Fibromyalgia, an example of central pain syndrome, is a chronic disease characterized by symptoms of generalized muscle pain, fatigue, memory problems and mood swings. As in many chronic diseases, the symptoms of fibromyalgia can appear and disappear and vary in intensity.
Although an individual with fibromyalgia may experience certain symptoms on a regular basis, when the symptoms worsen or occur more frequently over a period of time, it is called an exacerbation period or acute episode.
“An episode is the worsening or outbreak of symptoms that already exist,” says Dr. Daniel Clauw, professor of anesthesiology, rheumatology and psychiatry at the University of Michigan in Ann Arbor. “Patients use different time patterns for what they consider an outbreak, but in general they are several days or weeks of exacerbation of symptoms. Something shorter is considered a decrease in symptoms that a person with fibromyalgia can expect. “
- Generalized muscle pain
- Fatigue that hampers daily activities
- Stiffness, especially in the morning or after a long period of inactivity
- Cognitive difficulties, which include problems of memory, concentration and organization
- Emotional disorders, such as anxiety, sadness or depression
- Problems sleeping, such as difficulty falling asleep, waking up frequently or waking up without feeling rested
While these are common symptoms among people with fibromyalgia, each one experiences exacerbations in a different way.
“People with fibromyalgia have different acute episodes,” says Dr. Clauw. “A good way to explain it is that every individual with fibromyalgia has his Achilles heel, the symptom that really gives them problems. When fibromyalgia gets worse, that particular symptom really gets worse. “
The predominant symptoms of someone during an acute episode may change over time.
“Whoever has an episode may have worsening pain in the hip or back,” says Dr. Clauw. “But 10 years ago, that same person could have experienced menstrual cramps or headaches like his Achilles heel. The nature of fibromyalgia is that it is a syndrome of pain amplification and that pain can mutate. “
Triggers of periods of fibromyalgia exacerbation
One of the best ways to prevent an episode is to determine what could cause it in the first place. Like the symptoms, the triggers of fibromyalgia vary by person, but may include:
- Physical or psychological stress
- Temperature and / climatic changes
- Hormonal changes
- Travel and / or changes in the schedule
- Modifications in the treatment
- Lack of sleep
“We know that any type of stress, not only psychological, but also physical, immune or anything that interrupts the normal routine of the body can trigger an outbreak,” says Dr. Clauw. “Whatever it is, from a car accident to surgery or another kind of stressful life event can cause a worsening of symptoms. Rashes may also be due to behavioral triggers such as not sleeping well, suddenly interrupting exercise, or exceeding activity. “
Some exacerbations are inevitable, and certain triggers are out of control. You can try to identify what aggravates the symptoms of fibromyalgia by noting the activities, what you eat, how you sleep and how all these factors affect the symptoms. After targeting these factors for several weeks, you may see a pattern. This will help you know how to best manage the actions that can trigger an outbreak.
Treatment of an acute episode of fibromyalgia
Despite your best efforts, sometimes fibromyalgia will worsen. While you would like to take a magic pill, there is no treatment for fibromyalgia during an episode.
“The truth is that we are much better at preventing exacerbations than at treating them,” says Dr. Clauw. “There is no rescue medication for fibromyalgia. Approved drugs take weeks to start working, and analgesics like opioids do not serve many people. “
In the absence of effective medications, Clauw suggests that you take a look at the activities you are participating in that may be affecting the symptoms.
“Many people with fibromyalgia tend to overload things when they feel well,” says Dr. Clauw. “Learning to keep up can help you get out of the cycle of doing too much when you feel well and then pay it later when fibromyalgia gets worse.”
While you may be reluctant to add something to your routine if you are already tired and in pain, mind and body therapies can be great for lifting your spirits and relieving pain. Try complementary therapies such as meditation, deep breathing, and forms of exercise that include stretching and relaxation, such as yoga.