Fibromyalgia – Fight Pain: Confuse Your Brain   Leave a comment

Crossing your arms, after a hand injury, could reduce your perception of pain. So says this study, which was reported by the BBC.

The researchers say these findings could be used to plan studies of chronic pain conditions.

My good wife, Lynn, brought this article to my attention. I thought it worth a mention as I’ve been writing about the power of the mind, and how it effects pain, in recent posts.

Incidently, I have always found the BBC’s website an excellent source of health information, and I often recommend it to patients. The BBC has this to say on the subject of fibromyalgia – although it is a little out of date – and also have some interesting articles on the condition.

Fibromyalgia – All in Your Head?   7 comments

Fibromyalgia is a purely psychological condition. There is no physical component other than what you imagine. It is simply a case of mind over matter. If you were more positive, and could pull yourself together, this would not be happening to you.

I disagree.

However, maybe at least part of fibromyalgia can be controlled by addressing the psychological issues.

Many sufferers become defensive at the suggestion that fibromyalgia has a psychological component.  This suggestion can be like a “red rag to a bull”: They become visibly angry when this opinion is expressed.

I suspect that this reaction is because many people, and sadly, many doctors, really do think that fibromyalgia is a psychological condition. Perhaps by conceding that this is at least PARTLY true, sufferers are worried that the entire illness could be dismissed as something they could control. All they have to do is try a bit harder.

Fibromyalgia is a life-long, painful, exhausting, debilitating condition. Why would you NOT be psychologically affected by it?

Yet people with fibromyalgia often seem reluctant to pursue any form of psychological intervention for their illness. For example, I ran a poll asking people about fibromyalgia ebooks. I asked what sort of information people would hope to read about. One of the suggested topics was: “Counselling and Cognitive Behavioural Therapy”. In the poll, this was one of the least popular responses.

I must say that I am genuinely surprised by this. Why? Because once you’ve done everything you can to reduce the symptoms of fibromyalgia, and live as normal a life as possible, you still have to be able to cope with what’s left. Most people with fibromyalgia will never be completely well again. To me, that’s a scary and depressing thought. It takes inner strength to accept that you can still live a fulfilling life with fibromyalgia. Why dismiss something that could help you find that strength?

In a recent post, I wrote about having a positive attitude, and how it can be important to acknowledge when you’re having a good day. I got some interesting feedback. There seemed to be two main viewpoints. Some people were obviously offended – What did I think they had to be positive about? Others agreed that if you see even the good days as being miserable, you risk making your suffering even worse.

I see two explanations for why these different views exist. One is that some people suffer more severely than others because that is the nature of fibromyalgia. Your mental attitude has nothing to do with it. Such people find even the good days barely manageable. Therefore, if you are the sort of person that can walk about with a smile on your face just because, “things could be worse”, it simply means you don’t have a severe case of fibromyalgia.

An alternative explanation is that of the self-fulfilling prophecy: People, who believe that they have a terribly debilitating disease, reinforce this belief with their thoughts, words and actions. In doing so, they actually CAUSE their condition to worsen. In other words, a chronic illness, such as fibromyalgia, can be made almost unbearable by the persistent fear and belief that severe suffering is unavoidable.

Many of us think and express negative affirmations, such as “I feel too unwell to go out today”. Such affirmations can become habit, and we find ourselves saying this type of thing all the time. Every time we do so, we reinforce our ill health and actually contribute to it. But POSITIVE affirmations can become habit too: “I feel better today”. Said enough times, this really can lead to an improvement in your health.

Your mind is a powerful thing. Use it well.

We can reprogram our beliefs and, in doing so, make positive changes to our health. By learning to discard harmful habits, such as frequently thinking and expressing negative affirmations, we can use the power of our mind to ease the physical symptoms of fibromyalgia.

I agree.

Posted May 22, 2011 by Dr Chris Moore in Uncategorized

Tagged with , , , , ,

Fibromyalgia – A Question on Flares   7 comments

I’d be really grateful for any feedback/comments on this:

I wonder how many fibromyalgia sufferers deliberately do things that cause symptoms to flare.

For example, I occasionally have a deep tissue massage. It hurts like hell and I feel so unwell afterwards, I have to go to bed. The next day I am in a lot of pain.  So, why do it? On the second day, I will probably be free from pain and stiffness. Admittedly this doesn’t last forever – these symptoms gradually return over the next few weeks, but the whole thing is worth it to me to have a bit of respite. I’ve tried other types of massage, and they just don’t work for me.

I wonder if other people do things like this, for example exercise, or a day out with friends. Please let me know…

Fibromyalgia – Well for a Day   3 comments

Fibromyalgia is often referred to as an “invisible illness”. Despite suffering a multitude of debilitating symptoms, people with fibromyalgia tend to look well. This normal appearance leads others, even many doctors, to underestimate the effects of fibromyalgia. Some people even dismiss the disease completely, stating it is “all in the mind”.

It is difficult enough trying to lead a relatively normal life with fibromyalgia. This denial from the people around us has a negative impact.

I often see fibromyalgia sufferers with wrist supports. Others have walking sticks, or neck collars. I have recently bought a shoe-horn because I find it difficult to bend down to put my shoes on – it’s the sort of thing my grandmother would use, and she’s eighty-six!

Sometimes I wonder if these props have more than one purpose. Not only do they serve their primary function, supporting joints, aiding mobility, etc, they also give a visual clue to the user’s health problems.

There are other clues too:

People with fibromyalgia often look well, but they don’t always look happy. Is this because an unhappy facial expression is another signal of ill health that the sufferer is keen to send out to people?

How are you? Have you ever asked someone that question and wished that you hadn’t? It can open the floodgates to a flow of negative affirmations: “I feel terrible”, “I’m in a lot of pain today”, “I hardly slept last night”.

As a doctor, I often start my consultations with the question, “How are you?” This is such a common question that most people have a standard response – one that comes out automatically. I’m always very interested in their answer, because it tells me something about the sort of person they are.

When I ask this question in my practice, many people will say, “Very well, thank you”, and then remember where they are and laugh. At this point they will correct themselves, saying something like, “Well, I’m not great, obviously, or else I wouldn’t be here!”

Another common response is “Don’t ask”, preceded by a deep sigh.

What is your standard response to this question?

Many aspects of our health are psychological. If we are constantly giving out the message that we are unwell, we are in fact making illness a habit: By the way we act, and appear, and talk, it is easy to reinforce our negative health beliefs.

This behaviour is sometimes called the “sick roll”. It’s the behaviour we lapse into when we’re unwell. Unfortunately, in chronic illness, this roll can become a life-long habit.

I have a challenge for you: Be well for a day. Even though you don’t feel it, PRETEND. Don’t pick a day when you feel especially unwell, but don’t wait until you’re feeling great either – sadly, this day may never come. Discard your visual props, stand upright, smile and face the world. Get ready for the “How are you?” question, and answer, “I feel pretty good today, thank you”.

The way we behave really does have a strong effect on our health. But just as ill-health leads to negative actions – like playing out the sick roll – the same principles can be applied in reverse: By acting the way we do when we are well, even if we don’t feel it, we can make a positive impact on our health.

Posted May 19, 2011 by Dr Chris Moore in Uncategorized

Tagged with , , , ,

Homeopathy Helps Fibromyalgia – Science or Fiction?   Leave a comment

This is a reply to a question on homeopathy from Lizzy on Twitter. Thanks for your question Lizzy

Lizzy saw this article on homeopathy and wondered if it would really help with fibromyalgia.

The answer is yes… and no.

No, because homeopathy has absolutely no effect on the body when you consider all the nonsense of diluting something (harmful) down to an infinitesimal amount, and then putting the resulting product (water) into a pill.

Yes, because of the placebo effect

Making reference to the trial here is an excellent example of what researchers call cherry picking. There have been hundreds of trials on homeopathy. Referring to just one of them because it suits your argument is a joke. It’s like saying a coin will only ever land heads, as long as you ignore all the times it lands tails. (I wrote a post previously about the Coin Throwing Analogy, which explains this concept in more detail). I could just as easily cherry pick this trial which suggests that the effects of homeopathy are placebo only.

To be fair, there have been few well-conducted trials, which look specifically at homeopathy as a treatment for fibromyalgia. But research looking into other claims of homeopathists suggests it is ineffective. Even favourable evidence is usually very weak.

This review of complementary and alternative therapies for fibromyalgia, suggests that the majority of such therapies work no better than placebo. Before I get accused of cherry picking, I should also mention this review, which finds in favour of homeopathy, but only looked at one trial. Watch this space for a forth-coming review from the Cochrane Collaboration (Although I fear it will find there is “insufficient research” in this area to reach a definitive conclusion – hopefully not)

It’s also worth remembering that there is a lot of what researchers call “publication bias” in clinical research. In other words, not all the trials that are conducted get published. They are therefore not available to be included in a systematic review. Why is this?

Imagine you were a homoeopathist who wants to prove that your therapy is effective. You could conduct a clinical trial. But, what if the results showed that homeopathy performed no better that placebo? Would you attempt to get this research published, potentially discrediting your profession, and putting yourself out of work? Perhaps not. Maybe you would just forget it ever happened and carry on regardless. Meanwhile the pool of evidence, which would be all the more accurate for your contribution, is weighted by the kind of trials that homoeopathists DO like to see: the ones that suggest it works.

Of course, not all research on homeopathy is conducted by homoeopathists, so this effect is not as great as it could be.

There is an interesting piece of psychology, and perhaps one of the reasons that homeopathy has survived as long as it has: By tackling the subject of homeopathy, even though they are showing it in a poor light (complete darkness in fact), scientists lend credibility to this mode of therapy. Peddlers of homeopathy are always keen to point out that they are in “heated debate” with scientists. The irony is that had scientists just left this topic alone, we would probably have seen an end to this nonsense long ago.

Finally, there is another interesting point on this homeopathy page:

“This randomized controlled pilot study on the use of homeopathy in the treatment of fibromyalgia yielded encouraging results and suggests further investigation may be beneficial.”

Keep throwing that coin guys!

The Problem with Uncle Joe   Leave a comment

Uncle Joe is the old guy you’ve all heard about. He smoked all his life, drank alcohol to excess, ate unhealthily, never exercised, and died aged a hundred-and-three.

You’ve also heard of the guy who obsessed over his health, did all the “right” things, and died of a heart attack aged 30, whilst out jogging.

We often hear these types of story from people who argue that, no matter what you do, what’s going to happen will happen. But that’s not true. Most people like Uncle Joe will die before their time. Most people, who make good life-style choices, will remain healthy for longer.

You have to play the odds.

Yes, there are the occasional exceptions – the ones who do everything wrong, and still end up ok. But these are rare. You could walk across a busy road blindfolded, and reach the other side unharmed. That doesn’t mean you should.

So what would Uncle Joe have done had he developed fibromyalgia?

I’m guessing he would have just given in. He would have sat in a chair, or laid in a bed, getting weaker, more tired and suffering more pain. He would have got depressed quickly. Any motivation left in him would soon have vanished. He would have lost hope. Anyone trying to help him would have found their advice ignored. Pill bottles from the doctor would have remained untouched.

Before long, he would have been too weak to do much, even if he wanted to. How do you go out for a walk, or a swim, when you’ve hardly left the chair for months? How can you exercise when you were unfit even BEFORE you got unwell? How do you find friends, or a support group, when you’ve isolated yourself for so long? How do you break life-long habits, and start to think about improving your health, when you’re less motivated than ever?

There’s a bit of Uncle Joe in us all. He’s the part of us that just wants to give in and stop: Forget the pills, and the therapies, and the advice, and the exercise, and the socialising, and the routine – just go to bed and stay there.

We all indulge him from time-to-time.

I don’t think it’s necessarily a bad thing to feel sorry for yourself occasionally – why shouldn’t you? But we have to be careful of self-fulfilling prophecies. By saying you can’t do something, you set yourself up to fail. For example, thinking: “I can’t go out, I’m too weak”, means you don’t even try. Before long, your inactivity leads to drastic loss of fitness, then you really ARE too weak. You can then lie in your bed, knowing you were right all along, and thinking about how unfair it all is.

Or…

You could refuse to give in. Yes, you feel unwell. Yes, you are in pain. But by staying active, you keep what fitness you have. If you can do that tiny bit more, your fitness could even improve. By increasing your activity, however little, you can start to reduce pain, fight low mood and lessen fatigue. Don’t want to? Too tired? Too sore? Do it anyway. I know it’s counterintuitive, but it WILL help you.

Doctors often say to fibromyalgia sufferers, “Go and do some exercise”. This is dismissive and shows a lack of insight into what it is like to have fibromyalgia: Many doctors don’t realise just how inactive some fibromyalgia sufferers are. You’re in pain, it hurts to move, you’re scared of making things worse. Why would you want to do that?

Exercise implies going out running, or cycling, or playing squash. Many fibromyalgia sufferers are capable of this. Some – believe it or not – even run marathons.

But for many sufferers “exercise” just isn’t realistic. Many are practically housebound. Going from one room of the house to the next is difficult enough. How do you go from that to playing badminton?

It may be better to say, “Try and increase your activity”. No matter how small your capabilities, try and increase what you do. Go slow. Very slow. If you over-do it, you will bring on flares and feel like you’ve failed.

There are lots of ways you can measure your progress. One way might be to buy a pedometer. These are small electronic devices that you wear on your hip. They are not expensive. They measure how many steps you take. Wear one for a day and record your number of steps. Then SLOWLY try to increase it. You may have to get off the bus a stop early, or park the car a little further from the store than usual. Think about it – what small changes could you make? If all you can manage at first is walking about the house, fine. Slowly build it up.

You CAN do this. Don’t say you can’t and then start proving yourself right. Think positive.

There’s a quote from Henry Ford that I really like:

“Whether you think you can, or you can’t, you’re probably right”

Well said.

Can Fibromyalgia Cure Itself?   10 comments

Can fibromyalgia cure itself? Before you read on, I should stress – I don’t know the answer to this question – it’s rhetorical only. Sorry. But if you have any info on this, I’d be glad to hear about it.

I wondered about this after an email from Leti (Twitter: Dreaminloudly) Thanks for bringing up an interesting point Leti.

Leti sent me this article from CNN about the actor David Seidler, who says he cured his own bladder cancer with the power of his mind.

Now, don’t get me wrong, I’m a strong believer in the power of the mind. That’s why I write about psychology on my blog sometimes.  But I think you can take this idea too far – if you’re falling off a cliff, you’re going to hit the bottom no matter what you think.

Some cancers do go into spontaneous remission. It’s not known why or how (if it was known, we’d probably be well on our way to a cure), and we can’t even predict which ones will do this. It is very rare unfortunately.

If you’re one of the lucky ones, whose cancer cures itself, you will naturally assume that whatever you’ve been doing differently is the reason. If this thing was thinking positively, then that’s what you’ll give the credit to.

There are similar examples of people in spontaneous cancer remission feeling sure it was the power of prayer, or some change in diet, homeopathy, slaughtering a donkey at full moon, etc, that cured them, when in fact it was probably none of these things.

Science is pretty boring like that sometimes.

So what about fibromyalgia?

There are reports of fibromyalgia going into remission. Again, if this does happen (and I’m not convinced) then it is rare. Perhaps, a more likely explanation is that these people were misdiagnosed, and never had fibromyalgia in the first place. I’m not sure about this – I’d be happy to be proved wrong – I’ve certainly heard it said that fibromyalgia can resolve, (another thing for me to look into – the list grows ever longer)

It’s possible that people claiming to have “cures” for fibromyalgia are those that had spontaneous remission. They are assuming that whatever they did, before they got better, was the reason they got better. (The post hoc ergo propter hoc logical fallacy). Therefore these people feel they have found the cure to fibromyalgia.

Of course, some are just con artists, who know full well they’re full of crap.

Follow

Get every new post delivered to your Inbox.

Join 1,527 other followers