Article # 516. Back Pain

Article # 473. Foods to Prevent Joint Pain

Joint pain is a common occurrence as you get older. It can be caused by accidents, sports injuries, being overweight or conditions such as rheumatoid arthritis and osteoarthritis. While you may turn to over-the-counter pain relievers such as acetaminophen and ibuprofen, Nutrition Science News: The Journal of Natural Products Research and Innovation, points out that some foods act as natural pain relievers that target the causes of joint pain, rather than just masking the symptoms.

Ginger

This tasty, pungent root has a long reputation as a healing food used for treating conditions such as nausea and colds. It can also be an effective pain reliever. According to the magazine Chemistry World, ginger---which contains active ingredients called gingerols, zingerone and shogaols---can fight spasms and inflammation. While it's best to eat fresh ginger to reap its pain-fighting benefits, you can also find ginger available in liquid extract or capsule form.

Fatty Fish

Essential fatty acids found in foods such as fatty fish, including mackerel, salmon and tuna, plays a key role in moderating joint inflammation that accompanies arthritis. Increasing these healthy fats in your diet can relieve both inflammation and pain. Researchers revealed that omega-3 fatty acids were able to reduce lower back and neck pain caused by disc disease and arthritis in 59 percent of patients. Taking supplements of essential fatty acids also enabled 68 percent of patients to stop using non-steroidal anti-inflammatory drugs.

Antioxidant-Rich Foods

Foods such as orange juice and berries can help to prevent or slow joint damage, relieving joint pain. They are rich in antioxidants that help to fight free radicals that attacking joint tissues. Also, a study published in the April 2008 issue of the journal Osteoarthritis and Cartilage revealed that people with late-stage osteoarthritis have lower levels of antioxidants in their joint fluid. However, there's no proof that antioxidant-rich foods can effectively relieve rheumatoid arthritis pain.

Turmeric

This spice that gives curry its vibrant yellow color contains an active ingredient called curcumin that provides several benefits for your joints. According to Arthritis Today, a health magazine from the Arthritis Foundation, curcumin can help to reduce pain and stiffness caused by osteoarthritis and rheumatoid arthritis. It also influences immune system activity to help prevent joint inflammation.

Article # 457. 7 Ingredients to Ease Arthritis Pain

Green Tea

Green tea has been the subject of much health buzz in recent years, and with good reason. Compared with regular black tea, green tea looks weak and insubstantial. But this mild-mannered drink contains a natural antioxidant called epigallocatechin-3-gallate (EGCG) not found in black tea.

Omega-3 Fats

The healthiest of fats for people with arthritis or other inflammatory disorders are omega-3 fats. While other foods increase levels of inflammation in the body, omega-3s actually work to decrease inflammation by suppressing the production of enzymes that erode cartilage. The best foods for omega-3 fatty acids are salmon (wild, fresh or canned), herring, mackerel (not king), sardines, anchovies, rainbow trout, Pacific oysters, flaxseeds (ground and oil), chia seeds, and walnuts.

Carotenes

The carotenoids are a group of powerful antioxidant nutrients found in many fruits and vegetables. The best known is beta carotene (found in foods like cantaloupe, sweet potatoes, pumpkin, carrots, kale, butternut squash, and spinach), but its sister carotenoid, beta-cryptoxanthin, may also reduce the risk of developing inflammation-related disorders, including rheumatoid arthritis.

Olive Oil

In addition to healthy monounsaturated fats, olive oil contains a natural compound called oleocanthal which may help prevent arthritis-related inflammation. This compound blocks the same inflammatory pathways as ibuprofen and aspirin, medications commonly used to fight arthritis pain.

Carotenes

The carotenoids are a group of powerful antioxidant nutrients found in many fruits and vegetables. The best known is beta carotene (found in foods like cantaloupe, sweet potatoes, pumpkin, carrots, kale, butternut squash, and spinach), but its sister carotenoid, beta-cryptoxanthin, may also reduce the risk of developing inflammation-related disorders, including rheumatoid arthritis. Some of the best foods for beta cryptoxanthin include winter squash, pumpkin, persimmons, papaya, tangerines, red peppers, corn, oranges and apricots.

Vitamin C
Vitamin C is one of the nutrients most responsible for the health of collagen, a major component of cartilage. In addition, research suggests that people who eat a diet low in vitamin C may have a greater risk of developing some kinds of arthritis. For those reasons, it is important to make vitamin C-rich foods — such as guava, bell peppers (yellow, red, orange, and green), oranges, grapefruits, strawberries, pineapple, broccoli, kidney beans, kiwi, and cauliflower — a part of your daily diet.

Anthocyanins

Anthocyanins are powerful antioxidants that help reduce inflammation by inhibiting production of certain inflammatory chemicals. These compounds contribute to the health of connective tissue, and are even more powerful than vitamin C for defusing dangerous free radicals that can irritate body tissues and cause inflammation. Some of the best foods for anthocyanins include cherries, blackberries, black currents, blueberries, eggplant, elderberries, raspberries, boysenberries, red and black grapes, strawberries, and plums.

Spices: Ginger and Turmeric

Like fruits and vegetables, spices contain beneficial phytonutrients that can have powerful effects on health. Certain spices seem to have anti–inflammatory effects, and therefore should be considered for arthritis treatment. Among the most promising are turmeric — the Asian mustard–yellow spice found in curry — and ginger. Because ginger contains chemicals that work similarly to some anti–inflammatory medications, the benefits of ginger for arthritis pain are not surprising.

Article # 427. Tips to prevent Back Pain and Joint Pain

Don’t sit or stand for long periods of time

Sitting at your desk for 8 hours without relief can cause low back pain, neck and upper back pain. Standing for long periods of time without proper footwear and supportive flooring can also cause postural issues which may lead to foot, leg and back pain.

Resolution: Take a walk, get up from your desk and walk to the restroom, refill your water bottle, take a 10 minute walk around the office, get some fresh air, do some light stretching. For standing employees, stretching could be the most beneficial solution. Here are a few to give a try:

• Quadriceps: Stand on one foot while you bend the opposite foot behind, place your hand on your laces or ankle for support.
• Hamstring: Feet should width apart bend at the hips and reach for your toes. Keep your knees slightly bent to prevent injury
• Hip flexor: While standing bring one foot behind you forming a lunge position. Front knee is bent. Curl the tailbone under and press hips forward. Do not let the front knee pass the ankle of the front foot.
• Chest: Open up your arms in a tee position. Press the palm of your hand against a wall for added pressure
• Back: Bring the hands together in front and round the upper back and shoulders

Get outside

Allow yourself to take a break, if possible take 3-4, 10 minute breaks throughout the day. Get outside and enjoy the fresh air, take a short walk, get a coworker to join you. The benefit is not only in getting up and moving around, studies have shown that getting outside and away from the computer may improve work performance and working memory.

Make your office a gym

Utilize your furniture and space around your desk to perform a few simple exercises. This will not only help add some exercise into your day but will keep you alert and ready for whatever the boss throws at you! Here are a few examples of worksite exercises:

• Triceps dips- use the seat of your chair or the edge of your desk to brace yourself. With your body facing away from the desk/chair, hands are shoulder width apart, dip your body down about 6-10 inches, then press back up. Do 15-20 reps, 2 sets
• Pushups- use the wall, or your desk to do standing pushups. You should look as though you are performing a push up only standing.  For increased difficulty step farther away from the wall/desk. Do 15-20 reps, 2 sets
• Lunge- Step one foot out in front, dip down so the your front and back knee form a 90 degree angle, be careful not to allow your front knee to pass over your front ankle. Push back up to standing position, and repeat with the opposite leg. Do 10 reps each side, 2 sets
• Squats- Using your chair as a guide, stand in front of the chair, go to sit down but only squat to about 1-2 inches from the actual seat, then return to standing. Do 10-15 reps, 2 sets

Be your own Ergonomics advisor
Assess your current seated position at your desk, and ask yourself these questions:

• Do I look straight at the computer screen? Adjust your seat or screen height accordingly
• Are your wrists straight and elbows relaxed while typing? Adjust your keyboard and seat height accordingly
• Does the angle of your hips and back average at 90 degrees? Adjust back support and seat height accordingly
• Does your lower back feel supported? Adjust lumbar support. If needed purchase an inexpensive support such as a small pillow to increase lumbar support.
• Are your feet flat on the floor? Adjust seat height accordingly

Be aware of your posture
Avoid slouching, and hunching towards your computer or desk. If writing by hand use a raised surface if you need to be close to the paper. Good posture is important to strengthen your core and back muscles. Incorrect posture can lead to muscle imbalances and/or pain

Plan ahead
Plan your day in advance. What you will eat, when you will take a breather, and when you will exercise.

When you plan in advance what you will eat while at work you are less likely to grab something from canteen or snack shops. Make sure to pack enough food. Include some fruit, veggies, and whole grains. Example- Cooked carrots, broccoli, brown rice, and fresh salads/Greens. For desert, try fresh strawberries, Plums, Red grapes & other berries if feasible like blueberries, cranberries and black berries.

Plan when you will exercise. Pack a gym bag the night before so that you have your mind set on exercising either before, during, or after work.

Put a few breaks on your schedule so that you actually take them. When you get into a groove at work you may forget. Set a reminder to alert you.

Get some rest
According to Harvard Women’s Health, adequate sleep affects the following: Learning and memory, metabolism and weight, safety (risk of falling), mood, cardiovascular health, and disease prevention. The recommended amount of sleep is 7-9 hours/night. To reap the most benefit from the hours slept the additional recommendation is to keep a consistent sleep schedule, going to bed and waking at the same time most days of the week.

Get the stress out
Stress can cause many symptoms, such as: headaches, low productivity/concentration, nervousness, chest pain, hair loss, sleep problems, fatigue, body aches, anger and depression. To reduce the stress in your life, don’t try to pin point the stressor, first just try to give yourself 10 minutes a day of stress free time. Try a deep breathing exercise, listen to a mental imagery CD, sit outside and enjoy the sounds of nature, or try meditation. As you become more comfortable with this exercise try to increase your time in peace and incorporate positive thoughts, feelings, and emotions into your everyday routine.

Join or start a group activity/Get involved with the community
If your place of employment offers a gym or group classes, get involved. If not, why not start one.

Examples: volunteer, start a running/walking/biking/swimming/yoga/Pilates group or class, book club, bible study, etc.  A sense of involvement and community connection really can make a big difference.

It’s all about the balance!

It’s not about being perfect: eating healthy every meal every day, exercising every day, meditating, sleeping enough, being involved, etc. It’s ALL about BALANCE! Wellness involves emotional, environmental, physical, occupational, social, intellectual, and spiritual endeavors. It’s the attempt to allow yourself to make mistakes, and enjoy the journey that creates balance in one’s life.

Article # 426. Low Back Pain: Tips on Pain Relief and Prevention

What can cause low back injuries? Many things can cause low back injuries--muscle strain or spasm, sprains of ligaments (which attach bone to bone), joint problems or a "slipped disk." The most common cause is using your back muscles in activities you're not used to, like lifting heavy furniture or doing yard work or while exercising you might have attempted the workouts wrongly. A slipped disk happens when the disk between the bones bulges and presses on nerves. This is often caused by twisting while lifting. But many people won't know what caused their slipped disk. As people age, bone strength and muscle elasticity and tone tend to decrease. The discs begin to lose fluid and flexibility, which decreases their ability to cushion the vertebrae. Pain can occur when, for example, someone lifts something too heavy or overstretches, causing a sprain, strain, or spasm in one of the muscles or ligaments in the back. If the spine becomes overly strained or compressed, a disc may rupture or bulge outward. This rupture may put pressure on one of the more than 50 nerves rooted to the spinal cord that control body movements and transmit signals from the body to the brain. When these nerve roots become compressed or irritated, back pain results. Low back pain may reflect nerve or muscle irritation or bone lesions. Most low back pain follows injury or trauma to the back, but pain may also be caused by degenerative conditions such as arthritis or disc disease, osteoporosis or other bone diseases, viral infections, irritation to joints and discs, or congenital abnormalities in the spine. Obesity, smoking, weight gain during pregnancy, stress, poor physical condition, posture inappropriate for the activity being performed, and poor sleeping position also may contribute to low back pain. Additionally, scar tissue created when the injured back heals itself does not have the strength or flexibility of normal tissue. Build-up of scar tissue from repeated injuries eventually weakens the back and can lead to more serious injury. Occasionally, low back pain may indicate a more serious medical problem. Pain accompanied by fever or loss of bowel or bladder control, pain when coughing, and progressive weakness in the legs may indicate a pinched nerve or other serious condition. People with diabetes may have severe back pain or pain radiating down the leg related to neuropathy. People with these symptoms should contact a doctor immediately to help prevent permanent damage. Who is most likely to develop low back pain? Nearly everyone has low back pain sometime. Men and women are equally affected. It occurs most often between ages 30 and 50, due in part to the aging process but also as a result of sedentary life styles with too little (sometimes punctuated by too much) exercise. The risk of experiencing low back pain from disc disease or spinal degeneration increases with age. Low back pain unrelated to injury or other known cause is unusual in pre-teen children. However, a backpack overloaded with schoolbooks and supplies can quickly strain the back and cause muscle fatigue. To avoid back strain, children carrying backpacks should bend both knees when lifting heavy packs, visit their locker or desk between classes to lighten loads or replace books, or purchase a backpack or airline tote on wheels. What can I do for relief when I've hurt my lower back? The best position for relief when your back hurts is to lie on your back on the floor with pillows under your knees, with your hips and knees bent and your feet on a chair, or just with your hips and knees bent. This takes the pressure and weight off your back. If you're resting a hurt back, you may need 1 to 2 days of this sort of rest. Resting longer than this can cause your muscles to weaken, which can slow your recovery. Even if it hurts, walk around for a few minutes every hour. Is there relief for ongoing back problems? Treatment of on-going back problems must be directed at the cause. This may mean losing weight (because being overweight can make back pain worse), getting your muscles in better shape, and improving your posture when you're sitting, standing and sleeping. Tips for preventing back strain Don't lift by bending over. Lift an object by bending your hips and knees and then squatting to pick up the object. Keep your back straight and hold the object close to your body. Avoid twisting your body while lifting. Push rather than pull when you must move heavy objects. If you must sit at your desk or at the wheel of a car or truck for long hours, break up the time with stops to stretch. Wear flat shoes or shoes with low heels (1 inch or lower). Exercise regularly. An inactive lifestyle contributes to lower back pain. What's the best way to sit? Sit in chairs with straight backs or low-back support. Keep your knees a little higher than your hips. Adjust the seat or use a low stool to prop your feet on. Turn by moving your whole body rather than by twisting at your waist. When driving, sit straight and move the seat forward. This helps you not lean forward to reach the controls. You may want to put a small pillow or rolled towel behind your lower back if you must drive or sit for a long time. What's the best position for standing? If you must stand for long periods, rest 1 foot on a low stool to relieve pressure on your lower back. Every 5 to 15 minutes, switch the foot you're resting on the stool. Maintain good posture: Keep your ears, shoulders and hips in a straight line, with your head up and your stomach pulled in. What's the best position for sleeping? The best way to sleep is on your side with your knees bent. You may put a pillow under your head to support your neck. You may also put a pillow between your knees. If you sleep on your back, put pillows under your knees and a small pillow under your lower back. Don't sleep on your stomach unless you put a pillow under your hips. Use a firm mattress. If your mattress is too soft, use a board of 1/2-inch plywood under the mattress to add support. What exercises can I do to strengthen my back? Some specific exercises can help your back. One is to gently stretch your back muscles. Lie on your back with your knees bent and slowly raise your left knee to your chest. Press your lower back against the floor. Hold for 5 seconds. Relax and repeat the exercise with your right knee. Do 10 of these exercises for each leg, switching legs. While some exercises are specific for your back, it's also important to stay active in general. Swimming and walking are good overall exercises to improve your fitness.

Article 277. Hand Exercises for Rheumatoid Arthritis

 

Hand Exercises for Rheumatoid Arthritis

You need your hands to cook, clean, type, and do just about everything else. But you probably don’t think much about how important manual dexterity is unless you have rheumatoid arthritis (RA) or another type of arthritis that attacks your hand and finger joints.

RA is a disease in which the body's immune system engages in friendly fire against the joints. It often starts in your hands before spreading to the other joints.

“The hands and the feet are usually hit first, and these are the joints that are predominantly involved in everyone with RA,” says Eric Matteson, MD, a professor of medicine at the Mayo Clinic in Rochester, Minn. Hand exercises can help maintain range of motion, flexibility, and strength in your hands.

There is not a one-size-fits-all hand exercise prescription for people with RA, but a rheumatologist, physical therapist, or occupational therapist can help design a program especially for your hands. Here are seven hand exercises your program may include.

 

 

Hand Exercise for Rheumatoid Arthritis: No. 1: Start by holding your hand upright and pointing your wrist, fingers, and thumb upward. This also serves as the neutral starting position for many of the hand exercises that follow. Hold for 5 to 10 seconds. 

Hand Exercise for Rheumatoid Arthritis: No. 2: Keep your wrist straight in the neutral starting position and bend the base joints of your fingers, which connect the fingers to the palm. Keep your middle and end joints and your wrist straight. “This is already a big effort for people with RA,” Matteson says. Hold for 5 to 10 seconds. Repeat twice daily on each hand.

Hand Exercise for Rheumatoid Arthritis: No. 3: Keep your wrist and the base joints straight, and bend your middle and end joints of your fingers toward your palm, one at a time. Hold each position for five seconds. Repeat on all 10 fingers twice a day.

Hand Exercise for Rheumatoid Arthritis: No. 4: Bend each finger from the base joint downward using your other hand to move your fingers. Repeat this movement using the second row of knuckles in your finger. Repeat this exercise on the third row of joints in your fingers, closest to the fingertips. Hold for 10 seconds. Repeat on all 10 fingers twice a day. 

Hand Exercise for Rheumatoid Arthritis: No. 5: With your hand straight and fingers pointing upward, bend your fingers downward so they are touching your palm. Do not make a fist. Instead, your fingertips should be touching the palm of your hand. Hold for five seconds. Repeat on both hands twice a day. 

Hand Exercise for Rheumatoid Arthritis: No. 6: Starting with your wrist, fingers, and thumb pointing upward, make an “O” by touching your index finger to your thumb. Hold this for at least 5 and up to 20 seconds. Repeat two to 10 times twice a day. 

Hand Exercise for Rheumatoid Arthritis: No. 7: With your hands in the neutral position and all of your knuckles straight, slowly and gently spread your fingers as far apart as you can, like a fan opening up. From this position, make a fist. Hold each position for five seconds. Repeat on both hands twice a day. 

“These hand exercises are really effective for stretching and maintaining mobility in your hands if you have RA,” he says. “We don’t do these exercises for strength because the strength that comes with good hand mobility in the activities of daily living is quite satisfactory.”

 

Article # 251. 11 Exercises that Help Decrease Knee Pain

11 Exercises that Help Decrease Knee Pain

Knees are the most commonly injured joints in the body. Considering that when you simply walk up stairs, the pressure across your knee joints is four times your body weight, it isn't surprising. Simple, everyday wear and tear can end up hurting your mobility.

But it’s not too late. Like a rusty door hinge, with care and maintenance, you knees can be trouble free. Even if you already experience problems, exercising the muscles surrounding the knee joints— Quadriceps (front of thigh), Hamstrings (back of thigh), Abductor (outside thigh), and Adductor (inside thigh)—will help make your knees stronger and less susceptible to injury. Exercise keeps your joints from stiffening and provides needed support, making movement easier and reducing pain.

Here are some exercises you can do to both stretch and strengthen the knee area:

STRETCHES

Chair knee extension: Sitting in a chair, rest your foot on another chair so the knee is slightly raised. Gently push the raised knee toward the floor using only leg muscles. Hold for 5 - 10 seconds and release. Repeat 5 times on each leg.

Heel slide knee extension: Lie on your back, with left knee bent and left foot flat on floor. Slowly slide the left heel away from your body so both legs are parallel. Hold for 5-10 seconds, return to starting position. Repeat 5 times on each leg.

Knee flexion: Sitting in a chair, loop a long towel under your foot (resting on the floor). Gently pull on the towel with both hands to bend the knee, raising your foot 4 - 5 inches off the floor. Hold for 5 - 10 seconds, then release. Repeat 5 times on each leg.

Hamstring stretch: Standing, put one foot in front of you, toes up. With hands on the small of your back (or one hand holding a chair for balance), bend the opposite knee and hip (not your lower back), until you feel the hamstrings stretch. The upper body comes forward at the hip. Hold for 5 -10 seconds, then release. Repeat 5 times on each leg.

STRENGTH TRAINING

Wall slide: Leaning with your back against a wall, bend your knees 30°, sliding down the wall, then straighten up again. Move slowly and smoothly, using your hands on the wall for balance. Keep feet and legs parallel, and do not allow knees to go out over the toes. Repeat 5 -10 times.

Bent-Leg Raises: Sitting in a chair, straighten one leg in the air (without locking the knee). Hold for about one minute. Bend your knee to lower the leg about halfway to the floor. Hold for 30 seconds. Return to starting position. Work up to 4 reps on each leg.

Straight-Leg Raises: Sitting in a chair, rest your foot on another chair. Lift the foot a few inches off the chair while keeping your leg straight. Hold for 5 -10 seconds. Return to resting position. Repeat 5 -10 times. (Also work on increasing the time, up to 2-3 minutes if possible.)

Abductor Raise: Lie on your side, propped on one elbow. The leg on the floor bent, the other straight. Slowly lift the top leg, hold for 5 -10 seconds, then lower. (Ankle weights will increase the intensity). Do 1-3 sets with 12-15 repetitions each. Remember to rest in between sets.

Hamstring Curl: Stand with the front of your thighs against a surface (a table or wall). Flex one knee up as far as is comfortable. Hold for 5 - 10 seconds, then lower slowly. If possible, do not touch the floor between repetitions. (Ankle weights will increase the intensity.) Do 1-3 sets with 12-15 repetitions each. Remember to rest in between sets.

Step-Ups: Stand in front of a step, like a sturdy bench or stairs, about two feet high (or less if necessary). Step up onto the support, straighten your knees fully (without locking them) and step down. Maintain a steady pace. If you are comfortable with your balance, pump your arms while doing this exercise. Start with 1 minute, slowly building your time. Gets your heart pumping too!

Stationary Bike: Biking is a good way to increase strength and range of motion. Make sure you have the right positioning of the legs. At the bottom of the pedal stroke, the bend in the knee should be 15 degrees. Start with 10 minutes and slowly increase your time.

Depending on your current level of activity and mobility, a good start is 3 stretching and 3 strengthening exercises, 3-4 times a week. Stretching can be (and should be) done everyday if possible to prevent stiffness and achy joints. These stretches can be done a few times a day if needed.

Always check with your doctor before beginning an exercise program. These exercises are designed to help, not hurt. If you experience pain at any time during the exercise, stop. Pain is your body’s way of telling you that something is wrong.

BONUS TIP: If you have increased soreness after doing these exercises, it may help to ice your knee or knees for 10 - 20 minutes. Place a bag of ice (or frozen vegetables) over the joint, with a towel between to protect the skin. Elevate your leg on a chair if ice alone is inadequate.

Article # 168. Fibromyalgia

What is Fibromyalgia?

Fibromyalgia remains an elusive disease. It is really a syndrome, or a collection of problems that share pain, sleep disturbance, fatigue, abdominal discomfort, and trouble concentrating. Others experienced list of other problems, but everybody shares the common experience of lost quality of life. 

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 does share a common source of trouble, and that most likely is related to problems in the central nervous system. Alterations in chemicals that turn on and turned off parts of the brain and spinal cord probably play and important role in understanding and finding treatments for fibromyalgia. Hormonal disturbances, trauma, anxiety and depression, have also been implicated. Some believe there is a genetic link, or a situational origin that may have resulted from experiences dating back to a much younger age.

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
• 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

·         Acupressure and acunpuncture

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