How To Deal With Chronic Pain And Fatigue

Talk To Your Doctor About Chronic Fatigue Syndrome

If you suspect you may have ME/CFS, consult your doctor. You might keep an activity log or health journal to note changes in your wellbeing and help your physician understand your situation. With the aid of your physician, you can eliminate other possible causes of your fatigue. Then, together you can develop a plan for treatment and relief of symptoms.

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What Do We Know About Fibromyalgia

Of the two, fibromyalgia affects about 4 million Americans and is one of the most misunderstood conditions. Many times, family members and friends dont understand what having fibromyalgia means and what it means to suffer from it.

Many patients get their diagnosis between the ages of 20 and 50, but the incidence increases with age. By age 80, about 8% of adults have fibromyalgia. according to the National Fibromyalgia Association. About 75% to 90% of those who have fibromyalgia are women.

The cause of fibromyalgia is unknown, says Dr. Bolash. Genetics, trauma or an infection may play a role. Fibromyalgia sufferers say it feels like having the flu all the time.

Symptoms include:

• Fatigue and tiredness.

How Chronic Pain Leads To Fatigue

Research has indicated that individuals with intense pain or pain that lasts a long duration are more likely to experience fatigue. So, why do these two tend to go hand-in-hand?

Individuals with chronic pain frequently struggle to get a deep and restorative sleep. Thus, as tired as you might feel, your pain might cause you to toss and turn throughout the night, as well as wake up several times a night.

Experts further state that less sleep can actually decrease your pain threshold and tolerance, which means that a lack of sleep can often lead to more intense pain.

Without sleep, the body is less capable of healing and repairing itself. This further prolongs pain and also leads to longer recovery times from injuries.

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Chronic Fatigue Syndrome Diagnosis

As more research is done on ME/CFS, the criteria for diagnosis continue to be updated. There are a few possible sets of criteria physicians may choose to use in their diagnosis. However, most of these criteria sets require the following:

• Post-exertional malaise , or worsened fatigue after performing usual activities
• Unrefreshing sleep or other sleep problems
• Widespread pain or discomfort, such as muscle or joint pain or headache
• Two or more types of neurological or cognitive dysfunction, such as impaired memory and concentration
• Symptoms lasting longer than six months

There is no chronic fatigue syndrome test to verify whether or not a person has the syndrome. Instead, physicians take a history of patient symptoms, including family history. They often conduct tests to rule out the possibility of other diseases, including urine and blood tests. Physicians may also refer patients to specialists to ensure other diagnoses are ruled out.

Experts note that patients may be diagnosed with both ME/CFS and an additional source of chronic fatigue. Some comorbidities of ME/CFS include:

• Allergies and sensitivities

Take Breaks From Your Phone

Technology can be a catch-22 when it comes to resting. Playing Candy Crush, watching Netflix, or surfing the web may feel like a good way to wind down but its not real rest and may even make you more anxious. In addition, the blue light emitted from phone, tablet, and laptop screens can also mess up your sleep. Dont use screens within an hour of bedtime, Dr. Cohen cautions.

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What Fatigue Really Feels Like

Think about these scenarios:

• You had the flu and it knocked you out for a short period. You were too sick to get much done, and definitely too sick to work or play with your children.
• You had too much fun and a few too many drinks one night, then couldnt get off the couch the entire next day. You felt so weak and tired that you had to call in sick with some made-up illness.

Chronic fatigue resembles these situations, but its worse because it doesnt get better with medicine, rest, caffeine, a greasy breakfast, or time.

Indeed, Dr. Barlett told me that Im not alone in these descriptions.

People with RA will often describe their fatigue as a feeling of being completely wiped out or utterly exhausted or how I feel when Im coming down with the flu, she says. This type of fatigue does not seem to improve with sleep or rest, and very often is a sign that disease activity is increasing. Indeed, in work we did across many countries, almost everyone we spoke with mentioned extreme fatigue as the first and most reliable signs that they are about to have a serious disease flare.

Our fatigue is always there, nagging away.

Other Lifestyle Changes To Manage Me/cfs

Other ways to manage ME/CFS include:

• equipment â some people may need a blue badge for parking, a wheelchair, a stairlift, or other adaptations for their home
• changes in your place of work or study â when you’re ready and well enough to return to work or studies, your doctor should be able to advise you on changes that could ease your return

There’s limited or no evidence to recommend:

• resting completely â there’s no evidence this helps
• complementary medicine â there is not enough evidence that it’s helpful for ME/CFS

You should not take up vigorous unsupervised exercise such as going to the gym or for a run as this may make your symptoms worse.

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What Causes Your Fatigue

Many physical and mental illnesses, as well as lifestyle factors, can cause your fatigue, and that can make it hard to diagnose. In some cases, it might be something simple and easy to fix, like havingcaffeine at bedtime. But other causes, like heart disease or COPD, are serious, and you may need to start long-term treatment right away.

Your doctor can help you sift through your health issues, as well as diet, exercise, and other lifestyle habits, in order to zero in on the cause and help you on the road to recovery.

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What Helps My Fatigue

Even though nothing can completely alleviate my fatigue, there are some things that make it more manageable. If I dont treat it, it gets worse. To combat fatigue, my go-to habits include:

• Getting regular exercise and movement
• Eating healthy and stay hydrated
• Keeping a sleep routine
• Minimizing stress and keeping things simple
• Tracking my health and keeping a symptom journal
• Writing down things that are important
• Reminding others to remind me about things that are important
• Reading things three times over to understand or save for later
• Being kind to myself: I am fighting to climb an invisible mountain
• Taking certain vitamins and supplements like B complex, vitamin D, iron, and green tea

Dr. Barlett emphasized to me the importance of maintaining a sleep schedule. Ive spoken with many people who have experienced more fatigue during the pandemic, in part because they have felt more stressed, but also because their sleep schedules have become more erratic, she says. One of the best things we can do to ensure we stick to a regular sleep schedule by going to bed at the same time each night and get enough sleep. Too much screen time in the evening, heavy meals eaten late at night, and even strenuous exercise shortly before bed can also make it more difficult to fall asleep.

You can get creative with chores, she says. Dont pile all the laundry into one overflowing basket. Use it as an opportunity to make two trips and get a few more steps.

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Boost Chronic Pain Relief With The Natural Endorphins From Exercise

Endorphins are brain chemicals that help improve your mood while also blocking pain signals. Exercise has another pain-reducing effect — it strengthens muscles, helping prevent re-injury and further pain. Plus, exercise can help keep your weight down, reduce heart disease risk, and control blood sugar levels — especially important if you have diabetes. Ask your doctor for an exercise routine that is right for you. If you have certain health conditions, like diabetic neuropathy, you will need to be careful about the types of activities you engage in your doctor can advise you on the best physical activities for you.

Getting Plenty Of Rest

While sleep may not come easily to you if you experience constant pain, getting enough rest is vital for your body. Patients with fibromyalgia and other conditions that cause chronic pain often struggle to fall asleep or stay asleep. Fortunately, there are both therapeutic and medicinal ways to help you get some rest.

Therapeutic ways to help people fall asleep include:

• Guided sleep meditations
• Limiting or eliminating caffeinated beverages

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What Are The Symptoms Of Me/cfs

The key symptom or feature of ME/CFS is called post-exertional malaise . This means that your symptoms get worse after exercise or mental effort and dont improve after sleep or rest. PEM can be very disabling and can reduce your ability to function during regular daily activities. PEM is also common if you have long COVID.

ME/CFS may start suddenly or gradually over months or years. The level of activity that triggers your PEM will vary from person to person and can depend on how severe your condition is. For example, if your ME/CFS is relatively mild, you may experience PEM after going for a walk or a jog, but if your ME/CFS is severe, just reading a book or brushing your teeth could bring on your PEM. Your PEM may appear immediately after activity or may sometimes be delayed by up to 3 days. It can last for 24 hours or for a few days. A more serious relapse can last for weeks or months.

A common misconception is that people with ME/CFS have âchronic fatigue and are just very tired. Persistent and profound fatigue is just one symptom of ME/CFS.

Other common symptoms of ME/CFS, that may also increase with PEM include:

• thinking problems, loss of memory or poor concentration
• gastrointestinal changes such as nausea, constipation or diarrhoea
• sensitivities to light or noise, food, medicines or chemicals
• problems with temperature regulation

Everyone is different, so you might experience only mild symptoms, or you might develop more severe symptoms.

What Medications Can Treat Chronic Pain

Your healthcare provider may recommend certain medications to relieve chronic pain, including:

• Anticonvulsants for nerve pain.
• Antidepressants such as tricyclic antidepressants.
• Muscle relaxers.
• Nonsteroidal anti-inflammatory drugs or acetaminophen.
• Topical products that contain pain relievers or ingredients that create soothing heat or cold.
• Opioids . Opioids can be addictive, and you can build up a tolerance to them over time. Because of this, healthcare providers usually try other pain treatment options before prescribing opioids.
• Sedatives to help with anxiety or insomnia.
• Medical marijuana.

Other medical treatments your healthcare provider may have you try include:

• Transcutaneous electrical nerve stimulation : This procedure delivers small shocks through patches on your skin. The electrical impulses can relieve pain.
• Nerve blocks: For this treatment, your healthcare provider injects an anesthetic near the site of your pain to reduce feeling in the area. Nerve blocks can also sometimes provide diagnostic information and locate the source of your pain.
• Epidural steroid injections: This procedure is an injection of anti-inflammatory medicine a steroid or corticosteroid into the space around your spinal nerves known as the epidural space to treat chronic pain caused by irritation and inflammation of spinal nerve roots.

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Learn Deep Breathing Or Meditation To Help You Relax

Deep breathing and meditation are techniques that help your body relax, which may ease pain. Tension and tightness seep from muscles as they receive a quiet message to relax.

Although there are many ways to meditate, the soothing power of repetition is at the heart of some forms of meditation. Focusing on the breath, ignoring thoughts, and repeating a word or phrase — a mantra — causes the body to relax. While you can learn meditation on your own, it helps to take a class.

Deep breathing is also a relaxation technique. Find a quiet location, a comfortable body position, and block out distracting thoughts. Then, imagine a spot just below your navel. Breathe into that spot, filling your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon.

Ask About Flexible Work Arrangements

On days when the fatigue overwhelms Marco, he has the option of working from home. Its not an option for everyone but if you think your job might allows it, its worth asking about it, he says. My boss is pretty understanding and I try to limit it to days when the flare-ups are really bad, he explains. My last boss would never have let me do it though, so it really is about your office culture. Here are more tips for navigating work with chronic illness.

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Reasons Why Chronic Pain Makes You Tired

Fatigue can be linked to many issues, from stress and anxiety to poor diet. It may also be connected to pain, as I discuss further in this blog. Here, I go over five ways chronic pain can make you tired and give some advice for managing symptoms of fatigue that can make daily life more challenging.

Louise Baillie

Caring For Someone With Me/cfs

Having a supportive community of family, friends, school, work, employers and health workers, who understand the potential seriousness of ME/CFS, can also help improve the quality of life of people living with ME/CFS.

Everyone involved in supporting someone with ME/CFS needs to understand Post Exertional Malaise, which is an abnormal, biological response to exercise or activity. This means the patient will not be able to do all of the activities they used to be able to do, and will benefit from practical and emotional support. People with ME/CFS will each have different needs and preferences, so it is important to talk with them about how best to provide support. This may include help with daily routines, family life, accessing healthcare and other personal priorities.

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Identify Treatments Youve Tried

In addition to tracking the symptoms you have experienced, keep a list of treatments you have tried. The Centers for Disease Control and Prevention provides a medications and supplements list you can use to track your medications, their dosage, how well they help, and if you experienced side effects. Write a separate list of other treatments you have tried beyond medications and supplements, such as cognitive behavioral therapy, exercise, acupuncture, or meditation.

Fatigue And Sleep Problems

Another thing chronic pain sufferers frequently complain about is a lack of sleep. That makes sense. If your back is constantly bothering you, lying in bed for eight hours can be too uncomfortable to bear. Trying to sleep becomes impossible. What is the result? Fatigue caused by lack of sufficient sleep. But wait, it gets worse.

Excessive fatigue can also cause insomnia. As strange as it sounds, being emotionally and physically fatigued can prevent your body from entering that all important REM sleep. When that happens, it is easy to end up in a vicious cycle where fatigue causes insomnia and insomnia leads to more fatigue.

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Allergies Hay Fever And Fatigue

Symptoms: Fatigue, headache, itchiness, nasal congestion, and drainage

Allergic rhinitis is a common cause of chronic fatigue. But allergic rhinitis often can be easily treated and self-managed. To make a diagnosis, your doctor will assess your symptoms. The doctor will also find out, through a detailed history or testing, whether your allergies are triggered by pollens, insects , animal dander, molds and mildew, weather changes, or something else.

One way to reduce symptoms of allergic rhinitis including fatigue is to take steps to avoid the offending allergen. In addition, proper medication can help with symptoms. Drugs that might help include:

• Leukotriene modifiers
• Mast cell stabilizers

Allergy shotsimmunotherapy may help in severe cases. This treatment involves weekly shots of increasingly higher solutions of the offending allergens. Allergy shots take time to be effective and are usually administered over a period of 3 to 5 years.

Talking To Your Doctor Or Nurse

Prepare for your next appointment with your doctor or nurse by writing down questions that you want to ask.

Never be embarrassed to ask them to repeat and explain anything that you dont understand.

Your care and wellbeing is the doctors and nurses priority, so describe all of your symptoms to them. It can be difficult for anyone to understand how much fatigue can affect your life, and how distressing it can be, unless they have experienced it themselves. For this reason you may need to emphasise to your doctors and nurses the difficulties that it causes for you.

Discuss everyday actions that you find difficult, such as climbing stairs, cooking or bathing. If you have kept a fatigue diary you can bring it in to share with the health professionals looking after you.

It can often be difficult to discuss emotions, especially when you are ill, for fear of upsetting yourself and others. Try not to let embarrassment stop you discussing your emotions with your doctors and nurses. It may help if you take someone to the appointment with you. When you have fatigue it can be difficult to remember what the doctor or nurse has said and your relative or friend can help to fill in the gaps.

Specific questions you may like to ask:

• What could be causing my fatigue?
• What treatments may help me?
• How can I cope with my fatigue?
• What help is available?
• How can I best support my relative who has fatigue?
• What can I do to help reduce my fatigue?

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