Symptoms & Treatment Principles
By Bruce Campbell
(Note: From the series Treating CFS and Fibromylgia.)
Even though there is, so far, no cure for either CFS or fibromyalgia, there are many ways to alleviate the symptoms of the two conditions. While treatments don't heal either CFS or FM, they can reduce the effects of symptoms and help those destined for recovery to move forward.
Other articles give you the major treatment options for the four most prominent symptoms of CFS and fibromyalgia: fatigue, pain, poor sleep and cognitive problems. This article offers a list of CFS/FM symptoms and outlines an overall approach to symptom management.
People with CFS or FM usually experience several or even many symptoms. Other common symptoms in CFS and fibromyalgia beyond fatigue, pain, poor sleep and cognitive problems include:
- Abdominal pain (bloating, diarrhea/constipation)
- Alcohol intolerance
- Allergies & rashes
- Chills or night sweats
- Jaw pain
- Loss of libido
- Lymph node tenderness
- Numbness or tingling in hands, arms, legs, feet or face
- Ringing in the ears
- Sensitivity to light, sound, smell or weather
- Sore throat
- Weight gain or loss
It also bears repeating that people with CFS and FM often have additional medical problems, so some of your symptoms may be due to other conditions, such as those mentioned in the article Overlapping and Related Conditions.
The approach to treatment we recommend is based on five principles.
1) Focus on Improving Quality of Life
Because so far there is no cure for either CFS or fibromyalgia, the goal of treatment is not healing but rather controlling symptoms and improving quality of life. Medical treatments usually focus on addressing the most bothersome symptoms, such as poor sleep and pain. Self-help strategies like pacing, exercise and stress reduction can also help you feel better and more in control. While treatments don't heal either CFS or FM, they can reduce pain and discomfort, bring greater stability and lessen suffering.
CFS and FM affect many parts of your life, so managing them involves much more than just treating symptoms. The two conditions affect a people's ability to work, their relationships, their moods, and their hopes and dreams for the future. Managing them includes addressing stress and emotions, getting support and recasting relationships, and coming to terms with loss.
2) Use Multiple Strategies
Because people with CFS and fibromyalgia have more than one symptom and because each symptom may have more than one cause, your treatment plan is likely to embrace many approaches. These often include both medications and self-management strategies. For example, treating pain often involves both the use of medications and lifestyle strategies such as exercise; pacing; relaxation; the use of heat, cold and massage; setting limits and saying "no"; treating depression; and improving sleep. Cognitive problems ("brain fog") are typically addressed with a variety of techniques, such as the use of lists, pacing, doing one thing as a time, keeping an orderly house, doing mental tasks when sharpest, managing stress, and reassuring self-talk.
The symptoms of CFS/FM have several causes in common: overexertion, deconditioning, stress and emotions. Treating these causes with approaches such as pacing, exercise, relaxation and managing emotions has a multiplied effect, since each strategy affects multiple symptoms.
Finding the most helpful combination of treatments often requires experimentation. There is no standard medical treatment for either illness, that is, no medication that is predictable effective. For this reason, symptom control is usually achieved by trial and error. If you want to use medications to treat CFS or FM, a sensible approach is to find a sympathetic physician willing to work with you to find the drugs that help in your individual situation.
Experimentation is also useful to find lifestyle adjustments that are effective. For example, you may have to try different exercise programs to find one that helps you without intensifying your symptoms. We call this process of trying different approaches to find what works being your own CFS/FM scientist. Through practice, you develop skills such as self-observation, researching treatment options, achieving short-term goals and problem solving.
4) Adjust Your Lifestyle
The things you do and the way you live have a big effect on your symptoms, reducing them if you honor your body's needs or intensifying them if you don't. Your success in reducing symptoms and regaining control of your life will probably depend more upon your efforts and willingness to adapt to CFS/FM than on anything a doctor does for you. In the words of CFS/FM physician Dr. Charles Lapp, "There is no drug, no potion, no supplement, herb or diet that even competes with lifestyle change for the treatment of CFS or FM."
Lifestyle change strategies for controlling symptoms include exercise; relaxation and other stress reduction techniques; the use of pacing techniques like reducing overall activity level, having short activity periods, taking regular rests, and keeping records; addressing depression, loss and other emotions triggered by illness; support from family, friends and other patients; changes in diet; avoiding people and situations that trigger symptoms; and incorporating pleasurable activities into one's life.
5) Treat Other Medical Problems
Many people with CFS and/or fibromyalgia experience additional medical problems, so consider the possibility that some of the symptoms you experience may be due to medical conditions other than CFS or FM. Having multiple medical conditions complicates life and increases suffering, but by treating other conditions, you are likely to moderate your CFS and fibromyalgia symptoms.
Other illnesses often found in people with CFS include the following (listed alphabetically): allergies, candida (yeast infection), celiac disease, chemical sensitivity, depression, irritable bowel syndrome (IBS), neurally mediated hypotension (NMH), and sleep disorders such as apnea and restless legs syndrome. Conditions occurring together with FM include depression, gastroesophageal reflux disease (GERD), irritable bladder syndrome (interstitial cystitis), IBS, Lyme disease, migraine headaches, myofascial pain syndrome, and sleep disorders such as apnea and restless legs syndrome.
Besides the conditions just described, people with Chronic Fatigue Syndrome and fibromyalgia also experience other medical problems, particularly those associated with growing older. Among people who take our self-help course, the following conditions are common in addition to those already mentioned: arthritis, asthma, back and spinal problems, diabetes, high blood pressure, and thyroid problems.