Question: Hello. My name is Joan. I have chronic pain from fibromyalgia, and I wonder if you could talk about the fatigue component of fibromyalgia. I wonder if there are ways to mitigate the fatigue rather than giving in to it.
Answer: Hi Joan. Fibromyalgia is a difficult condition, in part because it has so many difficult symptoms -- fatigue being a very important one. The fatigue probably occurs for several different reasons, and so, it is important to think about whether or not the fatigue is a primary manifestation of fibromyalgia, from whatever it is that causes that condition -- for example, elevated levels of cytokines or inflammatory mediators in the body that drain us of our energy -- or whether it's a secondary problem that's a consequence of the illness, what it does to us, and the treatments that most patients receive.
So as you think about the fatigue, one consideration is: Am I getting the appropriate treatment for fibromyalgia? Am I on medications that will treat that condition, and help the pain and fatigue of fibromyalgia?
The second thing to consider is whether or not other medicines that you're taking -- for sleep, for depression, for pain -- are actually causing the fatigue and making that problem worse, in which case, maybe those medicines should be discontinued or changed.
And then finally, patients with fibromyalgia have lots of trouble maintaining their activity level and their fitness, and that plays into fatigue in a vicious cycle, making us worse and worse. So, any regular activity that you can get, any structured exercise that you can do is important, even if it's very simple walking. That will help combat the fatigue that you experience.