Fibromyalgia Support Group for Surrey and Sussex

Any Questions

Questions are answered by Norah Wickerson, Chartered Physiotherapist and Nutritional Adviser

Does Fibromyalgia cause bladder problems?

Yes, it certainly can cause several bladder problems. Some people suffer with interstitial cystitis which can be misdiagnosed as a urinary tract infection. Some people are more prone to stress incontinence, urgency incontinence and frequency of emptying the bladder. Some will even suffer with a combination of all of these.

Does Fibromyalgia cause painful stabbing pains in the lower abdomen?

Any unexplained recurrent abdominal pains should be investigated by your GP. Certainly do not assume that the pains are related to your Fibromyalgia, unless all tests come back normal. Fibromyalgia can cause unexplained abdominal pain. Indeed, the myofascia around the internal abdominal organs can be oversensitive just as it is elsewhere in your body. Another cause of these abdominal pains is IBS, which could be helped greatly by changes in your diet.

What do you know about Bioinflammatory by Biogenesis?

I totally agree that toxins have now settled in the soft tissue, namely the myofascia, but exactly how it gets here is not yet proven. I personally have not heard of a product called Bioinflammatory by Biogenesis, which is designed to shift these toxins from the tissues. In my own experience, both personally and now professionally, I believe that these toxins can be eradicated by removing foodstuffs from the diet which are encouraging the toxins to build up; and secondly, by deep massage and myofascial release techniques that physically break down the toxins which are then carried away by the circulatory and lymphatic systems. This is part of my non-invasive Combination Approach to tackling Fibromyalgia and Chronic Myofascial Pain.

[See also information about Bioinflammatory by Biogenesis. - SB]

Q. I would like to know why I can go swimming one day and be fine but if I go another day I can be really ill. I do nothing different on going to the pool. I just never know what reaction I will get.

A. This may be due to several factors but the main one I think is that you may have unstable blood sugar levels (Reactive Hypoglycaemia) and the exertion at the baths is causing a further reduction of your blood sugar levels and hence these days you will feel really ill afterwards. I suggest you eat some long-acting carbohydrates one hour before your swim, to control and level out your blood sugar levels. Oats are an excellent complex carbohydrate and can be in the form of a bowl of porridge or muesli with oat flakes, or oatmeal added to natural yoghurt. Also take some form of complex carbohydrates (e.g. oatcakes spread with cheese) to eat immediately after your swim to prevent a drop in blood sugar levels afterwards.

Q. I have found Malic Relief Supplements help. Why is that?

A. These supplements often contain vitamin B6, which is a very important vitamin to help regulate hormones. They also contain a substantial amount of chromium, which is the mineral that is essential in controlling blood sugar levels – so maybe you feel slightly better as your blood sugar levels are more stable than they were. Hence you get less carbohydrate cravings and feel better mentally and emotionally too, since the brain is the most sensitive organ to changing blood sugar levels.

Q. Before being diagnosed with Fibromyalgia, I started having 'attacks' which included intense pain in various parts of my body, headaches, and sometimes sensitivity to light. But I've always had a rash on the top of both arms, but have never heard anyone say the same. I no longer have 'attacks' but have many Fibromyalgia symptoms all the time.

A. The rash may have been the flare response. This is when the mast cells release histamine, causing redness, swelling and tingling. I believe, in this case, it is a sign that your myofascia (the lining around your muscles, ligaments and tendons) is over-sensitive and so can 'flare-up' very easily. This component of Fibromyalgia is called Chronic Myofascial Pain and is likely to be the cause of much of your pain, anywhere in your body.

Q. What, if any, health foods or vitamins are recommended?

A. I have had good success in many patients just by using an ordinary one-a-day multivitamin and multi-mineral supplement. I am not in favour of any super-strength vitamins and minerals provided a good varied diet is undertaken. I also recommend flaxseed oil, hemp oil, cool oil, or an omega 3, 6, 9 complex as a liquid supplement with meals to increase the intake of the essential fats. These oils are from organically grown sources and so are probably safer than fish oils which may contain unknown toxins from polluted waters. Always follow manufacturer's directions and check with your GP or pharmacist if you are taking other prescribed medication.

Q. I worry about driving the car more, with forgetful brain function, muscle seizure in the legs, not to mention the cocktail of drugs I need to take daily. Also the bouts of tiredness.

A. If you ever feel worried that you are not in a fit state to drive, then you really should not drive at all at these times. Maybe you could review the amount of drugs you need to take, especially painkillers which may cause tiredness or drowsiness. Could you do your driving tasks before taking the medication? Always try to have good ventilation in the car to keep you alert and find the most comfortable position to minimise muscle seizures. You may need to consider changing to an automatic car to allow you to concentrate on the road and have less things to think about, such as constantly changing gear etc. I find it makes any driving much less of a chore.

Q. Why is my breathing so difficult at times and worse when I lay down.

A. This may be due to several factors, and you should see your GP to rule out heart or lung problems. It is however, quite likely to be due to you hyperventilating. This is because you will probably have a restriction of your lower costal breathing due to fibrositic nodules in your intercostal muscles between your ribs. This makes it much harder to take a deep breath. You may also be sore in this area and suffer pleurisy type pain occasionally or feel like you have a tight band around your lower ribs. When more oxygen is needed you will then increase your rate of breathing as you cannot easily increase your depth of breathing. When you lay down on either side, you then further restrict this movement and so are more aware of your breathing. If you are overweight, these problems will be made worse.
I break down these fibrositic nodules and I teach breathing exercises to re-educate correct breathing control, and so reduce hyperventilation. Frequent yawning or sighing are classic signs of hyperventilation, as too is feeling short of breath when walking and talking at the same time.

Q. I have difficulty in climbing stairs. What can I do to make it les painful?

A. If you struggle to climb stairs because of pain, then rather than climbing stairs in the normal forward fashion, try climbing the stairs sideways, leading with the less painful leg as you ascend, and leading with the more painful leg as you descend. This reduces the disturbance to the myofascial bands in the pelvic area. Place both feet onto each stair and use the handrail wherever possible. By using this method, it takes longer to climb the stairs, but by taking longer you can keep your breathing calmer and reduce the unpleasant shortness of breath suffered by many Fibromyalgia sufferers when climbing stairs.

Q. What about walking up inclines?

A. If walking up hills causes you pain in your legs or lower back, which forces you to stop and rest frequently, then try this technique. Lean forward and place your hands on your thighs and walk up the hill in this slightly stooped position. You should find that walking up the hill is a little easier, and is a less painful experience. This technique relieves some of the pressure on the myofascial bands in the lower back.

Q. Can you explain the thirty-minute rule?

A. Try to apply the thirty-minute to as many activities as you can. When sitting down at the computer or watching television get up every thirty minutes and walk around for a few minutes. If you are reading or writing, knitting or sewing, painting or ironing, have a break every thirty minutes and potter around for a while before returning to the activity. By applying the thirty-minute rule you can relieve some of the stiffness and pain associated with staying in one position for too long.

Q. Is standing still harmful?

A. You will no doubt have noticed that standing still for any length of time is most unpleasant. It increases your pain in your legs and back and often makes you feel exhausted or even ill. I believe that this is due to the fact that it is our postural muscles that suffer the most with myofascial pain (associated with Fibromyalgia), and when standing we are using many postural muscles. Try to move around a little, rather than standing still. This utilises the exercise muscles rather than the postural muscles. Keep shifting your weight between legs. Where feasible, try to find something to lean or perch on in order to relax some of your postural muscles. A small fold-up portable stool may come in handy.

Q. I've heard that Rebounding is good for you. What is this?

A. Rebounding is an excellent form of low-impact, easy but effective exercise, and provides an gentle introduction to exercise for people who have been unable to do so for a long time. A rebounder, or ‘jogger’, is a small trampoline, and to use it you move up and down on it while keeping your feet constantly in full contact with the rebounder – no ‘jumping’ is involved. Even just two-minute sessions a couple of times each day can improve your circulation and lymphatic drainage, which are both very important to help remove the waste products that build up in the myofascia (muscle lining) all around the body. Elderly sufferers or those prone to dizziness need to take extra care and may prefer to hold onto a chair back during the exercise session and position the rebounder in the corner of a room for added reassurance. Over the weeks, build up to five-minute sessions twice a day, and, if you are able to, gently flap your arms as you rebound to further assist the circulation and lymphatic drainage. Any form of exercise stimulates the production of endorphins (happy hormones) which helps to raise your pain threshold, improve your mood and give a feeling of better wellbeing. If you are unsure as to whether you should use a rebounder, please check with your doctor. Rebounders are available in Argos, Index and large sports stores, and cost about £15.

Q. I can't sleep at night. What can I do about it?

All sufferers of Fibromyalgia are well aware of the sleep disturbances it causes. This causes many people to worry that they are not getting the recommended nightly eight hours of sleep. Since getting well over four years ago, I find that I now only need six hours’ sleep. If you find you are regularly waking early, and feel ready to get up, it is quite likely that your body has had enough sleep, so don’t feel that you have to stay in bed to make up the eight hours.

Below I have prepared some hints on achieving a better night’s sleep.

A cool pillow is known to be helpful in getting people to sleep, so place a hot-water bottle filled with cold water on the pillow before bedtime. Keep this bottle nearby to reuse anytime during the night to re-cool the pillow.

Lavender is known to have a soporific effect, so why not use mild lavender bath-salts in the late evening? A bar of lavender soap placed near to the pillow can supplement this effect, without overpowering those of us with an over-sensitive sense of smell.

Valarian tea can have a soporific effect when taken at bedtime but isn’t the most pleasant of drinks. Why not blend it with some camomile tea, or some other tranquility tea, to make it more palatable? Stimulating teas should definitely be avoided in the evening, such as ginger tea or gingseng tea, or anything with caffeine in (including hot chocolate).

While sitting in bed, a V-shaped pillow provides an effective body support, allowing your back muscles to be more relaxed.

If you find pins and needles disturbing during the night, then try this simple and effective method. Before going to bed, sit down and extend your arms straight forward, at shoulder level. You need just enough pillows placed on your knees to be able to rest your arms on whilst keeping them at about shoulder level. Sit here until pins and needles set in – this may be up to half an hour. Remain still and relaxed until the pins and needles have subsided. Pins and needles are often caused by the release of pressure on a nerve. By releasing the pressure on the nerves before going to bed, the risk of pins and needles occurring during the night is minimised.

Turning over in bed can be a very painful experience for sufferers of Fibromyalgia, if the movement is not properly controlled. During sleep the trigger points are (thankfully) relaxed and pain-free, but the sudden movement associated with turning over gets them aggravated, causing pain throughout the body. First to be ‘woken up’ are the trigger points in the neck and shoulders, which activate the trigger points lower-down the body, which in turn activate the ‘satellite’ trigger points in the hands and feet – by now the whole body is riddled with pain. The key therefore is to keep the trigger points in the neck and shoulders as relaxed as possible, as it is these trigger points that cause the chain reaction described above. First, slowly turn your feet over to their new side while keeping the rest of the body still and totally relaxed. Slowly turn your knees over. Next turn your hips over, while keeping your upper body totally still. Your upper body should follow in a similar fashion. The head is the last body part to move, and the most critical: disturbing the trigger points now will set off the chain reaction of pain and render all this preparation wasted. Keep the neck relaxed and roll the head on to the new side. Don’t lift your head; just let it roll freely to follow the rest of the body.

If you are regularly waking up in the night, feeling wide-awake, and taking a long time to fall back to sleep, these exercises may be for you. Get out of bed and gently walk around the room, taking some deep breaths as you go. Next, stand up straight, and bend forwards very slowly to touch just below your knees. Slowly straighten up, and repeat, very slowly, five times. Climb back into bed and try to stay relaxed until you drift back to sleep. These exercises have a relaxing effect on the adrenal glands, which are often overactive in Fibromyalgia, especially during the night.

Try to keep a regular time to go to bed and, more importantly, a regular time to get up – no later than 8am! If necessary, have a nap some time later, but don’t stop in bed like an ill person would. You need to think and act like a well person to become a well person. Good luck, and good night!

Norah Wickerson is a Chartered Physiotherapist and Qualified Nutritional Advisor in Derby. She treats Fibromyalgia patients from all over the country with her unique ‘Combination Approach’, and has been having some very good success. For more information, please call 01332 512004, or visit Norah's Web Site

See also Norah's article on The Combination Approach in which she explains her theories about, and treatment of, fibromyalgia.