anything that has no consequences in the next 24 or 48 hours .”
Physical activity is also crucial in managing fibromyalgia , with both aerobic and anaerobic workouts being beneficial . “ Physical exercise is the cornerstone of treatment , and it ’ s good to start slow and increase the amount of it slowly rather than being too ambitious at the start ,” advised Dr Kosek , adding that people with severe symptoms should initially work out with a physiotherapist to avoid excessive pain that could lead them to stop exercising .
Patients who are overly passive out of fear of triggering pain can try cognitive behavioural therapy to learn how to go about their business without the risk of severe flare-ups .
A minority of patients can also get some improvement from drugs such as anticonvulsants and antidepressants , which have a pain-relieving effect unrelated to their impact on psychological problems .
“ About 30 percent of patients get very good help from one or two of these drugs for a couple of years ,” she said . “ But for the majority of patients there ’ s not much difference , while for some the side effects are very pronounced , and they basically feel worse with the medications than without them .”
Good sleep habits and keeping stress at bay can also reduce pain .
A powerful way to lower stress involves patients learning and understanding that pain is not a symptom but a disease , underscored Dr Kosek , so that they can make sense of their discomfort while also being able to explain to others what ’ s going on with them .
“ Sometimes patients are stressed because they feel that nobody understands them , and they start to doubt themselves ,” she said .
Promising research The huge amount of funds and attention being paid to the long-term illnesses caused by COVID-19 have also boosted research on ME / CFS , which makes this a golden opportunity for making much-needed advancements in the understanding of the disease .
Most scientists and clinicians studying ME / CFS in the US are trying to maintain a dialogue with long COVID researchers to ensure patients with ME / CFS are included in clinical trials that can hopefully give some clues on how the disease develops , especially in its early stages , and how it can be prevented and treated , stressed Dr Bateman .
Two main theories around long COVID hold that the condition is caused either by bits of virus that stay in the body or by an overactive immune system that keeps attacking tissues . “ Is there persistent infection ? Did the infection trigger an autoimmune process ? The very same questions being asked about long COVID are what we have been asking about ME / CFS for two to three decades ,” she said .
We may get closer to some answers as more patients with long COVID and ME / CFS find their way into clinical trials .
In fibromyalgia research , one promising field of investigation is the role of the immune system in causing pain .
A study published last year in the Journal of Clinical Investigation showed that antibodies , which are produced by the immune system to eliminate foreign substances in the body , from patients with fibromyalgia could cause a fibromyalgia-like state in mice by increasing the activity of pain-sensing nerves , which suggests that the condition is a dysfunction of the immune system .
“ We also found that blood from patients who were more severely affected had on average higher amounts of these antibodies compared to blood of less severely affected patients , which to me as a clinician would indicate this is probably something that is clinically relevant ,” said Dr Kosek , one of the study authors .
The hope is that this information can help develop both better diagnostic tests that measure antibody levels and pharmacological treatments that can lower their amounts in the blood . Doing so could bring some relief to the subset of fibromyalgia sufferers who have high levels of these autoreactive antibodies .
“ I ’ m optimistic this approach will eventually help some patients with fibromyalgia but not all of them .” n
GlobalHealthAsiaPacific . com MAY 2022
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