Preventing Fibromyalgia Pain

by Karen Lee Richards Patient Advocate

I don't want the title to mislead you. There's no foolproof way to prevent all pain when you have fibromyalgia. But understanding how the FM pain cycle works can enable you to lessen the pain much of the time and even prevent some pain altogether.

The first thing we need to understand is that people with fibromyalgia have a problem processing pain correctly. Normally, pain is supposed to be an alert to tell you something is wrong that needs to be tended to. If you cut yourself, the pain tells you to stop the bleeding and apply an antispetic. Once the wound is treated and begins to heal, the pain lessens and soon goes away altogether - unless you have fibromyalgia.

Understanding the Pain Cycle

With fibromyalgia, instead of gradually easing the pain, the central nervous system essentially turns up the volume. What should be a mild, localized, short-term pain becomes a stronger, widespread, long-term pain. Think of the TV in your living room. When the volume is at a normal level, the TV serves its purpose of providing information and entertainment for anyone in that room. But if someone turns the volume all the way up, it becomes an unpleasant noise that spreads through every room in the house. That's what happens with FM - what should be a mild, maybe even unnoticeable, pain intensifies and spreads.

I can actually see this pain process at work when I stub my toe. Normally, if you stub your toe, you might yell,"Ouch" (or something more colorful), rub your toe for a few minutes, then go on your way as the pain subsides. Since developing FM, I've discovered that stubbing my toe now triggers a much more long-term pain process. First, the initial pain is more intense than it used to be. But more important is what follows. Within an hour or so, I notice that the lower part of my leg hurts - not intensly, but there's a definite aching feeling. A couple of hours later, my entire leg is hurting. By the end of the day, most of my body is aching more than usual. Those additional aches and pains may last for a few days.

Usually we don't know what triggers our pain cycles - why we hurt more some days than others. Often it's tiny, unnoticeable things. Our central nervous systems become so hypersensitive that we react to things like changes in barometric pressure brought on by weather fronts. I'm not suggesting you spend a lot of time trying to figure out what causes every pain flare. Focusing that much attention on your pain will only serve to make it hurt worse. But being aware of how the pain cycle works can help us make changes in what we do or the way we do it so we can try to reduce our pain levels.

Heading Pain Off at the Pass

One of the biggest mistakes people with FM make is waiting until they are in a lot of pain to take their pain medication. Our culture tells us to be tough when it comes to pain. Athletes who play through the pain are admired and lauded. And all the talk about drug abuse makes us feel guilty about taking pain relievers, so we try to hang on as long as we can without taking them. But when it comes to FM, trying to tough it out only makes it worse. Once that pain cycle gets started, it's much harder to tamp it down. It's important for fibromyalgia patients to take their medications on a regular schedule to help prevent the pain cycle from getting a foothold.

Other prevention tips are pretty much common sense things. If you're prone to stubbing your toe a lot, wear shoes more often. If you tend to overdo when you're having a good day, force yourself to scale back or do less strenuous activities so you don't spend the next week paying for one day's enthusiasm. Just try to be more aware of what you do and how you do it. You might try keeping a pain journal for a month to see if you can pinpoint things that may be increasing your pain levels.

I wish I knew of a surefire formula to prevent all of our pain. But until someone discovers that forumla, at least we can take steps to help minimize and control our pain levels.

© Karen Lee Richards 2009

Updated 5/20/2009

Karen Lee Richards
Meet Our Writer
Karen Lee Richards

Karen is the co-founder of the National Fibromyalgia Association. She writes for HealthCentral as a patient expert for Pain Management.