Fibromyalgia and nerve pain explained



The cause of Fibromyalgia remains unknown, many theories have been put forward and there seems to be no "one cause fits all" {Read: What is Fibromyalgia?} Experts believe there may be abnormal levels of certain chemicals in the brain and changes in the way the central nervous system (including the brain, spinal cord and nerves) process pain messages.

When you are the person on the receiving end of the pain it is difficult to comprehend such severity without obtaining an injury. I remember pre-diagnosis and the fear that something must be so wrong as I was in so much pain, weird horrible pain but I had no injury.

Many of us with Fibromyalgia, endure neuropathic pain on a daily basis.  As pain is not visible it is so hard to explain to a non-fibromyalgia person exactly what it feels like. It is therefore so hard for others to understand how much it can affect daily living. If you break a leg you have a cast, an outward sign of pain but with Fibromyalgia there is nothing.

Beyond "Have you ever had a bad case of Singles? Well, we live with that pain daily" it gets tricky.

Neuropathic pain is caused by this disruption in the nervous system. Signals are not sent correct information between the brain, skin, muscles and other areas.

Neuropathic nerve pain can feel like:
  • Burning sensation
  • Sensitive to touch
  • Excruciating pain like a knife turning inside.
  • Pins and needles.
  • Lightning sharp stabs in one area or many all at once. 
  • A chronic prickling on the skin.
  • Numbness.
  • Feeling pain from something that should not be painful at all, like a gentle touch or stroke.
Wrongly many people believe they are in pain and taking pain relief so nothing else can be done, this is wrong. It is different for everyone so no clear guidelines can be in place. You can manage Fibromyalgia with a combination of many things and learn to view this illness holistically. 

With Fibromyalgia it is very much trial and error finding the best way to manage this kind of pain. Usual over the counter pain relievers such as ibuprofen, paracetamol and aspirin is not effective for this kind of pain. So doctors usually prescribe other medication and sadly some do not explain why or even discuss the side effects of each. If you are lucky like me to have an amazing family doctor well capable of managing Fibromyalgia then consider yourself blessed for all other people here is a small intro to why each medication is prescribed for neuropathic pain. 

Anti-epileptics such as Gabapentin and Pregabalin
These have been shown to reduce nerve pain and associated symptoms by interfering with the overactive transmission of pain signals sent from the oversensitised nerves. 

Antidepressants such as Duloxetine and Amitriptyline
Antidepressants are usually selected based on their chemical structure. The best ones for pain are known as tricyclics. They are said to increase the neurotransmitters in the spinal cord that reduces pain signals. They do not work instantly and may take time to feel a benefit. This is often why many people stop using them as they do not see an instant result and are not told to give it a few months. 

Opioid painkillers such as Dihydrocodeine, Morphine, Fentanyl.
This one has become a bit of a "hot potato" at the moment as some studies claim that opioids do not work well for long-term use on neuropathic pain and there is a massive shift in prescribing due to addiction. I could personally write a book on this stating the pros and cons but will simply say, it is all down to individuals and what works for you and the pain you feel. 

Injections such as Cortisone
These may help as they can target specific points within the body. The injection contains local anaesthetic often with a small amount of steroid. The injection is usually undertaken in conjunction with other treatments such as physiotherapy.


But also there are other things that a Doctor may not prescribe such as:


Cannabis
This works due to the endocannabinoid system. Cannabis contains THC and CBD. When THC and CBD enter your body, they activate your CB1 and CB2 receptors which regulate the neurotransmitter and central nervous system, helping to manage pain levels.

"Smoking cannabis from a pipe can significantly reduce chronic pain in patients with damaged nerves" (Source)

Transcutaneous electrical nerve stimulation (TENS) 
A TENS machine produces a mild electrical impulse. It is said this selective stimulation of certain nerve fibres could block signals carrying impulses to the brain and spinal cord which may help relax the muscles and ease the pain. 

Other treatments 
These include treatments such as acupuncture, meditation, reflexology, massage, lifestyle changes such as diet and exercise.


I am not here to tell you what will work for you or give you medical advice. My main aim is to shine a light on neuro pain and show why it is hard to manage, explain and live with. 

It is soul destroying during the initial phase of Fibromyalgia when you are in so much pain yet so exhausted to bounce into becoming your own patient advocate. This is why many people simply accept medication that is so wrong for them as they are grasping at the hope it will help them to become the person pre Fibromyalgia. Many people sadly endure horrific side effects of medication and wrongly believe are symptoms of Fibromyalgia. It is so hard to educate these people and break this cycle. It is also hard to tell someone not to take a medication due to side effects when they may not get the same side effects. This is why I fully advocate using a symptom diary with Fibromyalgia and to listen to your body and not believe every symptom is due to Fibromyalgia, it may simply be a side effect of a medication. 

Education and understanding of yourself are essential with Fibromyalgia. But don't be too hard on yourself if you are newly diagnosed as it took me years to get where I am now, initially I had no energy to even pick up a book or complete a diary. 

It is tough, so always remember you are not alone.

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Love and gentle hugs

Ness xx

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Comments

  1. As a newly diagnosed fellow fibro sufferer, I found this post brilliant....Thank you so much Ness....xx

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    1. Hi Sue, thanks so very much. So glad you found it useful and so sorry you have fibro like I do. Love and gentle hugs Ness xx

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