Fatigue of Fibromyalgia More Severe Than Normal Tirednessby Karen Lee Richards Patient Advocate
A study of fatigue in fibromyalgia, published last week in the journal BMC Musculoskeletal Disorders, found that fatigue is not only an important symptom of fibromyalgia, but that the fatigue experienced by people with FM is more severe, constant/persistent and unpredictable that normal tiredness.
Study Methods and Results
Interviews were conducted with 40 individuals - 20 from the U.S., 10 from Germany and 10 from France. Twenty-eight of the participants (70%) were female and 12 were male.
When asked to state the three things that bothered them the most about having FM, 89% mentioned pain, 51% listed fatigue/tiredness/lack of energy, and 26% said it was the functional limitations.
According to the journal article, "FM fatigue was described as an overwhelming feeling of tiredness that was not relieved by sleep or rest and is often not in proportion to the effort exerted (i.e. participants described becoming tired after doing very little). Many described their fatigue as 'feeling weak' or their body feeling heavy and almost all participants talked about having to force themselves to do things or described having difficulty getting motivated to do things. Participants differentiated between FM fatigue and normal tiredness by referring to the fact that FM fatigue limited them in doing daily activities or caused difficulty concentrating, thinking clearly and/or remembering things."
The study found that the key elements of fatigue in FM from a patient perspective are:
An overwhelming feeling of tiredness.
Not relieved by resting/sleeping.
Not proportional to effort exerted.
Associated with a feeling of weakness/heaviness.
Interferes with motivation.
Interferes with desired activities.
Makes it difficult to concentrate, think clearly and remember things.
Although the conclusions of this study are nothing new to those of us with fibromyalgia, I was glad to see the fatigue of FM studied, described and published in a medical journal because too many people - some doctors included - think of it as just being tired. The fact is, there is no word (in English at least) that adequately conveys the depth of fatigue that accompanies FM. Exhaustion comes closest but still doesn't quite explain it.
I've described the fatigue of FM as feeling like someone has pulled my plug. It's as if my source of power and energy has been cut off. Another analogy might be made to power steering in a car. Have you ever tried to steer a car when the power steering wasn't working? It takes every bit of strength you can muster just to turn the steering wheel a couple of inches. When I am having a flare and the fatigue is at its worst, it takes every bit of energy I can muster just to do the simplest task, like take a shower or make a sandwich.
In some ways, the fatigue of FM can be more disabling than the pain. While we can push through the pain (to a point anyway), when the overwhelming fatigue takes over, there is nothing left to push with. And unfortunately, just getting a little extra rest doesn't help. In fact, sometimes we wake up feeling as bad or worse than we did when we went to sleep.
There are no simple answers to dealing with the fatigue of FM. Some doctors will prescribe Provigil, which can increase your energy some. For me, taking fairly large doses of Ubiquinol (a more-readily absorbed form of Coenzyme-Q10) has helped quite a bit. And, of course, getting extra rest and not overdoing it are essential.
For more tips on coping with fatigue, also read: Learning to Manage Your Energy
I'd like to hear how you would describe your fatigue, how it impacts your life, and/or any tips you have found that help you cope with the fatigue or increase your energy. Just click on "Comments" below to share.
Humphrey L, et al. Fatigue in fibromyalgia: a conceptual model informed by patient interviews. BMC Musculoskelet Disord. 2010 Sep 20;11(1):216.