A detailed guide to Chronic Fatigue Syndrome (CFS), including its symptoms, causes, and effective treatment strategies to improve energy and well-being.
“I have a problem—unexplained excessive sweating, like just stepping out of the shower, hair dripping wet, clothes soaked! … It has put a big damper on my lifestyle.”
“My limbs get so cold and painful … and yet my face will be sweating from the heat inside.”
“What exactly causes the excessive sweating? … I don’t bother to wear makeup in the summer because there is no point—it just melts off.”
Excessive sweating is one of those bizarre symptoms that rarely make it onto symptoms lists or grab the attention of researchers.
That’s understandable since we have much bigger problems. Still, it can have a major impact on your life.
While doctors and researchers have noted that excessive sweating can be a symptom of these conditions, you may want to talk to your doctor about complex regional pain syndrome. It has similar symptoms and some research suggests excessive sweating may be more common in that condition.
The only cause that’s “curable” is the medication side effect, and that may not be an attractive option to you if the drug is doing more good than harm. Your doctor may have ideas about medications that help control sweating.
If you do have to live with this symptom, you may want to keep some items on hand to keep it from being obvious and embarrassing.
Loose powders: Powder on your face may help absorb sweat before you even know it’s there. You can also apply it after drying sweat off of your skin to keep from being shiny.
Oil-absorbing face wipes can keep you from having greasy-looking skin as well. They’re generally better than napkins or tissues, which work in a pinch but may be worse for your skin as well as less effective.
If your sweating isn’t tied to any particular stimulus, you might not be able to keep it from happening. However, if it’s tied to heat—and especially our tendency to become overheated—you may find that some of these things reduce the problem.
Extra antiperspirant, re-applied a few times during the day, and applied to non-typical places where you tend to sweat a lot may help.
Taking cooler baths or showers, or running cooler water over your body before you get out, may keep you from getting overheated and sweating more.
Especially if you tend to be cold a lot, you may frequently find yourself dressed too warmly for the environment. Dressing in layers gives you more temperature-control options.
Choosing cold drinks over hot ones and avoiding hot foods can help.
Once sweating starts, it may be difficult to stop. You’re better off trying to prevent it in the first place.
One important thing about excessive sweating is making sure you stay hydrated. It’s important to replace both the water and the electrolytes you sweat out.
So much has been written about the opioid epidemic, but so little seems to be out there about what living with true chronic pain is like. My husband, the Jay, lived and died in incredible pain at the age of 58. As his wife, I lived that journey with him.
Jay is no longer here to tell his story, but I want the world to see what I saw. I want you to know how he went from working 60 hours a week doing hard physical labor until his pain grew worse and he could not even get out of a chair on his own.
I want you to know the deterioration Jay went through over the last ten years. I want you to know what a good day and a bad day are like when you live with chronic pain. I want you to know exactly what happened when the doctor decreased his pain medication. And I want you to know how my husband finally made the decision to commit suicide.
I want people to understand that when chronic pain runs your life, eventually you just want the pain to stop.
First a bit of history. I met Jay in 2005 when we both stopped drinking. Two years later, Jay began to lose feeling in his legs and started having fallen, as a result of compressed nerves in his spine. The pain was so bad Jay had to stop working and go on disability, which started his depressive episodes.
Jay had a series of lower back and neck fusion surgeries. This was when he has first prescribed painkillers, antidepressants, and anti-anxiety medications. From 2008 to 2011, Jay tried various treatments to control the pain that lingered even after third back surgery. These included steroid shots, nerve blocks, and a spinal cord stimulator. Ultimately he had a drug pump implanted that delivered morphine, in addition to the pain pills he was being prescribed.
In 2012, Jay was diagnosed with trauma-induced dementia. I believe that diagnosis was right, based on his symptoms, but not all of the doctors agreed. Some believed the confusion was due to high doses of morphine and/or his sleep apnea.
By 2016, Jay’s confusion and memory issues were increasing. He was on a steady dose of 120mg morphine daily, in addition to the medication he was receiving from his pain pump.
Jay’s depression seemed to come and go, depending on the day and his pain levels. He was weaned down on his Xanax to 2mg a day to help him sleep. He was aware of the risks of combining Xanax and morphine.
Let me tell you what a good day was like before they changed his medications. I worked a full-time job from 2 pm to 10 pm five days a week. I would get home, and Jay would have my coffee ready for me at night. We would stay up and watch TV until 2 or so. When it was time for sleep, I went to bed and he slept in his recliner.
We started sleeping apart after his first surgery in 2007. He was more comfortable sitting up in the chair, but could never sleep more than three hours at a time. He knew sleeping in bed would just keep me awake.
A good day always meant it was not cold or raining. On a good morning, he would be up first and get the coffee started. He would take our two miniature pinchers outside in the yard on their leash for potty time.
We usually had at least one appointment a week, but if not we could have a nice quiet morning. That meant coffee in front of the TV. After a couple of hours of that, he might switch over to playing his computer games, but he was never far from his chair.
A typical adventure for us would involve going to Walmart. Jay was not able to walk through the store, but he hated using the handicapped carts. I could always see a look on his face when he had to do it. After going to the store, we might have lunch or an early dinner at Steak n Shake or Cracker Barrel. It always needed to be someplace familiar and comfortable for him. More than once we sat, ordered, and then took our food home because he was in too much pain.
In the summer we might walk the dogs after dinner. Just a quick two-block walk, but a lot of times he would have to stop halfway and go back home. A couple of times I had to go get the car and pick him up because his legs just would not support him anymore.
A bad day was awful for me to watch, and absolutely horrible for Jay to live. It meant no real sleep, just catnaps in the chair whenever he could. He always made coffee for us, but on a bad day he would forget to add coffee to the coffee maker and we would just have hot water. The pain was so much he was just distracted.
On many bad days, I would look over and see tears just running down his face because he was in so much pain. It also made Jay’s depression worse. We spent many cold winter nights talking about how much pain would be too much and would make life not worth living. It is the most horrible feeling in this whole world to hear the person you love most talk about ending their life.
In January 2017 Jay’s pain clinic decided they could no longer prescribe the high doses of morphine he was on. In addition, they were not going to continue seeing him if he decided to stay on Xanax. The Xanax was prescribed by another doctor, but they did not care.
I begged the pain doctor — yes, literally begged — for some other option. The doctor said that if Jay continued the Xanax he would no longer see him. He would not give another option for medications, and at one point even said that most of his patients with pain were “making it up.”
The last thing the doctor said to us will stick with me forever. He said, “My patient’s quality of life is not worth losing my practice over.”
When we left that day, we were barely in the car and I knew what Jay was going to say to me. I will never forget how sad his voice was when he told me this was it for him. He was not going to continue to live like this.
Through the month of February, as Jay’s medication was decreased, we spent time doing things we did not normally do. We went out on Valentine’s Day, he bought me the first jewelry he had bought since my engagement ring, and we went out to a fancy restaurant for dinner. Jay tried to cram in as many good memories as he could into that last month, but I knew it was costing him.
Jay’s next doctor’s appointment was scheduled for March 2, and we knew they were going to decrease his medications again. The night before, he woke me up to tell me it was time. I knew what that meant, but I tried to be strong for his sake. We talked all night long about what it meant, and how it should be. It was the saddest, strangest, longest night of my life.
Jay knew he did not have enough pills to kill himself. He also knew that if he were to try and purchase a gun, they would not sell it to him. It would have been almost obvious what he was going to use it for.
In the end, I bought the gun that Jay used — and yes, we talked about the ramifications of that action. We went to the park where we had renewed our vows in 2015. We talked in the car for a while, and then we sat in the same place we had cut our wedding cake. I was holding his hand when he pulled the trigger.
Through the shock and horror, my immediate feeling was one of relief for Jay. To know that he was finally out of pain was a weight lifted off both of us.
Because I purchased the gun that Jay used to end his life, I was charged under our state’s assisted suicide law. This charge was later reduced to reckless endangerment, and I am currently on probation. People close to me want me to be quiet about my role in Jay’s death, and I was at first. But I cannot continue that way.
I know Jay wanted me to put his story out there. I know he wanted people to know what it was like to live with the pain he lived with daily. When the doctor took away Jay’s medications, they took away his quality of life. That was what led to his decision. Jay fought hard to live with his pain for a long time, but in the end, fighting just was not enough.
If you’re experiencing chronic pain, a doctor may recommend that you have a nerve block, a temporary or permanent procedure that disrupts specific nerve activity. It can help diagnose or treat certain types of neuropathic pain, or pain caused by nerve dysfunction or damage. Nerve blocks may be performed by injecting chemicals or anesthetics to the area or by deliberately cutting or damaging certain parts of the nerve.
Many people receive nerve blocks without even knowing it. For example, dentists commonly use nerve-blocking agents such as novocaine to numb the mouth during potentially painful procedures.
If your doctor is trying to diagnose a chronic pain condition caused by nerve dysfunction, he may use a nerve block to pinpoint the exact problem area. In addition to a nerve block, he may also perform an electromyography (EMG) and/or a nerve conduction velocity (NCV) test to narrow down the exact cause of your chronic nerve pain.
Nerve blocks can also treat chronic neuropathic pain, such as pain caused by nerve damage or compression. They are regularly used to treat back and neck pain caused by herniated discs or spinal stenosis. Nerve blocks may be used to control pain temporarily or permanently, depending on the procedure used.
A local nerve block is performed by injecting or applying local anesthetics, such as lidocaine, to a certain area.
An epidural is a local nerve block that involves injecting steroids or analgesics into the area that surrounds the spinal cord. Though common during childbirth, an epidural may be also be used to treat chronic neck or back pain caused by a compressed spinal nerve. Local nerve blocks are usually temporary, although some may be repeated over time.
A neurolytic block uses alcohol, phenol, or thermal agents, such as cryogenic freezing, to treat chronic nerve pain. These procedures actually cause damage to certain areas of the nerve pathway. This means a neurolytic block is usually appropriate only in severe chronic pain cases, such as cancer pain or complex regional pain syndrome (CRPS).
A surgical nerve block is performed by a neurosurgeon and involves surgically removing or selectively damaging certain areas of the nerve. Like a neurolytic block, a surgical nerve block is usually reserved for severe pain cases, such as cancer pain or trigeminal neuralgia. Most surgical nerve blocks are permanent.
Even a temporary nerve block such as an epidural carries a risk of permanent nerve damage. Because nerves are extremely sensitive and regenerate slowly, even a tiny error in calculation can cause devastating side effects. These include muscle paralysis, weakness, or lasting numbness. In some rare cases, nerve blocks may actually irritate the nerve further, causing an increase in pain.
Fortunately, skilled and licensed health practitioners, such as dentists, surgeons, and anesthesiologists, perform these delicate procedures.
While there is always a risk of nerve damage during these procedures, most nerve blocks successfully reduce chronic nerve pain.
You may feel temporarily numb or sore after your nerve block, and you may notice some redness or irritation to the area. This is usually not permanent and should fade with time. If you have had a surgical block, you may be asked to rest for a certain period of time after your procedure. Depending on the complexity of the surgery, you may have to spend a few days recovering in the hospital.
Some pain may persist after your nerve block, but that doesn’t mean the procedure wasn’t effective.
Additionally, some nerve blocks may cause swelling, which compresses the nerve and requires time to subside. If you find the side effects of your nerve block are lasting longer than expected, contact your doctor.
People around the world are becoming increasingly aware of natural remedies and alternative medicine.
However, this does not change the attitude of Big Pharma to enforce their drugs on an open-mouthed public despite their numerous and well-documented, harsh side-effects.
The almighty health benefits of cannabis are becoming increasingly accepted in mainstream society and are being bolstered by numerous recent studies.
The Foria Relief Company has even invented a vaginal suppository, based on aromatic cocoa butter, which is a perfect substitution for Vicodin, Midol, and Ibuprofen. It effectively treats menstrual cramps by relaxing the muscles. Additionally, it does not lead to psychotropic properties.
It is produced from pesticide and additive-free cannabis. Therefore, their active ingredients are used in a process without microbials and are combined with exact doses; 60 mg of tetrahydrocannabinol (THC) and 10 mg of cannabidiol (CBD).
The pain is blocked by the THC, which inhabits the pleasure areas of the brain’s cannabinoid system. CBD relaxes the muscles, treats the spasms, and has a favorable effect on inflammatory mechanisms within the body.
According to a woman who tried the vaginal suppository, it relaxed her clenched and cramped muscles and soothed the pain in her midriff. She explained that she felt the area below the waist to the thighs “as if floating in some other galaxy”.
Yet, this amazing remedy is only sold in California and is still not approved by the FDA. However, if you decide to use it, make sure you consult your doctor beforehand, even though there have been no complaints from people who have tried it.
A woman who has spent the past eight years in constantpain is hoping the specialist treatment will help her to rebuild her life.
In 2016 Emma Parslow Cope was diagnosed with the long-term condition fibromyalgia which causes an increased sensitivity to pain, exhaustion, headaches and problems with mental processes.
The 27-year-old, who lives in Thetford, said the condition has had an enormous impact on her life. She has had to leave her job and it has put a strain on her relationships with family and friends.
Miss Parslow Cope describes the pain throughout her body as like a “burning sensation” and she suffers from fatigue and has trouble sleeping.
She is now hoping to raise £10,000 to cover the costs of seeing a specialist at the Fibro Clinic in London and any treatment, medication and accommodation needed.
Miss Parslow Cope said: “I am desperate to get help so I can get myself in a state of managing so I can then do some volunteer work to build my life up.
“The specialist should be able to put me on a programme and understand me as a person. I hope they should be able to give me treatment to help me get some sort of proactive life back.”
A keen sportswoman, in 2010 Miss Parslow Cope hurt her hip during a college football match.
She believes it was this injury which led to the fibromyalgia but she was not diagnosed for six years.
On December 31 last year the former West Suffolk College student said she tried to take an overdose because of the condition.
“I just did not want to be here anymore,” said Miss Parslow Cope who attends the Fibromyalgia Bury St Edmunds support group run by fellow fibromyalgia suffer Brett Robertson. “It just takes over your head.”
She is now hoping to help raise awareness of the condition – which her twin sister Louise was also diagnosed with this year – which she says is misunderstood.
She said: “I want people to be behind fibromyalgia suffers. I want people to understand and the more people who are aware of it and understand it the better.
“I am tired of people saying it is not real because I am living with something which is severe and nasty 24 hours a day.”
It started as a dull ache right above the base of my spine.
There was no injury, no clear cause — just pain that seemed to come out of nowhere. At the time, I thought it would go away in a few weeks. I didn’t know it would turn into a four-and-a-half-year-and-counting odyssey of experimentation to battle lower back pain that simply refused to retreat.
I tried everything. I dove into twice-a-week physical therapy, daily exercises, regular walking breaks, and meditation. I bought a sit-stand desk. Nothing worked. After several months, if anything, my pain was worse.
This health problem, coincidentally, arose just as a career shift made improving US health policy my focus. After working as a consultant for hospital systems and insurance companies, I accepted a position at the federal agency that runs Medicare and Medicaid. My work focused on designing new ways to pay health care providers to reduce waste and provide higher-quality care.
Through my work, I realized just how massive the chronic pain problem is in the US. Defined as any pain lasting longer than three months, chronic pain afflicts more than 50 million Americans each year and has a net economic impact of around $600 billion. Lower back pain alone is the most common cause of disability for Americans under 45.
It struck me that policy and business leaders tackling the problem-focused almost entirely on what not to do: avoid excessive imaging studies, avoid invasive treatments and surgeries. Especially avoid opioid painkillers.
Given how common my problem was, I was surprised at how little research and policy was focused on what could be done to fix my pain.
It is certainly true that US clinicians went overboard on opioid prescribing, with horrifying repercussions. I am not going to argue here that opioids are a good treatment option — they appear not to be in most cases — or minimize the devastating effects of opioid addiction.
However, a full response to the opioid epidemic must go beyond reducing opioid use: We need to find ways to reduce pain through better treatment. Policymakers need to put more focus and public dollars toward understanding pain, and patients need to be supported in their pursuit of pain treatments that work.
Every day at work, I was learning about innovative programs to improve health outcomes for populations with chronic illnesses such as diabetes and hypertension. There was nothing similar for pain management. Chronic pain seems to be something that few doctors, let alone administrators and policymakers, really understand and know how to treat.
My own journey to find relief made the problem deeply personal. In the absence of clear knowledge and robust treatment options, patients like me are forced to spend a lot of time, energy, and money experimenting with different remedies.
I received an MRI to figure out the source of my back pain — it showed nothing. I am one of the 85 percent of low back pain patients whose pain is “nonspecific”: Doctors cannot pinpoint a cause. Of the many treatments that exist, there is not a definite winner. I tried various medications, several physical therapy regimens, and creams and injections of all sorts. I tried a small patch that sends high-frequency electrical pulses to suppress nerve activity, a treatment that actually helped a bit.
Desperate to exert control in the absence of effective treatments, I funneled my energies into remaking my office workstation. I was lucky to be able to work from home often, a privilege many lacks, so I had complete control over my environment. With the help of a specialized vendor, I fashioned a workstation that allowed me to either walk on a treadmill or lie on my side while working on two large side-by-side monitors.
My closet was full of the flotsam of tried-and-failed ergonomic cushions, massaging implements, and foam rollers. I rarely invited people over, dreading I would have to explain my bizarre apartment setup.
Eventually, I took a short trial of opioid painkillers. The pills were moderately effective but made me very tired. That, coupled with a fear of building tolerance, caused me to stop taking them after a few weeks. Fortunately for me, my pain is relatively low-intensity. The trade-off is different than for someone experiencing more pain. The crucial point is that — for me, anyway — painkillers were simply another treatment with a unique set of risks and benefits. My issue was, and remains, managing pain, not managing opioids.
Throughout my adventure of trial and error, coverage decisions from my insurance companies often seem random. Many treatments — for instance, massage or prolotherapy injections, in which a sugar solution is used to stimulate tissue repair — have been denied, on the grounds that the evidence of effectiveness is weak.
Yet other treatments with similarly weak evidence behind them, like steroid injections, are covered. I understand the reluctance to pay for a treatment that is unlikely to be effective, but this process of experimentation is all I have. I’m lucky to have the means to spend tens of thousands over the years out of my own pocket. Others don’t have that option.
On my quest to figure out why there seem to be so few good solutions to chronic pain, I discovered that less than 1 percent of National Institutes of Health research funding is dedicated to pain research.
Dr. Edward Michna, a pain specialist who works with the American Pain Society, ties this to the stigma around chronic pain. (The American Pain Society previously received funding from pharmaceutical companies that sold opioid painkillers.) “Even before opioid use became an epidemic, funders and politicians equated pain management with addiction treatment, and they ran away from funding it,” he said.
He pointed to a pervasive belief that these patients were exaggerating their pain to receive disability benefits and, in modern times, to get high on painkillers. “With some notable exceptions, it simply wasn’t an issue they wanted to get involved with.” It would be easy to dismiss his views as biased in favor of big pharmaceutical companies, but as someone who is in pain and wants help, his words resonated with me.
Pain is often a symptom of an underlying condition, which means that research into those conditions will ultimately alleviate pain. Cancer-related pain will probably improve if we find better treatments for cancer in general. But for tens of millions of Americans like me, our pain cannot currently be explained by a separate disease. We need more than just 1 percent of government funding devoted to pain research specifically.
Some researchers are beginning to embrace the theory that pain itself is a type of independent disease. They speak of “central sensitization” — the idea that in some people, for reasons yet unknown, the central nervous system changes over time to experience heightened pain. This isn’t New Age hand waving: It’s real science that demands further study.
Another important question for both researchers and health care providers in improving how we match patients to treatments. Often, when treatment ends up working, it remains unclear why it worked for a given patient and not for another, similar patient. When we say a treatment like prolotherapy injections has limited scientific evidence, that usually means that in trials, few saw benefits above placebo. If we could figure out what is different about those few who did see real benefits and identify them, the same treatment becomes more useful.
The opioid crisis — as grave as it is — threatens to overshadow these important issues. Right now, states and governing bodies are focused almost exclusively on reducing opioid prescriptions rather than finding alternatives. The National Committee for Quality Assurance, which sets quality standards for health plans, has a new measure that effectively penalizes providers who prescribe patients opioids over a certain dosage amount. Some states, like Maine, put in place caps on opioid doses.
It’s too early to tell how many patients who legitimately need opioids are having trouble accessing them as a result of these policies. But anecdotes from patients and clinicians suggest some people are suffering. Two small-business owners in Maine are suing the state over rules that require long-term opioid users to lower their dosages.
That policy was an understandable reaction to the fact that 313 people in Maine died from opioid overdoses last year. Yet we have to acknowledge the lack of good options for treating chronic pain. We should also recognize that while evidence behind opioids is weak and they are highly risky, some patients have been well-served by them.
Improving how we apply existing treatments also requires workforce training. A 2011 study found that US medical schools allotted an average of nine teaching hours to painmanagement. (The average for Canada was 19.5 hours.) Clinicians across all specialties should receive better training.
It’s not uncommon for the effects of fibromyalgia pain medications to wane over time. But what can you do about it? Here are seven different treatment options to explore.
If you are one of the approximately five million Americans with fibromyalgia, you know that pain can be severe, unpredictable, and exhausting. It can be constant for a period of time and then get better for a while — but it tends to just keep coming back.
Additionally, a painkiller that worked before may stop working, and what works for some symptoms may not work for others. Pain management needs to be constantly adjusted and may require a team of specialists who are familiar with fibromyalgia.
Common pain symptoms of fibromyalgia include stabbing, burning, shooting, or throbbing pain in any area of the body. Pain is usually worse in the morning. People with fibromyalgia may have tender areas on their neck, shoulders, back, or legs that are painful when touched.
And fibromyalgia pain can become even worse with physical or emotional stress. Common stressors that may make your fibromyalgia pain worse include a traumatic event, such as a car accident, repetitive physical traumas, or a physical illness.
Getting this pain under control is not easy. But it is possible.
Switching to a new fibromyalgiapainmedication is easier if you taper one medicine gradually before starting a new one. Always follow your doctor’s directions carefully and never stop a medication on your own.
Important options for treating fibromyalgia include finding the right pain medication, getting the proper psychological support, trying complementary therapies, and finding the right treatment team. If your fibromyalgia treatment is not working, ask your doctor to help you explore these options:
Pain medications. There are a number of medications now approved for fibromyalgia pain, including pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella). The narcotic-like painkiller tramadol (Ultram) has also been effective for fibromyalgia. “Switching between medications may be necessary and can be made easier with samples or vouchers to decrease the financial cost for the patient,” advises Dr. Abeles.
Sleep management. People with fibromyalgia often have trouble getting enough sleep — and lack of sleep can make fibromyalgiasymptoms worse. Make sure you avoid caffeine and stick to a strict sleep schedule. Ask your doctor if a sleep aid medication might help.
Social and psychological support.The stress of living with a chronic painful disease like fibromyalgia can make your symptoms worse. Research shows that increasing social support reduces fibromyalgia symptoms, such as pain. You may benefit from a fibromyalgia support group. Professional counseling to help you develop coping skills and better manage your symptoms has also been shown to be helpful.
Exercise.Exercise is an important part of feeling better if you have fibromyalgia. Studies show that exercise can help you improve your fitness level, feel better about yourself, and reduce the number of painful pressure points in fibromyalgia.
Acupuncture. One survey found that about 20 percent of people diagnosed with fibromyalgia and treated at a university-based clinic tried acupuncture within a two-year period. Some studies have found that acupuncture can help relieve fibromyalgia pain, but other reports say the effects are not long-lasting and the treatment doesn’t help with the fatigue or sleep problems common with fibromyalgia.
If you are being treated for fibromyalgia and your pain medications are not as effective as in the past, you have options. Remember that it is common for people with fibromyalgia to try different types of medications and other management strategies. It is also important to make sure you have a sympathetic, knowledgeable team of experts to help you manage your fibromyalgia symptoms.
Fibromyalgia is an unpredictable disease that requires a flexible treatment plan. One of the best things you can do is to educate yourself about fibromyalgia so that you can work closely with your treatment team and be a good advocate for yourself.
Have you come to hate talking on the telephone since you’ve had fibromyalgia or chronic fatigue syndrome? It’s a common thing with people frequently saying they have an especially hard time focusing on phone conversations.
So why is this? It hasn’t been studied, but several factors could contribute to this problem:
When you’re on the phone, you don’t get any of the non-verbal cues that come with face-to-face conversation. Communication experts agree that most of communication is non-verbal, and when you remove all those verbal cues, your brain has to work harder to comprehend what’s being said. Foggy brains may not be able to muster that level of focus.
We’re often in environments that are full of distraction. You hear a lot about “multitasking,” which doesn’t really mean that the brain is doing multiple things at once. Even in healthy people, according to experts, the brain is actually switching from one task to another. FMS and ME/CFS brains often have a hard time with multitasking.
The language problems common in fibromyalgia and ME/CFS—which includes word recall—can complicate conversation and make it stressful. If you’re afraid of forgetting common words or losing your train of thought, it may make your symptoms worse.
Holding the phone can be really painful for the hand, arm, shoulder, neck or even ear. Some phones get really hot, which can bother those who have thermal allodynia (pain from temperatures that wouldn’t normally cause pain). Fortunately, speakerphones and headsets can alleviate a lot of these problems.
It may be easier to write than talk when language impairment is acting up. Then, you can take more time with it, sort through your jumbled thoughts, and then proofread it. On top of that, when you receive written messages, you can keep them and refer back if necessary. You may remember things better when you read them, too.
When you do have to use the phone, try to eliminate all the distractions you can. Go into a quiet room and shut the door, maybe even turn out the light. If you need to relay specific information, make notes ahead of time and keep them with you. To help you remember information, take notes. That prevents frustrations like making a doctor’s appointment or plans with a friend and then forgetting the details the moment you hang up.
If you have problems communicating via telephone, it can help to let the people who speak with frequently know about it. Let them know that when you ask him to repeat something, it’s not because you were ignoring them. You may also want to encourage them to send you texts or emails instead of calling, especially if they know you haven’t been feeling well. It might be worth exploring Skype, especially for long-distance calls or conversations you expect to be lengthy.
Studies have shown that it’s a bad idea for anyone to talk on a cell phone while driving, even if it’s hands-free. While it’s not something that has been studied specifically, it seems safe to assume that those of us with communication-based cognitive dysfunction would be especially dangerous when it comes to talking while driving.
Despite the instant negative reaction to the thought of the Herpes virus and the association with sexually transmitted disease, there are a number of different Herpes viruses, including those responsible for Chicken Pox, Shingles, and Epstein Barr (mono).
Even the ones with the most negative stereotypes are much more common than people believe; around 90% of people have been exposed to HSV-1 (oral herpes, or cold sores), and the numbers for genital herpes are pretty close to the same. Once exposed to any of these viruses they can lie dormant in your body, reactivating at any time, usually as a response to stress. So, is there a connection between Fibromyalgia and Herpes?
Given the overlap in symptoms between Fibromyalgia and Epstein Barr, it’s not surprising that researchers would consider a possible connection; I know that I certainly did. I had mono when I was a junior in High school. I don’t remember much about it other than that I felt tired a lot. What I do remember was later (over the next couple of decades) that I would have what I referred to as “recurring mono” despite multiple doctors telling me that you can’t get mono more than once (something that has since been severely questioned by many doctors and researchers).
My throat would get sore, my lymph nodes would get swollen, I would feel achy (like the flu), and worn out. This was usually after I’d been running on full steam for several weeks, and I saw it as just my body crashing after I’d pushed it too hard. Back in 2006 when I was fighting strep infections every couple of weeks I actually managed to get a doctor to test me for Epstein Barr and low and behold I tested positive for an active infection (so much for not being able to get it more than once). Blood work has come a long way in two decades.
Fibromyalgia, to me, feels a lot like those episodes of mono, sometimes even including the swollen glands and low-grade fever that were common with the recurring mono. So, it’s understandable why I might question whether or not there may really be a connection between the two.
Research regarding the overlap of Fibromyalgia and Epstein Barr goes all the way back to (at least) 1987. Buchwald, Goldenberg, Sullivan, and Komaroff examined 50 patients with Fibromyalgia and tested them for Epstein Barr. The levels of the virus in their systems were not significantly different than those of the healthy and unhealthy controls.
The methods used to diagnose Fibromyalgia, at this time, were much less stringent than the 1990 guidelines called for, and probably more similar to the currently accepted guidelines. Two control groups were used for this study, one group containing healthy controls, the other patients who had been diagnosed with at least one chronic illness.
A large number of the patients (27%) reported frequent sore throats, as well as many of the other symptoms common to mono, but not common to Fibro. Testing showed no significant differences in the levels of EBV antibodies between the Fibro group and the health or unhealthy controls.
VCA-IgG indicating that the person has had the virus at some time existed in almost all participants (regardless of group). It’s important to note that many people can have Mono and never show any symptoms. VCA-IgM without EBNA antibodies indicates a recent infection; none of the Fibro patients tested positive for VCA-IgM.
EBNA antibodies indicate a past infection; this was found in most participants regardless of group. Given the results, it’s almost impossible to say that Herpes isn’t related to Fibro, or that it is. Since they tested against healthy (and unhealthy controls) and all showed evidence of past infections, it’s possible that their healthy controls were not as healthy as they thought, that the unhealthy control group may have had overlapping issues that were not diagnosed, and a number of other things, including limitations in the blood tests at that time.
Side Note – one really interesting thing in this study that jumped out at me was that even back in 1987 Rheumatologists were reporting that they believed Fibromyalgia patients may make up the largest percentage of their patients. This is back before the original diagnostic criteria were set, and long before most doctors really even believed Fibromyalgia existed. Evidently, the three doctors involved in this study did believe in Fibromyalgia. Perhaps, Fibro patients sought them out for that reason.
In 2012, Hedberg reported that latent Epstein Barr virus has been connected to many different auto-immune disorders including MS, Hashimoto’s thyroiditis, RA, Sjogren’s, Chrons, and a number of others that are often seen as overlapping disorders with Fibromyalgia. He also reported on a genetic mutation found in the blood that allows Epstein Barr to increase and maintain itself, possibly leading to autoimmune issues.
A great deal more research has been done regarding Chronic Fatigue Syndrome (CFS); both Epstein Barr and Herpes Virus 6 have been connected to Chronic Fatigue Syndrome; as many as 70% of those diagnosed with Fibromyalgia are also diagnosed with Chronic Fatigue Syndrome, and there is much debate as to whether Fibro and CFS may be two separate entities or two ends of the same spectrum.
Of course, all of that brings us to the recent findings of Dr. Duffy and Pridgen at the University of Alabama (Roll Tide!). They have been researching the possibilities of treating Fibromyalgia, chronic pain, and IBS using a combination of anti-virals usually used to treat HSV-1 (cold sores). They stumbled upon this potential treatment almost accidentally and are now on their way to stage-3 trials. This could be the thing that ties the Herpes virus to Fibromyalgia (and related conditions) and may provide significant relief for many of us.
Cannabis-infused sports creams claim to offer muscle relief. We spoke to experts to see if they’re worth a shot.
Chances are you’re no stranger tomuscle aches. Well, what if we told you that cannabis creams might help provide relief?
Yes, there’s a new type of topical ointment on the market, and it’s infused with cannabidiol (CBD) from marijuana. Manufacturers claim it can help alleviate acute pain and muscle soreness. CBD is similar to THC, except it’s non-psychoactive, meaning some researchers view it as the golden child of medicinal use.
Science has confirmed that cannabis is an effective pain reliever, reinforced in a massive new report from the National Academies of Sciences, Engineering, and Medicine. But there’s a big difference between ingesting cannabis or its individual chemicals orally and absorbing it through your skin. Here, the lowdown on this new crop (no pun intended) of pain relievers.
The ointment is made from infusing high-quality cannabis flowers in some kind of quality oil—coconut or olive typically—which extracts the active compounds, either CBD, THC, or both depending on the type of hemp used. This oil is then blended with other therapeutic herbs, like arnica or lemongrass essential oils, which are well-known pain relievers.
If you read the ingredient list, often everything in the jar is straight from mother earth. As long as that’s indeed the case with the cream you have your eye on, the formula is immensely safe, chemically, says Gregory Gerdeman, Ph.D., neurophysiologist who researches cannabinoid biology and pharmacology at Eckerd College in Saint Petersburg, FL. And since they’re formulated to be topical—absorbing into the top layer of skin—and not transdermal—which would pass through the skin and into your bloodstream—there’s no risk of getting high.
“When it comes to cannabis-based topicals for muscle soreness or other pain relief, there’s absolutely no reason why it should be a big deal to try,” he says.
They may be safe, but there’s one massive problem: There’s practically no scientific data to support the idea that a CBD-infused topical cream is any more effective than other topical pain relievers, like Tiger Balm, BenGay, or Icy Hot. Michelle Sexton, a San Diego-based naturopathic doctor and medical research director of the Center for the Study of Cannabis and Social Policy says that her patients do seem to have a great interest in CBD ointments, and roughly 40 percent of them have indeed tried one. However, these people are in her office now because the topicals didn’t work for them. “As a medical professional, my opinion is there’s little evidence to back up the claims being made—it’s all marketing for now,” she says.
There is an argument to be made for the simple fact that science hasn’t caught up to the trend (and laws) of 2017 yet. And there are doubtlessly researchers testing the efficacy of CBD–infused creams for pain relief as we speak.
The theoretical logic is there, Gerdeman says. What exactly is that thinking? Well, there are a few different ways CBD could help regulate pain—by increasing your natural endocannabinoids, decreasing your inflammatory response, and desensitizing your pain receptors (although it’s still unclear whether this stands when absorbed topically compared to orally).
Let’s start simple: Endocannabinoids are natural signals in your body that help maintain homeostasis by detecting and regulating hunger, pain, mood, and memory. CBD helps elevate your natural levels of pain-relieving endocannabinoids by blocking metabolism as they’re moving around your body.
The second method of pain relief centers around the damage you do when you work out. When you strength train, you create micro-tears in your muscles, which is why you feel sore as you heal. Once your immune cells detect damage, they release inflammatory mediators in order to repair the tissue. CBD, though has the ability to limit the release of some proinflammatory signals, thereby helping with pain without thwarting the healing entirely, Gerdeman explains.
Finally, you have receptors called TrpV1 that detect and regulate your body temperature. When activated, they put out heat, soothing your pain receptors. Using this channel, CBD makes these pain receptors hyperactive for a period of time, causing them to get hot, desensitizing them, and downregulating those pain–sensing nerve endings.
Phew—enough of that biology lesson. The real problem here is that all of this has yet to be proven in scientific studies on humans.
A study analysis in the Journal of Pain Research confirms that topical use of certain cannabinoid topicals can reduce pain in animals with inflammation or neuropathic pain. And science has found topical creams with THC and CBD help relieve pain for conditions like multiple sclerosis. But for the vast majority of chronic pain—and most certainly for acute pain like post-workout—the scientific jury is 100 percent still out. “There’s a little bit of data in support of CBD for pain relief, but to go from animal to human is a giant leap,” Sexton says.
“The pain and stiffness that comes post-workout or from overexertion certainly has a pro-inflammatory component to it, so it’s reasonable to think CBD or other cannabinoids might have benefits, but we have no research to support this yet,” Gerdeman adds.
The other issue? Topical creams will treat anatomical structures within 1 centimeter of the skin—and the muscle where your actual soreness is located is going to be deeper than that, explains Ricardo Colberg, M.D., a physician at Andrews Sports Medicine and Orthopaedic Center in Birmingham, AL.
The fatty tissue can only hold so much oil, so, theoretically, if you apply enough of a CBD–infused topical cream to your skin it might leak down into your skeletal muscle just out of diffusion, Sexton adds. But there’s no study to show this, and that means you’re going to be rubbing on a whole lot of the stuff.
This takes us to the next problem: There is no regulation around how much active CBD or THC is in each cream or how much of the compound is needed to see relief. Read: “If you have three products that say 1 percent CBD infused in coconut oil, one could be great and the other two could be crap—that’s the reality of cannabis medicine right now,” Gerdeman says.
That’s not to say CBD–infused creams definitely won’t reduce your acute pain or muscle soreness. That’s because pretty much all of these creams on the market right now have other scientifically-proven analgesic compounds, like menthol, camphor, and capsaicin which are also found in other, non-CBD topical pain relievers.
“Any cream with a heating or cooling sensation desensitizes the nerves to pain by distracting them with stimuli on top,” Dr. Colberg explains. Plus you’re often massaging the area as you apply, which improves circulation and reduces muscle spasms, he adds.
So do you need CBD? All our experts agree that until we have more peer-reviewed research, all claims are marketing hype and not evidence-based.
But there is an argument to be made for simply believing the CBD adds that special something. “Scientific literature says there’s a 33 percent chance of the placebo effect helping people, so for some, just using a cream they believe can help will provide some relief,” Dr. Colberg adds.
The short of it: Science hasn’t confirmed creams with CBD will have any greater benefit than those without, but there’s little-to-no risk in trying it out (other than wasting your money, of course). And if you believe in the power of CBD–infused creams, that may be enough to score some relief.
If your state has legalized both compounds, look for a cream with 1:1 CBD to THC as well as another cannabinoid BCP (beta-caryophyllene) if possible, which manufacturers have seen better results with, Gerdeman suggests. Try Apothecanna’s Extra Strength Relieving Creme ($20; apothecanna.com) or Whoopi & Maya’s Medical Cannabis Rub (yes, that’s Whoopi Goldberg’s line), which was designed specifically for menstrual aches and pains (whoopiandmaya.com).
If you don’t live in a legalized state, you can typically still get CBD–infused creams. Since there’s no regulation or standardized testing, your best bet is to find trustworthy brands that use creams free of toxins but with additional pain relievers like menthol, capsaicin, lemongrass, or camphor. Try Mary’s Nutritionals Muscle Freeze ($70; marysnutritionals.com) or Elixinol’s CBD Rescue Balm ($40; elixinol.com).
