This summary of a Cochrane review presents what we know from research about the effect of exercise for fibromyalgia. The review shows that in people with fibromyalgia:

A.D.A.M. Medical Encyclopedia.

Fibromyalgia

Fibromyositis; Fibrositis

Last reviewed: February 14, 2011.

Fibromyalgia is a common syndrome in which a person has long-term, body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues.

Fibromyalgia has also been linked to fatigue, sleep problems, headaches, depression, and anxiety.

Causes, incidence, and risk factors

The cause is unknown. Possible causes or triggers of fibromyalgia include:

• Physical or emotional trauma
• Abnormal pain response - areas in the brain that are responsible for pain may react differently in fibromyalgia patients
• Sleep disturbances
• Infection, such as a virus, although none has been identified

Fibromyalgia is most common among women aged 20 to 50.

The following conditions may be seen with fibromyalgia or mimic its symptoms:

• Chronic neck or back pain
• Chronic fatigue syndrome
• Depression
• Hypothyroidism (underactive thyroid)
• Lyme disease
• Sleep disorders

Symptoms

Pain in the main symptom of fibromyalgia. It may be mild to severe.

• Painful areas are called tender points. Tender points are found in the soft tissue on the back of the neck, shoulders, chest, lower back, hips, shins, elbows, and knees. The pain then spreads out from these areas.
• The pain may feel like a deep ache, or a shooting, burning pain.
• The joints are not affected, although the pain may feel like it is coming from the joints.

People with fibromyalgia tend to wake up with body aches and stiffness. For some patients, pain improves during the day and gets worse at night. Some patients have pain all day long.

Pain may get worse with activity, cold or damp weather, anxiety, and stress.

Fatigue, depressed mood, and sleep problems are seen in almost all patients with fibromyalgia. Many say that they can't get to sleep or stay asleep, and they feel tired when they wake up.

Other symptoms of fibromyalgia may include:

• Irritable bowel syndrome (IBS)
• Memory and concentration problems
• Numbness and tingling in hands and feet
• Palpitations
• Reduced ability to exercise
• Tension or migraine headaches

Signs and tests

To be diagnosed with fibromyalgia, you must have had at least 3 months of widespread pain, and pain and tenderness in at least 11 of 18 areas, including

• Arms (elbows)
• Buttocks
• Chest
• Knees
• Lower back
• Neck
• Rib cage
• Shoulders
• Thighs

Blood and urine tests are usually normal. However, tests may be done to rule out other conditions that may have similar symptoms.

Treatment

The goal of treatment is to help relieve pain and other symptoms, and to help a person cope with the symptoms.

The first type of treatment may involve:

• Physical therapy
• Exercise and fitness program
• Stress-relief methods, including light massage and relaxation techniques

If these treatments do not work, your doctor may prescribe an antidepressant or muscle relaxant. The goal of medication is to improve sleep and pain tolerance. Medicine should be used along with exercise and behavior therapy. Duloxetine (Cymbalta), pregabalin(Lyrica), and milnacipran (Savella) are medications that are approved specifically for treating fibromyalgia.

However, many other drugs are also used to treat the condition, including:

• Anti-seizure drugs
• Other antidepressants
• Muscle relaxants
• Pain relievers
• Sleeping aids

Cognitive-behavioral therapy is an important part of treatment. This therapy helps you learn how to:

• Deal with negative thoughts
• Keep a diary of pain and symptoms
• Recognize what makes your symptoms worse
• Seek out enjoyable activities
• Set limits

Support groups may also be helpful.

Other recommendations include:

• Eat a well-balanced diet
• Avoid caffeine
• Practice good sleep routines to improve quality of sleep (See: Sleeping difficulty)
• Acupressure and acunpuncture

Severe cases of fibromyalgia may require a referral to a pain clinic.

Expectations (prognosis)

Fibromyalgia is a long-term disorder. Sometimes, the symptoms improve. Other times, the pain may get worse and continue for months or years.

Calling your health care provider

Call your health-care provider if you have symptoms of fibromyalgia.

Prevention

There is no known prevention.

References

1. Abeles M, Solitar BM, Pillinger MH, Abeles AM. Update on fibromyalgia therapy. Am J Med. 2008;121:555-561.
2. Häuser W, Bernardy K, Üceyler N, Sommer C. Treatment of fibromyalgia syndrome with antidepressants. JAMA. 2009;301:198-209.
3. Wolfe F, Rasker JJ. Fibromyalgia. In: Firestein GS, Budd RC, Harris ED Jr., et al., eds. Kelley's Textbook of Rheumatology. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 38.
4. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res. 2010;62(5):600-610.

Review Date: 2/14/2011.

Reviewed by: Michael E. Makover, MD is a professor and attending in rheumatology at the New York University Medical Center, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

April 2011

I have new pains, here and there that doesn't go away:

• 
  
• Body aches all the time but some places more then others
• Joint pains:  knees, elbows, shoulders, fingers etc..
• Hard time to get up and go down the stairs ;  Stiff Feeling worsens as the day progresses
•  Cramps in the legs and hips (nighttime or daytime)
•  Long period of Pain: to left shoulder for about 3 days, couldn’t lift my arm and then the neck for another 3 days (could hardly turn my head)
• Muscle fatigue ( have to drop my arms, dropping things while holding, have to rest when folding clothes after a few pieces etc)
• Frequent headaches in the temples or base of neck
• Feeling of crawling sensations all over
• Sweating a lot (never sweat so much even when I was in sports)
• IBS is out of control
• Hot flashes
• Feels like my heart jumps a beat and feel it in my throat
• Sternum aches (woke me up this morning)
• Itchy skin, mostly on my legs and arms, like being bit by fleas, doesn’t last long
• Itchy ears most of the time(use a Qtip to scratch them)
•  Prickly feels to my hands and feet
• I seem to forget a lot more, even if we had talked about it just a few days ago.
• Allergies are bad right now
• Pressure whistling in ears
• I urinate more often than before.  (I have to wear protection as I drip without control)

I just know something is wrong.  I hate going there and feel like I am loosing everyones time. 




By mid June, I was diagnosed with Fibromyalgia.  

September 2010

In our little corner of the world, there is not a lot of opportunity for work but I was told about a job opening as a General Store Manager in the region.  I just knew if I got an interview that I would get the job so I did some soul searching:

was i ready for the commitment?  Was I ready for the challenge?  I had my own company before but this was retail ??  How about the kids?  and the husband?  I need to talk to them for a see what they say.   The hours are not 9-5, do I want still want it?  How about my summer and my animals?

I did send a resume' and waiting to see what would happen.  I did get the call and the owner wants to meet.  Yay !  In my kitchen!!!  

That's a real switch from the city interviews, let me tell ya but I didn't care, as long as I could let him know that I was the girl he was looking for !

GOT THE JOB !   Really, I wasn't surprised.  Told ya, I knew it ...  Starting right away.  I am very happy.  Finally I will meet the people around here.  It has been 3 years and I still don't have friends !  I have become antisocial, well almost lolllllll

Wow, what a reception I received from the customers.  One customer in particular said:

It is such great change to come to the store and to be received with such a great smile, every time !..

Another said:

What a great personality you have. You will fit well here.  The folks will just love you ! 

And another:

It will be so nice to come in and be served in french, you have no idea how happy that makes me.  

I felt great to be working again.  It had been 3 years.  I never thought I would go back to work, I was retired at the age of 40 ! 

All wasn't what it appeared to be.  All were not happy that I returned to work.  My kids had a terrible time to adjust to the shift work, the husband had lost his wife that did everything around the house and the long time workers had new rules and regulations to comply with.  I have to admit, it was tough but I had done it all before.   I figured in no time all would settle down and all would appreciate the hard work. I had committed to the owners, they were counting on me, I didn't want to let them down.  I have pride too , you know.  I wasn't a quitter.  

I meet great people.  Everyone was super nice.  It was always a pleasure to see them come in and ask me how my day was.  I even found long lost family members !  I made friends too.  They came in early mornings to have a little chat over a fresh brewed coffee...  I loved the morning shift !

Months passed by and more and more it became obvious that this wasn't going to work out for anyone.  My daughter was now in severe anxious attacks.  She was not doing well in school, the teachers were worried and so was my doctor.  We had to start therapy, fast.  It wasn't long after this, my first flare up showed up!. In the back of the store, bent over in pain leaving the other worker in charge of the floor by herself (which is not acceptable, always two workers for safety and service at all times).  One day it was so bad, I couldn't stay any longer and had to call in a replacement.  (After a series of tests, I was diagnosed with IBS).  I couldn't lift the crates of pop up the stairs, or the pieces of woods outside.  My ankle was so painful, I had a permanent limp. Even, I couldn't reach over the top shelves without pains in my back and shoulders.  Something was definitely wrong....

I called in the owners and told them the bad news.  I had to go for many reasons but my daughter was also in trouble.  I had to return home and take care of things, including my health. 

I felt that I had failed them all including me.  

I made an urgent doctor's appointment...

April 2010

What a beautiful early spring day !  Mom and dad are coming over to help out with the flowerbeds and we'll have lunch together.  Hubby is home but the kids are with friends.  

In the path to the front door, I twisted my ankle on a patch of ice.  Mom says I heard a crack but I saw stars...  Holy Hell, that hurt...

I sat on the front steps and couldn't let mom look at it for like 5 min...  She finally removed my shoe and we saw immediate discoloration ans swelling.  Crap, that didn't look good at all.

Hubby and Mom took me under the armpits and moved me on the couch in the living room.  Right away ice packs and no more fun for the day.

Still today, I do physiotherapy on this foot and I will never probably get it back to what it was.  Still hurts, I still limp, I still damn the day it happened...

This is 2 weeks later

Quelle belle première journée de printemps! Maman et papa viennent pour me donner un coup de main avec les parterres et nous déjeunerons ensemble. Le mari est à la maison mais les enfants sont avec des amies.  

Dans le chemin à la porte d'entrée, j'ai tordu ma cheville sur un morceau de glace. Maman dit qu'elle a entendu un craquement mais j'ai vu des étoiles... L'enfer, le mal du diable...

Je me suis assis sur les marches et ne pouvais pas laisser maman le regarder pour comme 5 minutes ... Elle a finalement enlevé ma chaussure et nous avons vu immédiatement la décoloration et l'enflure . Merde, ca ne regarde pas trop beau ca la !

Mon mari et mam m'ont pris sous les aisselles et m'ont déplacé sur le canapé dans le salon. Tout de suite sachets de glace et fin le fun pour le reste de la journée.

Encore aujourd'hui, je fais de la physiothérapie sur ce pied et je ne le récupérerai probablement jamais ce qu'il était. Toujours des maux, je boite toujours, je maudit encore le jour que c'est arrivé...

October 2009

I don't talk much about grandma passing.  I even stop praying.  Maybe because I am scared.  Maybe because I don't want to feel anything.  I rather ignore it then dealing with it.  I have enough to deal with still but I need to keep my mind focused on something else.  I need something new.

Guess what I got into now ? hahahaah  

This is my new chicken coop ..  We turn this playhouse into a chicken coop !!!

Thank you hun, I know you think I am loosing it but he made me happy, again !!!

These are my first flock:  Plymouth Barred Rocks.  Will have to wait about 15 weeks before they can lay eggs but it gives me lots of time to learn all about them.  

I have one Rooster, the light colored one on the left

Yap, that's him LOLLLL

July 25 2009

Grandma had been in and out of hospital for her heart most of her life.  She carried a pacer now for over 40 years.  But 2 weeks earlier she was diagnosed with generalized cancer.  I didn't know it but I was seeing her for the last time.  She was under heavy morphine, she was awake sometimes and asking for this and that to the family members that was present.  We prayed often with her.  She held my grandpa's picture close to her heart the whole time.  We took turns being at her bedside in private.  It was my turn.  I was silent.  I held her hand trying to hold back my tears.  Still silent.  I didn't want to say goodbye.  I kissed her hand with tears running down my face.  I lift my head ..."thank you for everything you have done for me, grandma.  You are the greatest person i ever known.  You were the best mom.  The best.  The strongest person in my life.  Thank you, thank you...." 

I had to get up, I had to get out as I couldn't help myself anymore and stormed out of the room bawling on my heart out.  My aunts were holding me up, one asked if I wanted a Valium, the other a glass of water... they are now dragging me to the emergency room ...  I had lost all control...

The next morning while we were finishing our coffee and head back to the hospital, the phone rang, dearest Grandma had passed away.

I looked in my mother's eyes and saw her pain, felt her pain, I saw her worried look towards me, I didn't want to share my pain .... 

I ran upstairs, jumped in the closest bed and cried like a 2 years old.  I lost it, that was it, I was inconsolable.  Mom found me a short time later and put her hand on my back and tried to calm me down.  I screamed.. "  Nooooooooo,.... I wasn't there.... Not yet.....I wasn't there...."

Obviously in sorrow herself tenderly said.." She left us with the people that could be there at that time... she chose them as they were strong enough ... "    I wanted to be there, I wanted to hold her hand, I wanted to be there for her as she had been all my life... I had failed her...  Mom continues " She is waiting for you, she wants you to fell her warmth, all her warmth she has for you, get up and let's go to the hospital...""  

There was NOTHING else that would have snapped me out of it and made me get out of that bed.  Those were the words of a desperate mother to ease her daughter's pain.  Thank you mom for being there, thank you for being there every since.. xox

Ma grand-mère avait fait du va et vient d’hôpital pour son coeur la plupart de sa vie. Elle a porté une batterie maintenant pendant plus de 40 ans. Mais 2 semaines plus tôt elle a été diagnostiquée avec le cancer généralisé. Je ne le savais pas mais c’était ma dernière visite avec elle. Grand-maman était médicamentée de morphine, elle était éveillée parfois et demandait de ceci et ca  aux membres de la famille présente. Nous  prions souvent avec elle. Elle a tenu une photo de mon grand-père près de son coeur. Nous avons chaqu'un un tour avec elle en privé. C'était mon tour. J'étais silencieuse. J'ai tenu sa main essayant de retenir mes larmes. Toujours silencieuse. Je ne voulais pas dire au revoir. J'ai embrassé sa main avec des larmes sur mes joues. Je soulève ma tête... "merci pour tout ce que vous avez fait pour moi,  mémère. Vous êtes la meilleure personne que j'ai jamais connus. Vous étiez la meilleure maman. La meilleure. La plus forte des personnes. Merci, merci...."

J'ai dû me lever et sortir comme j'en pouvais plus.  Je suis sorti comme un ouragan de la chambre braillant de tout mon coeur. Mes tantes me soutenaient, une me demande un Valium, l'autre un verre d'eau ... ils me dirige maintenant à la salle des urgences ... j'avais perdu tout contrôle...

Dans la maison des mes grand-parents, le matin suivant tandis que nous finissions notre café pour retourner a l'hôpital, le téléphone sonne, grand-mère est décédé.

J'ai regardé dans les yeux de ma mère et vu sa douleur,  j'ai vu son regard inquiété vers moi,  je n'ai pas voulu.... 

J'ai couru en haut, a sauté dans le lit le plus proche et crié comme une enfant de 2 ans,  j'étais inconsolable. Maman m'a rejoint un peu plus tard et a mis sa main sur mon dos et a essayé de me calmer. J'ai crié.. "Nooooooooo.... je n'étais pas là.... Pas encore ..... je n'étais pas là...."

Évidemment dans la peine elle-même, tendrement dit.. "Elle nous a quittée avec les gens qui pourraient être là à ce moment-là ... elle les a choisis comme ils étaient les plus forts..." J'ai voulu être là, j'ai voulu tenir sa main, j'ai voulu être là pour elle comme elle avait été toute ma vie ... je l'avais laissée tomber... Maman continue "Elle nous attend, elle veut que tu ressens sa chaleur, toute sa chaleur qu'elle a pour toi... lèves toi et allons à l'hôpital ..." "  

RIEN D'AUTRE qui m'aurais fait sortir de ce lit. Ceux-là étaient les mots d'une mère désespérée pour atténuer la douleur de sa fille. Maman merci pour être là, et merci pour être là depuis .. 

xox

July 2009

So, another truck load of triple mix and a mother's day gift that needed a home.  A Pond !...Instead of digging into the rocky clay soil we have here in NB, I decided to go up.  I latterly moved a mountain !  Heavy rains on the second day and I had quit.  I physically couldn't do it anymore.  

My Hubby decided to get the ATV hooked up with a snow plow thingy and pushed as much as he could, nothing too much happened to tell you the truth as he was digging himself into a hole ! Slippery as hell and wet as hell, heavy as hell.  

2 days later, I got my rubber boots on and fought the beast with a shovel LOLLL   Got high enough good !...  took the rest of the day to get the pond into place securely so that the sides wouldn't collapse with dirt pressure, added snow, more rain or whatever else that could me this one big mess !

Downstairs we had cut railroad track logs thingies.  I got there and got the ones that were the closest in length so I didn't have to cut them.  Bingo, got enough ....  one by one up the stairs out to the garden..this is like way to much work for anyone but obsviously, not for me...grrr !  I got them in place and added spikes so they wouldn't move!  Now we got steps!  Beautiful!

The next day, I knocked at a few doors on this highway i was on.  I had seen flat rocks in what it looked like a dirt pit.  Nobody could help me so I got my truck in there and took as much as the truck would hold.  It took me hours!  Slowly, one rock at a time.  Gosh, never would I think of rock gardening again.  My back was aching so bad.  I sat in the seat of the truck and felt like every vertebrae had moved an inch off side !....This was too much!  Got home and dang, I had to unload every freakin' rock off the truck, one by one and puzzle them in place, applied them  around the edge of the Pond liner...  Done !  Finally !  I am pooped !

Next day, mom and I want shopping for cheap/sale/bargain plants.  I hate shopping but my mother is a pro.  Mom knows how to find a deal anywhere, she's unbelievable!  But really today, I should have stayed home, my back is still not ok.  Wow!  it's a mess, I have a hard time to keep up with her in the aisles.  Mom has so much energy, she does.  I feel older then she is.  She's on fire !

On the 8th day PLANTING DAY !!!  yay !!  i planted the purchased plants, all gift plants and  my own divided plants that I had in my position. Tadda !!

It did look good, yeah it did but something was missing.  I knew that i had to do something for erosion.  It wouldn't stand up to the winters and spring melt.  Tree trunks?  Got lots of them around but i am no lumberjack.  So then what?.........................flat rocks !!!!!  

But is was worth it !  I am very happy with the end results but I wouldn't do it again.....alone !!!!

This one is later in the season, the plants have matured a bit ...  it's amazing!  I love it...

And so did the rest of the new flower beds.  This is the back of the house.  I have added a birdbath

and a few weeks later.......... nice

this is a before picture early plantation:

and the front of the house.....that was instant maturity because the plant exchange was from a local neighbor that knew her stuff and all the samples given were not sample size, they were mother plants already so BAM !..

I bought this seat in Moncton were the lady was selling all her assets.  She had a few interesting pieces but I absolutely wanted to go home with this one.  

As you can see the pic above, I extended the flowerbed to give it more definition.  I know, I know...


And this is a few weeks later !

I love the marriage here of colors, height and textures:  My favorite front corner !

And we can't forget the veggy patch !!!   ...  That was more daily work that my flowers.  The weeds in here were a daily to do.  The soil I received wasn't triple mix so it was constant, manure vs compost vs peat moss and watering 

May 2009

Well, as you can see next, I haven't been able to keep my own promise.  I had to fix it, add more, ding more, extra more...Holy Gees, I am obsessed !!  I just couldn't just leave it.  It wasn't to my standards so there....

I had to call mom for help there though.  I had a hard time with the lifting, mush to my surprise, my heart rate was through the roof, out of breath, sweating like I have never sweat before.  I took much longer then expected.  I would work for a day and then off 2.  Wow, unlike me !!  Just to get rid of the grass was a job, never mind the 16 cubic foot truck load of dirt I had to move around....

At the same time, just I would normal do things, I created this veggy garden by hand.  No tiller, no machines, no magic wand.... Thinking back, I would do it all over again if I could !!  Loved it.

And the front too.... no really, What did you expect?  Don't you get to understand me by now?...go go go..never stop, here's Nat, there goes Nat...  I love creating beauty.  Flowers are my passion, my creations

Of course, You will see soon enough, the matured look of this...doesn't look like much now but just wait a sec !!!

June 2008




I tried to find the original pic in November at the back of the house but I only could find this one ???  Where did it go?... oh well, there it is for now.




I wanted to show you what it was before the deck!

After... Year 1





My first year creation at the back of the house.  Mostly annuals but the perenials were gifts.  I promised not to create too many flower beds here, after all, We have a lot of acreage to cover.  I had control myself....

Then I said, "  We'll, can't leave the front looking like that so shortly after the back was planted, I planted under the window, created a corner to prevent mowing problems and flower pots.

It all seems a lot of work.  Well yeah, It was lolll...   I was overworked and never paid loll  but see, I was trying to make another home for ourselves.  While  my husband was at work as an employee, I was home trying to do as much as I could without him.  Here and there, hubby would pick up a drill or a ladder and get at it too but most of the time, he was already tired from his day.  It is taking a lot longer to get project finished.  It isn't the same life, nothing was the same....

Ma première création d'année à l'arrière de la maison. La plus part sont des annuelles mais le vivaces m'ont éte donnees en cadeaux. J'ai promis de ne pas trop en faire  après tout, nous avons une grande superficie pour couvrir. Faut bien avoir un certain contrôle de soi-même....!



Alors je me suis dit, "Je ne peux pas laisser le devant de la maison comme ca.  Bon la juste un peu sous la fenêtre, et un coin pour empêcher des problèmes de tondeuse et des pots à fleurs ici et la.   C'est tout, pas plus. 


Tout semble beaucoup de travail. Bien ouais, c'était lolll ... j’étais surmené et jamais une maudite cent !! J'essayais de nous faire une autre maison pour nous. Tandis que mon mari était au travail comme un salarié pour la première fois dans 15 ans, j'essayais de faire autant que je pouvais sans lui. Des fois, il aidait avec des projets avec besoin des outils ou une échelle.  Mais la plupart du temps, il été déjà fatigué de sa journée. Il prend beaucoup plus de temps pour finir un projet maintenant mais c'est comme ca.  Ce n'est pas la même vie, rien n'est le même....