Fibromyalgia -- Need help on how to handle severe pain

Posted by ripley @ripley, Jun 14, 2023

I was told by a Rheumatologist last year that I have Fibromyalgia. She referred me to my GP for treatment, but he doesn't know anything about this disease. I need advice on how to handle the pain which is sometimes so severe and lasts all day. It usually eases some by bedtime, but lately I've been waking up about 3:00 AM with bad legs pains that keep me from falling back asleep. Since this started 18 months ago, the pain has gone into remission for a few months and flares up again for a couple months. The insomnia and other issues remain. My latest flare started about 5 weeks ago. The only meds I'm taking are Tylenol, which doesn't help, and sometimes Cyclobenzaprine at night. I am afraid of Cymbalta after hearing horror stories about terrible withdrawal issues when wanting to discontinue it due to it's side effects or when it stops working. It seems like all the drugs used for this disease have withdrawal problems. Any help would be appreciated.

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@ripley

When you were on Flexeril, what dose were you taking? Do you ever need the Tizanidine during the day for pain? Thank you.

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Ripley, I was on 5 mg of Flexeril and I would only take 1/2 tablet. I do occasionally take 1/2 of a 4 mg Tizanidine during the day if I am in a lot of pain....I try not too if I can help it. Remember, I can't take much medicine as I am ultra sensitive. I pray you get better. Pain is so tiring. Blessings....

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@heisenberg34

Yes, I try to remember to do that as well. Keyword being "remember".

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Yes, big bada boom
Now with added PMR, I'm on Prednisone (corticosteroid) and that makes me even foggier. I have to assure my adult son that I'm not sliding into dementia. But that look on his face when I remember wrong. Classic.

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@heisenberg34

OK, let's try this again. The pain pump was surgically implanted in my abdominal wall after a successful trial. I had been on Gabapentin, Diazepam, and Tramadol since 2017. Those meds, along with a spinal cord stimulator (implanted in 2018) got me back to about 85% of normal. Then in Feb of 2021, all the pain returned like a sledge hammer. No one can explain it. Innumerable pain specialists were baffled. That left me with the option of the pain pump. Was put in on April 15 of this year. I believe it dispenses hydromorphone or some such morphine derivative. No pain relief at first. Took several readjustments of pump's output before I felt any relief. Even then it was minor. Another few adjustments began to offer real pain mitigation. After getting the remote set up a couple of weeks ago and getting another readjustment or two, I am able to work for almost a full day without screaming pain. The remote allows me to deliver a "bolus" or extra medication, if I am having a bad day. Usually heps a lot. The pain pump was a result of my own digging until I found a pain specialist who was willing to do the trial. The successful trial led to having a neurosurgeon do the implant surgery. No big deal. I only took a couple of Tylenol for a few days to help with incision pain. I was able to wean myself completely off the Tramadol. Is the pain pump perfect? No. Would I have preferred a surgical method of correction to get pain relief? Yes. But, this is the best thing I could have done, apparently. I thank the Lord for guiding me through this process. Please feel free to reach out for any other questions.

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The return of your pain being described as a sledgehammer is very familiar. I ended
up in so much pain and thought the fibro had simply gotten worse. Then ot got so bad that upon waking up, I couldn't get out of bed or walk without assistance. I went to the ER and they were baffled. I saw my general doctor a couple days later and I was diagnosed with Polymyalgia Rheumatica (PMR). It is rare to have both fibro and PMR but definitely possible.
Perhaps ask if you could get bloodwork done to check for it. There is more information on the PMR Board and sone very friendly and helpful people. It's worth a try because although there are side effects to prednisone, the best is being almost pain-free. Sadly it doesn't help with fibro pain, just the inflammation caused by PMR.
Good luck.

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With PMR, pain started in the back of my neck then I noticed it spreading to my shoulders, then my back. When it got to my hips and legs, I had trouble walking and while laying down, found it impossible to lift either leg up off the bed. I had to roll over to the edge, grab a sturdy chair and pull myself up. Light stretching helped and by the end of the day, I always felt better.
If any of this seems familiar, please get it checked out.

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@vellen

Yes, big bada boom
Now with added PMR, I'm on Prednisone (corticosteroid) and that makes me even foggier. I have to assure my adult son that I'm not sliding into dementia. But that look on his face when I remember wrong. Classic.

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vellen, Unbelievable, But, I am much sharper when I am on prednisone. Go figure! I feel the best when I am on it, emotionally & physically. The down side is puffiness, weight gain and my mind goes 500 miles an hour, I can't sleep and it makes me sweat.

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@covidstinks2023

vellen, Unbelievable, But, I am much sharper when I am on prednisone. Go figure! I feel the best when I am on it, emotionally & physically. The down side is puffiness, weight gain and my mind goes 500 miles an hour, I can't sleep and it makes me sweat.

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I know the sweat, I also find my heart pounding about 15-20 minutes after a meal, very annoying. Isn't it crazy how so many of us experience different side effects?
I can take the morning pred on an empty stomach which is good because I've never been able to eat food for a good 3-4 hours after waking.
So far, I have only lost weight and I'll see if that has leveled off yet this week when I go in for a dr appt. My clothes are still pretty loose so I don't think it's changed much.
Perhaps once I'm on it a few more weeks, that will change but I've always lost weight with stress and having fibromyalgia and PMR, is definitely stressful!

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When Plato said, 'Part can never be well unless the whole is well,' he wanted, It seems to underscore the primacy of what is important when looking for solution to larger health issues (not cutting finger and how to fix it) he meant we need OVERALL balanced approach to health (mental and physical) for just about anything that dislodges us from living a reasonably rewarding life.

So when I see even an advice like stay in moderation, we each know it can mean different things to different people. So what is RIGHT moderation for me TODAY. It matters little what I was before a major injury or upheaval in my life, or before even five or more years ago. Of course having stepped into my eight decade means my moderation is different than when I was in younger times. Frankly, Don't push thru yourself really means 'Stop treating your body as outsider' because WHY one even want to do what one's body does not want or can do.

So when yesterday with each grocery bag ten lbs I reached my apt floor, I said, teasingly: Hey, wanna walk up few more floors? I also knew the voice is also saying: You can always turn back from ANY STEP.
I walked up four more floors huffing and puffing and started walking down. But even one floor seemed too much so I looked for elevator and got off at my floor. I, my bodymind, felt good. No worrying about PT or pills so far.

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@rashida

@ripley I am surprised your rheumatologist has sent you back to your GP after your diagnosis.. As far as I have ever known, the doctor who diagnoses the patient is the one who continues to treat the patient for the illness diagnosed. Could you not go back to your rheumatologist and ask her to prescribe something to control your pain?

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I have found a Doc's specialty does not necessarily limit expertise. Like most of us in our professions, Doc's have areas of medicine they are very interested in and often continue to follow research on those areas regardless of their stated "specialty." Finding a Doc that attempts to keep up, as much as possible, with the evolving state of Fibromyalgia is a win, no matter the specialty!

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For 13 Yrs i was able to control Fibro pain well but the added pain from neck surgery and a botched T 3 epidural made my diagnosis change to Central Pain Syndrome. It’s very high pain. I take Lyrica and have medical Cannabis on hand but I avoid it bc it constipates me badly and that has caused its own set of diff problems. All this is consuming my muscles bc cortisol stays elevated. I know I will go to heaven sooner than I thought I would in my younger healthier years which was prior to age 50. I am now 72. I’ve fought hard! Hey going to heaven is a fabulous thing! I just hate to sadden my friends, husband, children and grands.

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@sueinmn

Oh my, you took the words right out of my mouth when you said, "The specialty I've gotten the most healing and progress out of, the quickest, has been physical therapy/physical medicine and rehabilitation. But it's crucial to find a PT or chronic pain program with experience in chronic pain/chronic fatigue/fibromyalgia, and central sensitivity, otherwise it can be really invalidating and hurt more than it can heal."

I suffered for years from a laundry list of pain causing issues, followed by a severe and long lasting lung infection that turned me into a couch potato and just about finished me! My PCP referred me to a Pain Rehab Clinic, where I see a laundry list of providers, the most valuable of whom is my PT. I am back among the "living and doing" - still some pain, but tolerable, still bad days, and a need to carefully pace myself.

Mind over matter is no joke - my therapist and PT are teaching me to acknowledge the pain, then figure out how to work through it.

I always try to remind people, your care providers have hundreds of patients, they will never know and understand every detail of what each of us faces. There fore we must be our own best advocates.
Sue

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Hi Sue,
You’ve been very helpful in the Mayo sites you mentor in. I wonder if you are aware of a website that fibromyalgia/CFS patients have found helpful: You Tube’s Dan Neuffer CFS Unravelled. He was sick for years and got well. Through his experience and interviews with other sufferers/recoverers and other professionals , he developed a program called ANS Rewire. It aims to reset the autonomic nervous system, which has gone awry and causes the various symptoms, like pain, fatigue, etc.
thanks for your mentoring.
J

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