FIBROMYALGIA


Fibromyalgia is characterized by chronic widespread pain, and a heightened and painful response to pressure. It is described as “Central sensitization syndrome” caused by neurobiological abnormalities which  produces a physiological pain and cognitive impairments as well as neuro-psychiatric symptomatology.

SIGNS AND SYMPTOMS
Chronic widespread pain, fatigue, heightened response to tactile pressure.
Tingling of skin, prolonged spasm, weakness in limbs, palpitation, functional bowel disturbance and chronic sleep disturbance.Some may also experience cognitive dysfunction
Other symptom often attribute to fibromyalgia that may possibly include myofacial pain syndrome.


CAUSES
Unknown.
Possible: Genetic predisposition, stress, hypodopaminergia, abnormal serotonin metabolism,deficient growth hormone, physical trauma, poor sleep etc

DIAGNOSIS
There is no single diagnostic test.
Most widely accepted set of classification criteria for research purposes was given  in 1990 by multicentre criteria committee of American College of Rheumatology: a history of widespread pain lasting for >3 months, affecting 4 or more quadrants of body i.e both sides and above and below waist.

                                                Tender points

18 designated points.the patient must feel pain at 11 or more points to consider him for fibromyalgia.

Criteria :
Location throughout

Particularly in neck,shoulder,arm, buttocks,hip,thigh

It hurts when pressed but pain doesn’t radiate.

TREATMENT
Psychological/behavioural therapy
Pharmaceutical

Physical therapy
Exercise improves fitness and sleep and may reduce pain and fatigue. Strong evidence suggest that cardiovascular exercise is effective for some patients. Long term aquatic exercises has been proved beneficial as it combines aerobic and resistance training.

AEROBICS
Modes of exercise such as walking and biking can yield long term benefits for fibromyalgia . Startoff with low intensity below your actual capacity and gradually progress.Water aerobics ideal for people with increased pain in patients with chances of worsening of symptoms with exercise

Strength training
To minimize fibromyalgia relates pain.With strength training you focus on one muscle group per session alternate upper and lower extremity training. Isometrics can also be performed.

Avoid eccentric exercises including those with heavy weights which may cause injury.using light weights start with low number of repetitions also rest is very important. Perform exercise 2-3days per week with duration of 25-30 minutes of workout everyday.

Flexibility Stretches should be performed for all major muscle groups.

Combination therapy
Medicine +diet+exercise+cognitive behavioral therapy.

SIGNIFICANCE OF EXERCISE

  • It controls pain and fatigue and prevents decline of muscle strength and endurance, improve flexibility, sleep and energy.
  • Muscles that are not conditioned use excess energy which can contribute to fatigue and aggravate pain,hence exercise helps to improve oxygen delivery and increase muscle temperature leading to pain relief and relaxation.
  • Strengthen ligaments tendons.
  • Increase endorphin pain relief.
  • Decrease anxiety and depression.

OTHER
Yoga:Which incorporates exercises, stretching, and meditation, is a great way to increase fitness.The physical postures(Asanas)can alleviate aches and pains, concentration exercises help to overcome fibrofog (loss of mental clarity), and meditation helps you to focus on present instead of ruminating about your pain/

Tai-chi has also been found beneficial. It emphasizes on relaxation. Its like”meditation with movement”with dramatic flowing movements instead of forceful movement The goal of Tai-chi is to bring principles of Ying and yang into harmony.


Daily activities and hobbies: Experts say that daily activities a household chores as playing with kids, washing windows, mowing yard, gardening an all be beneficial when it comes to increasing fitness and reducing symptoms.

Qigong and meditation: Its called the mother of Chinese healing. It combines meditation dance movements and breathing exercises.It helps to improve energy, decrease fatigue and alleviate pain.

Heat therapy: dry and moist :helps you to relax and alleviate pain.

NUTRITION
EAT : fruits and veg raw, natural protein.
DON’T EAT: fried food, veg meat, food with white flour, increase sugar caffeinated drinks.


We would love to hear from you, coping up skills you have incorporated in your daily life to deal with fibromyalgia.





Towards a Healthy Menopause…


Menopause marks the opening of the new chapter in women’s life. It is the time when women stops having menstruation.
Menopause can be divided into following phases:
Perimenopause: Its the transition years when the hormonal levels start depleting and women experiences changes at the physical and emotional levels.
Premenopause: These are the years leading up to the last menstrual period.
Post menopause: Its the phase when the women hasn’t experienced the menstrual bleeding minimum 12 months
Women experiences a variety of symptoms as a result of hormonal changes associated with transition through menopause. It occurs in age group of 45-55 years.The hormonal levels decline to a level that menstruation is no longer possible with this shift comes several physical and psychological changes. Its important for women to prepare for these changes by taking good care of their bodies.





SYMPTOMS

  • Hot flushes: It is most common symptom. It is the feeling of warmth that spreads over body, lasting around 30 seconds to few minutes. Flushed(reddened) skin and palpitation and sweating.
  • Urinary incontinence, burning on urination, itching and dryness.
  • Vaginal changes as estrogen affects vaginal lining, experimental women may feel pain during intercourse and may note a change in vaginal discharge.
  • Breast changes: shape changes,signs of atrophy can be seen.
  • Bone loss: The bone loss is rapid in perimenopausal phase.Typically women reaches her peak bone mass by 25-30 years, after that there is decrease in bone mass 0.3% per year.This bone mass is 3% per year in perimenopausal phase which may lead to osteoporosis.Other associated symptoms may be back pain,joint pain.
  • Cholesterol levels: The total cholesterol and LDL (Bad) cholesterol levels increase which leads to increased risk of heart problems.
  • Weight gain
  • Emotional symptoms: Menopause doesn’t always create a series of emotional issues. Some women celebrate the menopause as freedom from birth control concerns or menses.However it is also common to feel unsettled about body changes which seems beyond one’s control.The symptoms include, loss of fertility, aging, loss of sexuality, mood swings, fear of cancer.
But, dear ladies remember; the clouds do eventually lift! meanwhile try alleviating your menopausal symptoms with proper diet and exercise.

EXERCISES TO ALLEVIATE SYMPTOMS OF MENOPAUSE
Even if you’ve never formally exercised, its never too late to start… nor it is too late to reap benefits.The key is to start slowly and do things you enjoy such as:

AEROBIC EXERCISE: Exercises such as walking, cycling, dancing, etc. Aerobics have shown to reduce the stress levels,increase your stamina levels and prevent you from gaining weight.

STRENGTH TRAINING EXERCISES: Low to moderate intensity strengthening exercise helps to build muscle mass which typically is lost due to ageing. Also the bone density increases thus preventing you from getting injuries or osteoporosis. It helps you to increase metabolism and thus preventing from gaining weight.

FLEXIBILITY: It is very important to maintain flexibility of joints and muscles as it prevents from injuries.

Following exercise program can be implemented :
Warm up: active range of motion and mild stretches to major muscle groups
Exercise period: 30-45 min of aerobic exercise
Cool down: slow down the exercise and do stretches.

Make sure all the stretched are held for 15-20 seconds and repeated twice each side.While doing exercise do monitor your heart rate. Perform all exercise atleast 4-5 days a week and alternate 3 days complement aerobic exercise with strengthening of all major, muscles and small muscles group in form of circuit training.

Start aerobic exercises with 50-60% intensity and strengthening can be done by using weights, 40-50% of the weight they can lift maximally for 1 repetition.

STRESS REDUCTION
Aerobics do help to reduce stress.
Tai Chi has also shown positive results for reducing the emotional imbalance caused due to changes in hormones. Meditative exercises and relaxation can done.

Rhythmic Breathing: Rhythmic breathing involves a fixed rhythmic pattern where of inhalation,retention, exhalation,retention is of 2:1:2:1. Don’t hold breathing if you are suffering from blood pressure or any heart disease. 
  • Inhalation 1-2-3-4
  • Pause after inhalation 5-6
  • Exhalation 1-2-3-4
  • Pause after exhalation 5-6
BALANCE EXERCISES
When we reach our 40s,it is not always easy upright. This is because after the age of 25, our balance begins to decrease falls in the later years often result to wrist and hip fractures,which can have devastating effects on lifestyle or even threat to life

Exercise A
Stand directly behind a table or chair and place your feet slightly apart. Lift one leg six inches outside.
Hold the position for 10 seconds.Repeat with the opposite leg.

Exercise B
Stand directly behind a table or chair and place your feet slightly apart. Slowly bend towards your chest lifting your foot six inches off the floor.
Hold the position for 10 seconds and repeat with The opposite leg.

Exercise C
Stand directly behind a table or chair and place your feet slightly apart. Lift one leg back keeping your knee straight.
Hold the position for 10 seconds. Repeat with the opposite leg
The above exercises should be performed 2-3 times a day.

Balance exercise safety guidelines:
Be aware of your posture.Try to maintain your weight over your ankle.
Avoid fast movements including quick turns or changes in position.
Use a chair as a place to not only perform seated exercises but also to hold on to while standing.
always get up slowly when rising from the chair.
Donot close your eyes when exercising or standing from your chair.

T-TAPP exercise
A series of unique movements that are designed to improve spinal alignment, flexibility, strength as well as to build muscle, to improve lymphatic function, raise metabolism and control glucose levels.

YOGA
It helps to maintain flexibility and promote relaxation.



 

                       YOGA POSES
 FOR PERIMENOPAUSAL SYMPTOMS

OTHER MEASURES
  1. Have a regular annual check-up
  2. Breast examination,mammogram
  3. Pap smear
  4. Blood tests
  5. Bone density
  6. Heart risk assessment

Whatever you do,make the commitment now to become more active.Taking control of your health is one way to make menopause a more pleasant experience.

DISCLAIMER :Refer your gynecologist before starting any of the above exercises.

Exercising During Menses


Exercising during periods (menses) might not be a great idea for most of us. One would rather stay in bed and take rest as long as this agonizing discomfort is relieved. While many fear and beliefs regarding menses have changed over years, exercise is a better option to cope up  with those days of the month. Exercising 30 minutes will help you to relieve the symptoms associated with menses or even the Premenstrual syndrome. Physical activity also let loose “feel good hormones”  which combat bad moods and stress.
                               
Push yourself to Exercise
When you are ill and irritable during menses, it can be difficult to start of an exercise. But just a little motivation to start the work out and continue it for 10 minutes and  you may be surprised to see that you still have that energy to continue. Get moving! and it can lessen your pain and discomfort. Exercise can also give you healthy boost of energy.
I would advice that, all women of any age should continue exercising even during menses. You know your body well and you will soon find out how your body responds to exercise, so you can adjust your level of exercise and activity accordingly.
You need to listen to your body if you think you need to take it easy then do so. Dont let periods be an excuse to get out of exercise but yes same time dont push yourself too hard.


Exercises which can be done during Menses
AEROBIC EXERCISE
It helps you to enhance your mood and enthusiasm and energy levels. Perform exercise with moderate intensity. It will help you to alleviate your cramps and reduce bloating. It also helps to increase blood circulation.
YOGA
Focuses on breathing and relaxation technique to alleviate stress and tensions. It provides time for you to focus on your emotions. Stretches for abdomen can help to soothe painful uterine muscles.
LIFTING WEIGHTS
If you dont feel like doing aerobics lift weights will help you to built up stronger muscles and bones and increase your metabolism which will burn fat.
HOME EXERCISES
1) PELVIC STRETCH
When muscles are contracting it causes pain, best way is to stretch it. One of the great exercise to stretch your abdomen and same time to strengthen your back is Bridging.
Lie flat on the floor with both hands resting by your sides. Your feet firmly flat on floor shoulder width apart. Slowly contract your abdominal, lower back and gluts and lift your midsection. Focus on slow upward and downward movement. Ideally 1 rep every 5-10 sec.

Bridging

2)STABILITY EXERCISE
Try keeping your body well aligned so your muscles are relaxed.
Pelvic rocking exercise is cat pose in yoga.
a) On all four position let pelvis fall down naturally as far as possible and then raw in the pelvis back in by curving spine.
Don’t let abdominal muscles drop as you are in this position.
b) Sit on a chair and lean forward and back and side to side while keeping body straight.


OTHER  METHODS

  • Hydrate:  Drink plenty of water throughout the day. It will help you to remove toxins from your body.
  • Avoid tea,coffee:  It may cause  hampering of the iron absorption and utilization leading to anemia .
  • Warm bath or  a Heat pad  on abdomen will help you to relax your abdominal muscle and increase the blood supply.
  • Decrease salt intake: As water retention will be more if you consume more salts and hence bloating happens.
  • Acupressure: Applying 15-30 seconds of direct deep pressure on acupressure points using thumb or fingertips till you get a numbness and repeating it on opposite side again. It helps to relieve menstrual cramps ,regulate menstrual cycle and also relieves bloating.                                                                                                                             Spleen 6: located inner side of ankle about 4 finger breadths above ankle bone. Stomach 36located 3 inches below knee and one finger breadth away from outer aspect of shin bone
SPLEEN 6
STOMACH 36



Getting menses is the most beautiful transition of a girl to women-hood. Its just like our any other physiological process. If its properly understood and taken care of it will soon just be a part of your life.

Cheers !!!