However, I was immediately confronted by the problem that my days were empty of activity or responsibility. I remember dragging myself out to a local cafe in the afternoons while my fiancé was at work. I wanted the anonymity of a public place, where I could feel ‘normal’ for awhile. It was the only cafe I could go to because the chairs were sensible rather than funky.  Still, I had to bring my back-rest with me, which generated stares from other patrons.  I would cover it with my coat in order to try to hide it from attention. I could no longer type or hold a book due to pain, so I was embarrassed to be sitting at a table without a laptop or reading material, like everyone else. I listened to audiobooks or free online course video lectures instead. I would set up my tablet so that it looked like I was working, rather than listening and staring around. I envied all the other people my age, surrounded by papers, purposely tapping away on their computers. The goals that I had been pursuing were on pause, indefinitely. I grieved for my old life. I pushed myself to go to the cafe, even on days I experience brain-fog or fatigue, because staying home felt like giving up. I spent that year in a state of shock. I was always someone whose identity was wrapped up in my work. I didn’t know who I was anymore.

Part III: Learning Self-Care Skills to Manage my Fibro

Gradually I started trying to put the pieces back together. When I got diagnosed with my chronic condition all the information about exercise seemed so out of touch with the reality of my life. At the time, I had trouble bending forward, which meant I needed help with basic tasks like shaving my legs. I had trouble getting up or down from sitting on the floor. I rarely took the stairs and had trouble walking or standing for longer than ten minutes. Since I was already tired, sore and busy then I wasn’t going to be able to go to the gym. I couldn’t afford a personal trainer. With my back pain there was no way I could participate in the group yoga classes I used to take in university. Even more frustrating was the fact that all the research I came across proved how beneficial exercise is to health. I knew that I should exercise but I felt like I couldn’t.

I found two at-home instructional DVDs in yoga/pilates and tai chi that I was actually able to do, which helped me to improve my physical functioning. I started seeing a physiotherapist who put together a thorough stretching routine for me to do daily. Without doubt, this is the single most effective thing I tried to improve my health and well-being. My pain decreased and my quality of life increased.

I was fortunate to be referred to a Cognitive Behavioural Therapy program by my pain clinic. I found participating in the course very valuable for learning tools to  manage the negative thoughts and feelings that accompanied my fibromyalgia. One of the core parts of the program was learning to identify negative thinking traps, or ‘cognitive distortions’.  These are thoughts that “sound rational and accurate, but really only serve to keep us feeling bad about ourselves.” I learned that I tend to think in “all or nothing” terms – a cognitive distortion. I would say to myself things like “if I can no longer pursue my career, I am a failure in life”. In CBT, I learned to challenge these distortions with the reality of each situation. For example, in response to the statement above, I challenged it by saying “While being in pain means I have to do less, that does not reflect on my personal worth, nor does it mean what I can do is meaningless”.

I was also referred for a Mindfulness Based Stress Reduction course by the pain clinic. In this course, I learned to be more mindful of the present moment. I learned that worrying about the future or dwelling on the past, only makes me suffer more in the present.  It’s better for my quality of life if I return my focus to the next best thing I can do for myself in this moment. Critically, the MBSR course reminded me that, even with pain and flare-ups, there are small moments of enjoyment, if I only stop and notice them – the taste of a good meal, sharing a hug, a sunny day, or a favourite hobby. One of the key lessons I learned through mindfulness is that my thoughts, feelings and sensations, no matter how difficult, are changeable, like the weather. When I hold on to the fact that even my darkest moods will eventually lift, I feel calmer and more in control.

Part IV: Coping with Relapse

In 2014 I started a part time distance program for social work and completed the first year. But it wasn’t to be. I got a cold over the 2015 holidays and suffered the worst fatigue and brain fog I’d ever known. At the time I was just starting to look for a social work practicum placement. There was no way I could commit to working 15 hours a week out of my home. For the second time I had to withdraw from school.

I felt completely overwhelmed at the outset of my fatigue relapse last year.  First, there was the emotional reaction to a new situation: anxiety about whether it was here to stay, frustration that life was about to get more difficult, and grief at the prospect of losing what abilities I still had.  Secondly, there was the practical challenge of figuring out how I would cope, like what new treatment options to try or how to manage my daily routines and responsibilities.  Lastly, I faced the impact of a relapse on my relationships, such as the increased caregiver burden on my partner, and feeling less able to be present with family and friends.

My relapse brought me back to the beginning of my illness journey and how I coped after my diagnosis. I was able to use many of the lessons that had been learned the hard way the first time around. In essence, what I have learned is that I have the power of choice over what I focus my attention on each day. Through challenging negative patterns of thinking, being present, taking in the good, and pursuing an enjoyable hobby, I try to emphasize what enriches my life and let go of what doesn’t. Of course there are always bad days and I don’t believe any amount of positive thinking frees us from ever experiencing difficult times. I personally have found, however, that changing my worldview has dramatically lessened the amount of suffering I go through during relapses and has improved my quality of life. I spent that winter using the time to learn new things. I taught myself calligraphy, I read, and I wrote more often on my blog.

Part V: Moving Forward, Maintaining Balance

That spring, my energy began to slowly improve. I found a kind of peace in accepting that whatever I do next, it needs to allow me to work with my body and not against it. I think that’s why blogging and writing has ‘clicked’ more for me now than when I first started. I have found that grieving for your old life and finding acceptance in your new life is an ongoing process, not a one-and-done kind of thing.

Being at home allows me to respond to each day as it is. I’m fortunate to be able to stay at home. I sleep in late because without ten hours I am a brain-fogged zombie. I can’t type because of shoulder pain but I can use speech recognition software. I stretch, do gentle exercise, walk, and make sure I move around during the day. I balance my activities with self-care, which is how I am able live more fully, even with fibromyalgia.

In the summer of 2015 I felt well enough to finally plan my (fibro-friendly) wedding. On a beautiful August day I married the man I’d fallen madly in love with eight years earlier and who has been my saving grace through this whole journey.  He didn’t blink when it came to assuming care-giving responsibilities – he does the housework, the laundry and the dishes on top of his full time job. He is always understanding when we have to change plans or just stay at home. Most of all he is so supportive. He celebrates the small accomplishments of my life without ever making me feel ‘less than’.

I’m grateful for how I’ve grown through encountering all of the challenges that come with chronic illness. Learning mindfulness meditation and focusing on the present has given me a more helpful perspective. I’m a happier person when I remember to ‘stop and smell the roses’. I feel like I’ve become more patient, more adaptable, more assertive and more accepting than I was before fibromyalgia.  I’m proud of making it through every day, especially on the tough days where no amount of self-care stops your symptoms, and you just have to hold on to the knowledge that it will pass. Everyone living with chronic illness should be proud of the strength they have developed to manage daily life.

My new motto is something I read shortly after my diagnosis –  “It’s not the life you imagined, but it’s a good life nonetheless.” It’s something I hope for myself and everyone who lives with fibromyalgia.

National-Fibromyalgia-Awareness-Day-May-12

A Tale of Two Types of Laparoscopic Surgery to Treat Endometriosis

A TALE OF TWO TYPES OF LAPAROSCOPIC SURGERY TO TREAT ENDOMETRIOSIS

 Learn about the most effective type of laparoscopy for endometriosis.

Last summer I had an appointment with my OB-GYN to figure out the next step for treating my internal pelvic pain, which she suspected was caused by endometriosis.  The pain had significantly ramped up in recent months and was virtually constant.  My OB-GYN recommended having a laparoscopy, which she described as a minimally invasive surgery to diagnose and removed endometriosis lesions that might be present in my pelvis.  I left that appointment believing that there was only one type of laparoscopic surgery to treat endometriosis.

I was wrong.

The procedure I finally had this past winter (after months of waiting), with a type of laparoscopy called ablation or coagulation. During this procedure, endometrial lesions are burned away with a high energy heat source, usually a laser. This is the most common type of laparoscopy for endometriosis. Three months after having the surgery, my chronic pelvic pain has never been worse. Ablation was not effective for treating my endometriosis.

However, there is a second kind of laparoscopy for treating endometriosis, called excision. This procedure is less common than ablation, requires more skill, and is more time-consuming.

“Excision removes endometrial implants by cutting them away from the surrounding tissue with scissors, a very fine heat gun or a laser beam…Excision allows the gynaecologist to separate the implants from the surrounding tissue, thus ensuring that the entire implant is removed and no endometrial tissue is left.”[i]

The most important difference between these two types of laparoscopic surgeries, according to a new study, is that excision is more effective than the ablation.[ii]  Researchers compared three recent studies that examined the outcomes of ablation versus excision laparoscopies for treating endometriosis.  They found that excision laparoscopies, compared to ablation, resulted in:

  • a significant reduction in painful periods
  • a significant reduction in chronic pelvic pain
  • a significant reduction in straining with bowel movements
  • a non-significant reduction in painful sex

The researchers concluded that their review “showed significantly greater improvement with laparoscopic excision compared with ablation” in the treatment of endometriosis. I wish I’d known last summer. Now I’m beginning the long process of being referred for excision surgery.

What I Wish I Knew Before Having a Laparoscopy to Treat Endometriosis

[i] http://endometriosis.org/treatments/endometriosis-surgery/

[ii] Pundir, J., & Omanwa, K. (2017, April 26). Laparoscopic excision versus ablation for endometriosis-associated pain – Updated systematic review and meta-analysis. Journal of Minimally Invasive Gynecologyhttp://www.sciencedirect.com/science/article/pii/S1553465017302637

Acceptance, Grief & Chronic Illness: The Top 4 Ways I Learned to Cope After my Diagnosis

Acceptance Grief and Chronic Illness:THE TOP 4 WAYS I LEARNED TO COPE AFTER MY DIAGNOSISYou probably vividly remember that moment when you sat in a doctor’s office and were told that the explanation for all your confusing symptoms was summed up in a word: fibromyalgia. For some of you, this diagnosis was the first chronic condition you were diagnosed with. For others, it was the second. And for those who had already been diagnosed with multiple chronic illnesses, this one was just another to add to the collection. The reality is that fibromyalgia is one of ten conditions the National Institutes of Health recently labelled Chronic Overlapping Pain Conditions (COPCs ).[1] These include chronic migraine and headache, interstitial cystitis, vulvodynia, IBS, low back pain, endometriosis, TMJ disorders, and chronic fatigue syndrome,  In addition, fibromyalgia is commonly diagnosed alongside autoimmune and inflammatory conditions, like rheumatoid arthritis and osteoarthritis.[2]  Finally, anxiety and depression are much more likely to be co-morbid (found simultaneously) in people living with fibromyalgia.[3]  Many fibromyalgia patients will have the déjà-vu experience of sitting in a doctor’s office and being diagnosed with yet another chronic illness.

I recently relived that experience myself. I sat in my OB-GYN’s office and was told that a recent laparoscopy confirmed that I have endometriosis alongside my fibromyalgia. I told myself that after years of dealing with chronic pain, this was no big deal – same problem, different location. All I needed to do was learn what my treatment options were and then go home and use the self-care skills I have developed over the years to manage my pain. A few days later, while I was examining my incision scars, I broke down in tears. “Get a grip,” I told myself, “this is nothing new“. But as the pelvic pain returned, despite the laparoscopy, and I confronted the reality of dealing with another hard-to-manage chronic illness,  I had to acknowledge my feelings of anger and sadness over this new diagnosis. Intellectually I know that being diagnosed with endometriosis will not change my life as dramatically as my fibromyalgia diagnosis did. I’ve already had to leave my career because of my disabling fibro symptoms. Instead, I stay at home pursuing hobbies, like writing and calligraphy, while I look after my health.

So I wondered, why is this second diagnosis affecting me so much?  To answer this question, I needed to remember what I experienced after my first diagnosis.  As anyone who has had a significant diagnosis knows, you go through a period of grieving afterwards. Grief is the “primary emotional process of reacting to… loss” (Absenger, 2015).[4]  The stages of grief after a diagnosis include: numbness-disbelief, separation distress, depression-mourning, and recovery.[5] While there are similarities to the stages of grief that people generally experience after any loss, the grieving process for people diagnosed with a chronic illness has unique characteristics.  In an article for social workers helping clients with chronic illness, Kate Jackson (2014) explains the difference:

Most often, grief is a reaction to a single, time-limited event… Grief associated with chronic illness, however, is more complex for many individuals.  For people who are chronically ill, the losses are multiple and permanent and therefore difficult to resolve. Because these losses are unending, they’re known as infinite losses.

The scope of losses due to chronic illness are broad and complex, and they can change during the course of an illness.  The loss of health and ability can, in turn, cause losses in a person’s career, social life, sexual function, body image, relationships, parenting ability  and daily functioning, among other areas.  Most fundamentally, these secondary losses caused by chronic illness can fracture self-identity and diminish self-esteem.  The fact that many people with chronic illness feel that their experiences are invalidated by stigma and disbelief can further their sense of isolation.

The concept of infinite losses helped me to understand why a second diagnosis brought up so many difficult emotions. I have had to acknowledge that the grieving process over one, or multiple, illnesses is not a ‘one and done’ kind of thing. Grief comes in waves. If your illness changes, or you develop a new illness, your emotional response will also change because, correspondingly, the losses you experience are new and different. Prior to the pelvic pain that led to my laparoscopy, my fibromyalgia symptoms had stabilized and I had reached a state of acceptance about my illness. I wanted to believe this was a permanent state. I resisted the idea that a new condition would cause me to grieve again (because who wants to go through that once more?). However, I have come to recognize that the losses caused by endometriosis in my life are significantly different than those caused by fibromyalgia.  For me, endometriosis is entangled with my desire to start a family and be a mother, my body image and my sense of femininity. In contrast, fibromyalgia has primarily affected my career aspirations and the part of my identity that was defined by my professional accomplishments.

Once I acknowledged that I was grieving over my second diagnosis, I felt a greater sense of peace.  Resisting these feelings consumed a lot of my energy and effort. Jackson (2014) explains that “people with unresolved grief may experience more profound and difficult-to-treat depression and anxiety”.  Furthermore, the symptoms of a chronic illness can be worsened by unacknowledged grief, including pain, fatigue and cognition.  As people living with chronic illness, I think it’s important that we be on the lookout for experiencing grief when we develop a new illness, or a change in a current illness.  Understanding that grief and acceptance are fluid states can help us be more open to acknowledging grief.  It’s important to seek out support and help once you recognize these feelings. Here are a few tools and resources for coping with grief about your chronic illness, based on what has helped me:

  • Mindfulness meditation: “Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally,” according to Jon Kabat-Zinn, a pioneer of mindfulness in medicine. The Mindfulness Based Stress Reduction (MBSR) program created by Jon Kabat-Zinn to teach mindfulness to patients had demonstrated remarkable benefits for reducing chronic pain as well as anxiety and depression in fibromyalgia.[6] You can find an MBSR program in your community, or there is a free version online http://palousemindfulness.com/. Alternatively, you can learn meditation using a free app on your phone. Two of my favourites include the Insight Timer and The Meaning of Life Experiment. You can practice mindfulness through meditation, body scans, mindful eating, or mindful movement like yoga or Tai Chi.
  • Cognitive Behavioural Therapy: Studies have found that participating in CBT can help reduce pain, depressive thoughts, and improve quality of life for people with chronic pain.[7] One of the core parts of the program is learning to identify negative thinking traps, or ‘cognitive distortions’.  These are thoughts that “sound rational and accurate, but really only serve to keep us feeling bad about ourselves” (Grohol, 2016).[8] These programs also focus on helpful behaviour changes like learning deep relaxation as well as pacing activities. CBT programs are run in most communities and your doctor should be able to refer you to one.
  • Find a support group, whether in person or online. It can be incredibly powerful to know that you are not alone in facing the challenges caused by your chronic illness. There are private facebook groups for every condition, where you can find support and people with shared experiences. The #spoonie hashtag can help you find other people with chronic illness on twitter. If you are able to, an in-person support group can be an important source of connection if you are struggling. No matter how much support your family and friends can provide, it can help to talk with people who have the same condition(s) you do.
  • Talk with a professional therapist: Unresolved grief is a difficult issue to work through. Many people benefit from talking with an experienced therapist, one-on-one. My advice is to find a counsellor with experience in working with clients who have chronic illness- your specialist may be able to refer you. It’s critical that you ascertain that the therapist validates the existence of your chronic illness and does not tell clients that the illness ‘is all in their head’. Think of the first appointment as an interview, where you see if you are compatible and ask about their professional experience. You may wish to learn more about the therapeutic approaches used by different therapists prior to choosing one. For example, I found that the empathetic, strengths-based counselling provided by a social worker fit much better with my personality than the objective, analytical technique used by a psychiatrist.

Acceptance Grief and Chronic Illness

[1]http://www.overlappingconditions.org/About_COPCs

[2] http://www.sciencedirect.com/science/article/pii/S0025619615002438

[3] https://www.verywell.com/fibromyalgia-comorbid-overlapping-conditions-716184

[4] Absenger, W. (2015). Mindfulness and the Stages of Grief in Chronic Disease. ACEF. Retrieved 15 April 2017 from http://amacf.org/mindfulness-stages-of-grief-in-chronic-disease/

[5] National Cancer Institute. (2014, October 8). PDQ® grief, bereavement, and coping with loss. National Cancer Institute. Retrieved 15 April 2017 from http://www.cancer.gov/cancertopics/pdq/supportivecare/bereavement/patient

[6] Paul Grossman, Ulrike Gilmer, Annette Raysz and Ulrike Kesper. 2007. Mindfulness Training as an Intervention for Fibromyalgia: Evidence of Postintervention and 3-Year Follow-up Benefits in Well-being. Psychology and Psychosomatics 76: 226-233

[7] Holmes, A., Christelis, N., and Arnold, C. (2012). Depression and chronic pain. MJA Open Suppl (4):17-20.

[8] Grohol, J. (2016). 15 Common Cognitive Distortions. Psych Central. Retrieved on December 15, 2016, from http://psychcentral.com/lib/15-common-cognitive-distortions/

Evidence for New Fibro Drug Therapies: Options to Take to Your Doctor if Your Current Treatments aren’t Working

Evidence for New Fibro Drug Therapies: Options to Take to Your Doctor if You Current Treatments aren't Working

New research into drug therapies helps people with fibromyalgia increase their treatment options. Learning about these new medication options can help you and your doctor you find the best treatment regimen for you.

If you live with fibromyalgia, you know firsthand that one of the primary features of this condition is a lower pain threshold compared to healthy people. There are a number of changes in the body caused by fibromyalgia that increase our sensitivity to pain. One set of changes affect how the spinal cord relays pain sensations from the body to the brain. Several drugs target specific receptors, called NMDA receptors, which are located in deep spinal neurons that carry sensory information to regions in the brain that relate to pain processing. NMDA receptors are activated by signals relayed to the spinal cord by peripheral neurons that sense pressure in muscles, tendons, etc. This type of receptor is activated by the neurotransmitter glutamate. Studies have shown elevated levels of glutamate in the brain and spinal cord of patients with fibromyalgia.[i] There is a strong correlation between elevated glutamate and increased pain in people with fibromyalgia. NMDA receptors can amplify pain signals in patients with fibromyalgia because they are activated to a greater degree by the presence of increased glutamate concentrations in the brain/spinal cord, which trigger pain signals sent to the brain by the deep spinal neurons.

NMDA receptors can be prevented from firing by certain compounds. Two drugs in particular seem effective at decreasing NDMDA receptor activation. One is called memantine. Memantine blocks NMDA receptors and decreases glutamate levels. “A randomised, double-blind study in 63 patients with fibromyalgia compared memantine… with placebo over a 6-month period. Compared to placebo there was a significant reduction in pain and pain threshold and improvement in global function, mood and quality of life”.[ii] Memantine was originally developed to treat diabetes, but has also been used to treat dementia; it has been found to also be effective in treating chronic regional pain syndrome.

Ketamine is another potent NMDA receptor blocker (yes, the illegal party drug). Studies have shown that it can effectively reduce pain for a subset of fibromyalgia patients “Thus, of 58 patients with fibromyalgia in the above 3 studies, 33 (57%) responded to low dose ketamine (0.3mg / kg) infusion, as defined by a reduction of pain by 50% or more.”[iii] However, studies have not adequately investigated long term use of ketamine. However, ketamine has been proven effective in treating chronic regional pain syndrome, which shares many similar characteristics to fibromyalgia.

Another interesting tip focuses on diet changes that can help lower pain levels. Glutamate is found in MSG (monosodium glutamate). Other related compounds, called excitotoxins, like aspartame, can cause harmful over-activity in the brain. “One study showed that 4 weeks of exclusion of monosodium glutamate (MSG), aspartame, and other excitotoxins, resulted in over 30% improvement in fibromyalgia symptoms in 84% of those who completed the diet”.[iv]

What about inflammation and fibromyalgia? A number of studies have found increased levels of pro-inflammatory messengers (called cytokines) in blood collected from FM patients.[v]  A drug called low-dose naltrexone has been investigated for its potential benefits in treating fibromyalgia because of its anti-inflammatory properties.[vi] Naltrexone is primarily used to treat opioid overdoses, but when taken at a low dose before bed, studies have found a statistically significant reduction in FM pain compared to the placebo. A recent study found that “after eight weeks of LDN administration, plasma levels of a range of broadly pro-inflammatory cytokines were decreased. In addition, we found that participants reported less pain and symptoms following LDN. Combined, these results support the hypothesis that LDN may help chronic pain conditions, such as fibromyalgia, by acting as an atypical anti-inflammatory medication”.[vii] Pain reduction was found to be 15% and symptom reduction 18%. While these results are modest, for many FM patients desperate for options, low-dose naltrexone could be a valuable part of their treatment regimen.

Evidence for New Fibro Drug Therapies: Options to Take to Your Doctor if You Current Treatments aren't Working

Works Cited

Littlejohn, G., & Guymer, E. (2017). Modulation of NMDA Receptor Activity in Fibromyalgia. Biomedicines 5 (5), 15-27.

Parkitny, L., & Younger, J. (2017). Reduced Pro-Inflammatory Cytokines after Eight Weeks of Low-Dose Naltrexone for Fibromyalgia. Biomedicines 5 (2), 16.

Ross, R., Jones, K., Bennett, R., Ward, R., Druker, B., & Wood, L. (2010). Preliminary Evidence of Increased Pain and Elevated Cytokines in Fibromyalgia Patients with Defective Growth Hormone Response to Exercise. Open Immunol J, 3, 9-18.

Citations

[i] (Littlejohn & Guymer, 2017)

[ii] (Littlejohn & Guymer, 2017)

[iii] (Littlejohn & Guymer, 2017)

[iv] (Littlejohn & Guymer, 2017)

[v] (Ross, Jones, Bennett, Ward, Druker, & Wood, 2010)

[vi] (Parkitny & Younger, 2017)

[vii] (Parkitny & Younger, 2017)

Could a Treatment for Herpes also be Effective for Treating Fibromyalgia?

Could a treatment for herpes also be effective for treating fibromyalgia?A recent study investigated whether it would be effective to  treat fibromyalgia patients with an anti-viral and anti-inflammatory drug combination that is normally used to treat the herpes virus (cold sores or genital herpes). The anti-viral drug used in this study also treats the shingles virus (which additionally causes chickenpox). Specifically, researchers tested a famciclovir + celecoxib drug combination called IMC-1. The study was based on the hypothesis that life stressors could re-activate latent viral infections  (viral infections from earlier in life that become dormant), which in turn cause fibromyalgia to develop. This hypothesis is based on anecdotal evidence of patients who develop fibromyalgia after experiencing infections and/or periods of stress. Does that sound familiar?

The results of this double-blind, placebo-controlled study were positive: participants receiving the anti-virals had significantly less pain and fatigue compared to participants who received a placebo. Encouragingly, IMC-1 was well tolerated by study participants, with few side-effects. Researchers concluded that the effectiveness of the anti-viral drugs suggests that the herpes virus may play a role in the development of fibromyalgia for some patients. Interestingly, this conclusion was based on the efficacy of the drug rather than testing the study participants for the herpes virus. I wonder whether this line of investigation could be expanded to include other potential viral triggers.

This hypothesis resonates with me because in the months before I developed fibromyalgia, I had a mumps infection, which I always attributed as a trigger for the onset of my fibromyalgia. In addition, I have had shingles, which the anti-viral used in the study also treats. This is a fascinating new area of research that will hopefully provide more answers and solutions to the treatment of fibromyalgia. In the meantime, if you have the herpes virus (or other significant viral infection) and fibromyalgia, I recommend taking this study to your doctor to see if IMC-1 might be an effective option for you!

Reference:

Pridgen, W. et al. (2017). A famciclovir + celecoxib combination treatment is safe and efficacious in the treatment of fibromyalgia. J. Pain Res., 10, 451-460. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5328426/