Saturday, October 27, 2012
How to Dress for Less Fibromyalgia Pain Fibromite-Tested Tips! By Adrienne Dellwo, About.com Guide Updated May 10, 2011 About.com Health's Disease and Condition content is reviewed by the Medical Review Board. Is your skin painful to touch? Do your clothes cause fibromyalgia pain? Mine do! Bras, waistbands, even the tie on my old bathrobe -- anything that puts pressure on my chest or abdomen can at times set off either burning or intense, stabbing pains. I've tailored my entire wardrobe to accommodate this particular symptom, but I've never read a word about it anywhere. Wondering if I was crazy or if it was a common thing among those of us with fibromyalgia syndrome (FMS), I asked about it in the About.com Fibromyalgia and Chronic Fatigue forum. Turns out, I'm not alone. A lot of people posted that they have the same problem and thought they were the only ones. One woman described the pain as feeling like a "terrible sunburn." Clothes can cause pain all over, on your tender points, and on areas that are numb or tingly. With the help of our forum users, I've put together these tips for dressing when you have fibromyalgia: Spare Your Waist Unless you want to wear long, flowy dresses all the time, you've got to find ways to spare your waist from all of those waistbands. I've found several ways to get around this: •Pitch the Pantyhose -- Buy Thigh-Highs Forget control tops! They might feel OK when you put them on, but the last thing your body wants is to be squeezed for hours on end. Thigh-highs keep your legs looking nice while keeping your mid-section much happier. •Go Low! When it comes to underwear, try bikini briefs that sit down on your hips instead of the fuller styles that go clear up to your waist. And while you may not like the thought of low-rise pants that expose your belly button, try on a pair to see how much kinder they are to your gut. For those of us who don't want to bare all that skin, a long shirt can cover your midsection nicely. •Do the Sit Test When you try on pants, don't just stand in front of the mirror. Sit down. Slouch. Lean forward. If they're still comfortable, you've got a winner. •Venture into the Maternity Section I'm not talking about those horrid pants with the big baggy section in front, but about the ones with the "under belly" band. It's a nice wide band at the top that's designed to sit lower on an expanding belly. For the non-pregnant, these pants are just an incredibly comfortable way to go. I got this style of pants and skirts while I was pregnant, and I'm still wearing them. No one knows they're maternity, and I can keep them on all day. •Draw-String v. Elastic When it comes to sweat pants, a draw string wins out over an elastic waistband because it's adjustable. If your weight fluctuates or you eat a lot while wearing them, you can give yourself a little more room. True, the elastic will stretch, but you'll find it puts more pressure on you when it does. Some people have luck with loosening or removing the elastic. •Lounging About Let's face it -- some days, clothes are just out of the question. A lot of us have spent entire days, maybe even weeks in attire most people consider only appropriate for sleeping. For those times, I recommend a bathrobe with a zipper instead of a tie. Also, a lot of pajamas these days are shirts with pants or shorts. A nightgown is kinder to your body, but of course, your legs might get cold. I'm considering leg warmers, especially now that 1980s styles are all the rage. Beating the Bra Blues An underwire may support you nicely, but you'll likely be ready to rip it off before lunch. Here are some alternatives: •Soft-Cup Bras Even if you're a larger size, you can find soft-cup bras that will give you support. Check out the selection at a specialty shop or a plus-size boutique. Also, get a bra fitting. Most women don't wear the right size, and a too-tight band is doing you no favors. Look for wide shoulder straps as well -- they don't dig into the shoulders like thinner straps often do. •Sports Bras As long as they're not too tight, sports bras are comfortable and put far less of a squeeze around your rib cage. They also hold everything right in place. •Bralettes or Bandeaus If you're smaller, one of these styles might be the way to go. A bralette is an unlined soft-cup bra that's designed for comfort. It's most popular among teenagers because it doesn't provide much lift. A bandeau is basically a tube of fabric that goes around your chest. Again, the support isn't the best, but it won't poke you anywhere and cause pain. A Feel for Fabrics The texture and weight of a fabric can make a big difference in how it feels to you. Here are the ones that come highly recommended for those with fibromyalgia: •Cotton •Silk/Satin •Stretchy knits •Fleece •Flannel Some people also prefer shirts with the tags printed on the fabric instead of sewn in. Socks that Squeeze Ah, that elastic dilemma again! This is a tough one, since many of us seem to have chronically cold feet, but no one wants loose, sloppy socks bagging around their ankles. So what can you do? •Experiment with length Look at where your socks hurt you, and see if a different length will miss those spots. •Try thinner fabric A heavy sock will put more pressure on your foot when you wear shoes. Thinner might be better. •Look into socks made for people with diabetes Fibro pain has a lot in common with diabetic neuropathy, so this makes a lot of sense. "Sensitive foot" socks are widely available online and at specialty shoe stores. Take it Off! Lastly, if you're in the privacy of your own home, take off everything that's not comfortable and find something that is. The UPS guy has seen it all, I'm certain, and you'll feel better for it. And really, isn't that the most important thing?
Unrefreshing sleep has long been noted as a feature of fibromyalgia, and it's one that may be linked to many of our symptoms. One study reports that as many as 95 percent of people with fibromyalgia report having unrefreshing sleep. A growing body of research is leading to a better understanding of unrefreshing sleep in this condition -- its features, its effect on us, and how it may be alleviated. What is Unrefreshing Sleep? Unrefreshing sleep, also called nonrestorative sleep, is not the same thing as insomnia (which can also be present in fibromyalgia). It's not tied to how hard it is to get to sleep or to how long you sleep. Instead, unrefreshing sleep is more about the quality of your sleep. It's light, and even after sleeping for a full night, you wake up feeling exhausted and as if you've hardly slept. However, the impact of unrefreshing sleep can go well beyond feeling tired. While unrefreshing sleep and other sleep-related problems are considered a symptom of fibromyalgia, research shows that they're tied to abnormalities in brain chemistry and the immune system in a complex way and, according to a 2012 study, may serve as "both a cause and a consequence of fibromyalgia." Impact of Unrefreshing Sleep Research links this poor-quality sleep to multiple symptoms of fibromyalgia, including: •Increased tenderness •Lack of overnight recovery from pain •No morning feelings of well-being •Cognitive impairment (fibro fog) •Poor performance of tasks •Morning achiness •Stiffness •Fatigue •Psychological distress Why is Sleep Unrefreshing in Fibromyalgia? So far, it's not well understood why sleep is generally unrefreshing in people with this condition. The most obvious explanation is that it's hard to sleep when you're in pain, and many people with fibromyalgia report significant pain from simply lying down on their tender muscles. The tendencies to get chilled or become overheated and sweat excessively may also contribute to sleep problems. Research shows that dysfunction in the autonomic nervous system (ANS) may play a key role, as well. The ANS is separated into two parts -- the sympathetic (fight-or-flight mode) and parasympathetic (rest-and-digest mode.) According to an emerging theory of fibromyalgia, the sympathetic nervous system appears to be stuck "on," preventing the body from truly relaxing and being able to sleep. This state is similar to "sleeping with one eye open," such as new parents do when they're alert to a baby's every cry, or like you might experience when you're especially worried about oversleeping and therefore wake up and check the clock over and over. A 2009 study suggests that heart-rate variability, which is a measure of autonomic function, was abnormal during sleep in participants with fibromyalgia. This supports the theory of increased sympathetic activity that disrupts sleep. Because pain disrupts sleep and poor sleep leads to pain, it can become a self-perpetuating cycle. Treating Unrefreshing Sleep Research suggests that several medications may be able to improve sleep quality in fibromyalgia. These include: •Lyrica (pregabalin) •Cymbalta (duloxetine), Savella (milnacipran) and other SNRIs •Elavil (amitriptyline) •Xyrem (sodium oxybate) Lyrica, Cymbalta and Savella are FDA-approved for this illness. Elavil is a tricyclic antidepressant, and Xyrem is a narcolepsy drug that's strictly controlled. Some people with fibromyalgia report success with other prescription or over-the-counter sleep aids as well. Research suggests that melatonin supplementation may improve sleep and pain in fibromyalgia. If your sleep is unrefreshing, you should talk to your doctor about what options may be right for you. Sources: Chervin RD, et al. Journal of rheumatology. 2009 Sep;36(9):2009-16. Objective measures of disordered sleep in fibromyalgia. Citera G, et al. Clinical rheumatology. 2000;19(1):9-13. The effect of melatonin in patients with fibromyalgia: a pilot study. Clauw DJ. PM & R: the journal of injury, function, and rehabilitation. 2010 May;2(5):414-30. Perspectives on fatigue from the study of chronic fatigue syndrome and related conditions. Hussain SA, et al. Journal of pineal research. 2011 Apr;50(3):267-71. doi: 10.1111/j.1600-079X.2010.00836.x. Adjuvant use of melatonin for treatment of fibromyalgia. Moldofsky H. CNS spectrums. 2008 Mar;13(3 Suppl 5):22-6. The significance, assessment, and management of nonrestorative sleep in fibromyalgia syndrome. Moldofsky H. Joint, bone, spine: revue du rhumatisme. 2008 Jul;75(4):397-402. The significance of the sleeping-waking brain of the understanding of widespread musculoskeletal pain and fatigue in fibromyalgia syndrome and allied syndromes.
Research Brief New research demonstrates that the sleep problems associated with fibromyalgia have a substantial impact on quality of life, suggesting that sleep problems may need to be more of a focus for treatment. Fibromyalgia is frequently accompanied by sleep disorders, including: •Insomnia, •Restless legs syndrome, •And obstructive sleep apnea. However, another sleep problem is suspected of being a core feature of the illness. It's called "unrefreshing sleep." In this study of nearly 2,200 people with fibromyalgia, researchers report that: •11% reported no symptoms related to sleep difficulty, •Nearly 26% reported one symptoms related to sleep difficulty, •And 63.5% reported two or more such symptoms. The more symptoms people reported, the worse they rated their health-related quality of life. The impact of sleep-related problems was significantly greater for people with fibromyalgia than for health people in the control group, suggesting "a uniqueness of the burden of sleep difficulties" for people with this condition. Researchers concluded that sleep problems should be emphasized more by doctors and patients when deciding on treatments. My Perspective I whole-heartedly believe that our sleep problems should get more attention. Some experts won't even diagnose fibromyalgia in someone who doesn't have disrupted sleep, and some researchers believe the illness may be the result of long-term sleep dysfunction. While that may not be true of every case, I think it applies to at least one subgroup. I've had sleep disorders my entire life, and I do believe they lead to poor healing, chronic pain, and, eventually, fibromyalgia. Most of us know that the better we sleep, the better we feel - and vise versa. However, the goal of treatment for most of us is alleviating pain, with little consideration for the fact that improving sleep quality may well be the best way achieve pain relief. A few years ago, I saw research calling for sleep studies as part of the fibromyalgia diagnosis and treatment process. While it's an expensive and, quite honestly, grueling process, I agree with that. (See: Getting a Sleep Study with Fibromyalgia Have you focused on getting sleep problems diagnosed and treated? What helps you sleep better?