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Chronic Pain

Chronic Pain

Often defined as any pain lasting more than 12 weeks



A complex condition with a wide variety of symptoms

Cancer Pain

Cancer Pain

Caused by the cancer itself or by the cancer treatment



Has many symptoms that tend to vary from person to person



Many different types with a wide range of symptoms.

Did you know?

Did you know?1

8% of Irish adults suffer from Chronic Pain as a result of a specific condition
85% of Irish Chronic Pain sufferers go to their Pharmacist for advice
20% of Chronic Pain sufferers say the condition has a very significant effect on their overall quality of life
59% of people suffering with Chronic Pain have stopped hobbies / activities due to their Chronic Pain
23% of Chronic Pain sufferers have quit a job due to their Chronic Pain
56% of Irish Adults socialise a lot less as a result of their Chronic Pain
20% of Irish Adults have retired from work due to their Chronic Pain
36% of Chronic Pain sufferers worry that they do not fully understand Chronic Pain
63% of Irish Adults suffering with Chronic Pain worry that their Chronic Pain will impact their ability to lead an independent lifestyle
57% of Chronic Pain sufferers have a goal of reducing their pain

99% of Irish chronic pain sufferers consult their GP / Doctor for advice

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Chronic Pain & Your Workplace

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Chronic Pain

Just about everyone feels pain from time to time. When you cut your finger or pull a muscle, pain is your body's way of telling you something is wrong. Once the injury heals, you stop hurting.

Chronic pain is different. Your body keeps hurting weeks, months, or even years after the injury. Doctors often define chronic pain as any pain that lasts for 3 to 6 months or more.

What is Chronic Pain?1

Just about everyone feels pain from time to time. When you cut your finger or pull a muscle, pain is your body's way of telling you something is wrong. Once the injury heals, you stop hurting.

Chronic pain is different. Your body keeps hurting weeks, months, or even years after the injury. Doctors often define chronic pain as any pain that lasts for 3 to 6 months or more.

What Makes You Feel Chronic Pain?1

The feeling of pain comes from a series of messages that zip through your nervous system. When you hurt yourself, the injury turns on pain sensors in that area. They send a message in the form of an electrical signal, which travels from nerve to nerve until it reaches your brain. Your brain processes the signal and sends out the message that you hurt.

Usually the signal stops when the cause of the pain is resolved -- your body repairs the wound on your finger or your torn muscle. But with chronic pain, the nerve signals keep firing even after you've healed.

Types of Pain2

Pain can be classified by the type of pain or by body region. Classification by pain types includes:

  • Neuropathic pain: burning, stabbing, tingling, insect crawling, shooting, associated with allodynia, hypersensitivity or other sensory changes.
  • Nociceptive pain: aching, boring, worse on movement, anatomically defined, fluctuates in severity.
  • Mixed i.e. a combination of both neuropathic & nociceptive pain symptoms.
  • Visceral pain: dull, diffuse, ill-defined.
  • Autonomic symptoms: colour and temperature changes, sweating, trophic changes.

Although chronic pain is often neuropathic, it can also arise from other types of pain and it is possible to classify chronic pain by the underlying condition or body region which is causing the pain.

Neuropathic Pain2,3

Neuropathic pain is pain caused by damage to or malfunctioning of the somatosensory system. This is the system made up of sensory receptors and neurons (nerve cells) in the central nervous system and the peripheral nervous system (outside of the central nervous system).

Typical effects are felt as a burning, stabbing, stinging, numbing or tingling type of pain. This type of pain can often be spontaneous, and can be felt as sudden shocks. Neuropathic pain can also be felt as a hypersensitivity to touch or cold.

Neuropathic pain has several causes:

  • Nerve compression: for example carpal tunnel syndrome
  • Nerve damage: for example peripheral neuropathy resulting from diabetes mellitus or Guillain-Barré syndrome
  • Abnormal or disrupted processing of pain signals by the brain and spinal cord: for example in ‘phantom’ pain following an amputation, post-herpetic neuralgia following shingles (herpes zoster) infection, and complex regional pain syndrome

Nociceptive Pain2

Nociceptive pain is the type of pain which results from injury or damage to body tissues e.g. a accident or trama, injury or burn, post-operative or due to a break or fracture. Nociceptive pain is usually well localised (dependent on area of tissue damage) and is typically described as a sharp or stabbing type of pain, or as an ache.

The most common type of nociceptive pain is lower back pain although it can also be a result from oncology therapies i.e. post-surgery / post radiation treatments, malignant tumours, degenerative musculoskeletal diseases e.g. osteoarthritis and osteoporosis.

Nociceptive pain can last long after the injury or damage which caused the pain. Psychological factors often play a part should nociceptive pain not resolve as quickly as expected (NHS Quality Improvement in Scotland, 2006).

Psychogenic Pain2

Psychogenic pain is physical pain that arises from psychological factors, and by itself, occurs far less commonly than nociceptive or neuropathic pain. Although any pain type can be complicated by psychological factors such as mental, emotional or behavioral factors, it is controversial that chronic physical pain arises from purely psychological factors alone.

Psychological factors and symptoms of psychogenic pain often complicate pain related disabilities – although the pain has a physical cause, the psychological factors exacerbate or enhance the pain to be more severe than found in most individuals with a similar physical cause of pain.

The cycle where psychological factors exaggerate physical pain in this way is sometimes described as chronic pain syndrome. An individual with chronic pain anticipates its reoccurrence, becoming more anxious about the pain which in turn makes them less able to deal with the pain. The pain is then perceived to be more severe, which then precipitates more anxiety - becoming almost a self-fulfilling prophecy.

Which Conditions Cause Chronic Pain?1

Sometimes chronic pain can begin without any obvious cause. But for many people, it starts after an injury or because of a health condition. Some of the leading causes include:

  • Past injuries or surgeries
  • Back problems
  • Migraines and other headaches
  • Arthritis
  • Nerve damage
  • Infections
  • Fibromyalgia, a condition in which people feel muscle pain throughout their bodies

What are the Symptoms of Chronic Pain?4

Chronic pain may arise from an initial injury, such as a back sprain, or there may be an ongoing cause, such as illness. However, there may also be no clear cause. Other health problems, such as fatigue, sleep disturbance, decreased appetite, and mood changes, often accompany chronic pain. Chronic pain may limit a person’s movements, which can reduce flexibility, strength, and stamina. This difficulty in carrying out important and enjoyable activities can lead to disability and despair.

Tips for living with Chronic Pain5

Below are a number of tips for living with Chronic Pain


1. Learn deep breathing or meditation to help you relax.

Deep breathing and meditation are techniques that help your body relax, which may ease pain. Tension and tightness seep from muscles as they receive a quiet message to relax.

Although there are many ways to meditate, the soothing power of repetition is at the heart of some forms of meditation. Focusing on the breath, ignoring thoughts, and repeating a word or phrase -- a mantra -- causes the body to relax. While you can learn meditation on your own, it helps to take a class.

Deep breathing is also a relaxation technique. Find a quiet location, a comfortable body position, and block out distracting thoughts. Then, imagine a spot just below your navel. Breathe into that spot, filling your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon.

2. Reduce stress in your life. Stress intensifies chronic pain.

Negative feelings like depression, anxiety, stress, and anger can increase the body's sensitivity to pain. By learning to take control of stress, you may find some relief from chronic pain.

Several techniques can help reduce stress and promote relaxation. Listening to soothing, calming music can lift your mood -- and make living with chronic pain more bearable. There are even specially designed relaxation tapes or CDs for this. Mental imagery relaxation (also called guided imagery) is a form of mental escape that can help you feel peaceful. It involves creating calming, peaceful images in your mind. Progressive muscle relaxation is another technique that promotes relaxation

3. Boost chronic pain relief with the natural endorphins from exercise.

Endorphins are brain chemicals that help improve your mood while also blocking pain signals. Exercise has another pain-reducing effect -- it strengthens muscles, helping prevent re-injury and further pain. Plus, exercise can help keep your weight down, reduce heart disease risk, and control blood sugar levels -- especially important if you have diabetes. Ask your doctor for an exercise routine that is right for you.

4. Cut back on alcohol, which can worsen sleep problems.

Pain makes sleep difficult, and alcohol can make sleep problems worse. If you're living with chronic pain, drinking less or no alcohol can improve your quality of life.

5. Join a support group. Meet others living with chronic pain.

When you're with people who have chronic pain and understand what you're going through, you feel less alone. You also benefit from their wisdom in coping with the pain. Also, consider meeting with a mental health professional. Anyone can develop depression if he or she is living with chronic pain. Getting counseling can help you learn to cope better and help you avoid negative thoughts that make pain worse -- so you have a healthier attitude. Asking for help is a sign of strength, not weakness.

6. Don't smoke. It can worsen chronic pain.

Smoking can worsen painful circulation problems and increase risk of heart disease and cancer.

7. Track your pain level and activities every day.

To effectively treat your pain, your doctor needs to know how you've been feeling between visits. Keeping a log or journal of your daily "pain score" will help you track your pain. At the end of each day, note your pain level on the 1 to 10 pain scale. Also, note what activities you did that day. Take this log book to every doctor visit -- to give your doctor a good understanding of how you're living with chronic pain and your physical functioning level.

8. Eat a healthy diet if you're living with chronic pain.

A well-balanced diet is important in many ways -- aiding your digestive process, reducing heart disease risk, keeping weight under control, and improving blood sugar levels. To eat a low-fat, low-sodium diet, choose from these: fresh fruits and vegetables; cooked dried beans and peas; whole-grain breads and cereals; low-fat cheese, milk, and yogurt; and lean meats

9. Find ways to distract yourself from pain so you enjoy life more.

When you focus on pain, it makes it worse rather than better. Instead, find something you like doing -- an activity that keeps you busy and thinking about things besides your pain. You might not be able to avoid pain, but you can take control of your life.


1. Date Accessed. 09/08/2017
2. Date Accessed. 09/08/2017
3. Date Accessed 11/09/2017
4. Date Accessed. 09/08/2017
5. Date accessed 14/08/2017


Date of Preparation: September 2017


Migraine is a complex condition with a wide variety of symptoms. For many people the main feature is a painful headache. Other symptoms include disturbed vision, sensitivity to light, sound and smells, feeling sick and vomiting.

What is migraine?1

Migraine is a complex condition with a wide variety of symptoms. For many people the main feature is a painful headache. Other symptoms include disturbed vision, sensitivity to light, sound and smells, feeling sick and vomiting. Migraine attacks can be very frightening and may result in you having to lie still for several hours.

What are the symptoms?1

The symptoms will vary from person to person and individuals may have different symptoms during different attacks. Your attacks may differ in length and frequency. Migraine attacks usually last from 4 to 72 hours and most people are free from symptoms between attacks. Migraine can have an enormous impact on your work, family and social lives.

Are there different types of migraine?1

Yes. The International Classification of Headache Disorders system gives different names to the different types of migraine and headache that involve different symptoms. This helps doctors to diagnose and treat them.

The most common types of migraine fall into two categories:

  • migraine with aura
  • migraine without aura

Types of Migraine

Migraine Without Aura2

The majority of migraine sufferers have Migraine without Aura.

The most common symptoms of Migraine without Aura are:

  • Intense throbbing headache, usually on one side of the head, worsened by movement and lasting from 4-72 hours.
  • Nausea, sometimes vomiting
  • Sensitivity to light
  • Sensitivity to noise
  • Sensitivity to smells
  • Stiffness of the neck and shoulders.
  • Blurred vision

If you experience two or more of these symptoms, and if they prevent you from continuing with normal daily activities, then you may be suffering from migraine without aura.

Migraine With Aura3

Migraine with Aura refers to a range of neurological disturbances that occur before the headache begins, usually lasting about 20-60 minutes.

About 20% of people with migraine experience ‘aura’ in addition to some or all of the symptoms of ‘Migraine Without Aura’.

The disturbances are usually visual e.g.

  • Blind spots
  • Flashing lights
  • Zig-zag patterns

Aura can also present in other ways:

  • Pins and needles on one side usually starting in the fingers/ arm, sometimes spreading up into the face
  • Slurring of speech
  • Muscular weakness
  • Loss of co-ordination
  • Confusion

The other symptoms of migraine will usually follow the migraine aura. These are:

  • Intense throbbing headache, usually on one side of the head, worsened by movement and lasting from 4-72 hours
  • Nausea, sometimes vomiting
  • Sensitivity to light
  • Sensitivity to noise
  • Sensitivity to smells
  • Stiffness of the neck and shoulders
  • Blurred vision

If you experience two or more of these symptoms in addition to the aura symptoms and if they prevent you from continuing with normal daily activities, then you may be suffering from migraine with aura.

Tips for Living with Migraine4

Migraine is so much more than just a headache and is a complex neurological condition. If you suffer from migraine you should firstly educate yourself about your condition. Information is power and a good self-management programme is often the key to reducing the frequency and intensity of your migraine attacks.

  1. Learn about your condition. The website of the Migraine Association provides independent advice and information on your condition.
  2. Keep a migraine diary to try to identify your triggers or patterns of attacks. The Migraine Association can provide you with a migraine diary or there are many online migraine diary apps which people find useful such as Curelator or Migraine Buddy.
  3. Learn to recognise your symptoms so you will know when an attack is about to happen so you can take your medication at the correct time and put your prevention plan in place before the attack is too severe.
  4. Do not go for long periods of time without eating. In the past there was an emphasis on the types of food people were eating as potential triggers such as chocolate, cheese or red wine. While some people still feel certain foods will trigger an attack, the consensus now is that the gap between meals is a more important potential trigger. Keep some nutritious snacks such as sunflower seeds or cereal bars to hand throughout the day.
  5. Keep rehydrated. Dehydration is a trigger for migraines. Sometimes at busy or stressful times we forget to drink water but it is an essential daily ritual for the migraine sufferer.
  6. Eat a healthy balanced diet and reduce the amount of processed foods you consume. Nitrates, chemicals, additives and elements such as MSG can trigger migraine attacks. A healthy diet will also provide you with key nutrients such as magnesium and B Vitamins which are essential for brain health and overall wellbeing.
  7. Stress is a proven trigger for migraines. Stress Reduction techniques such as a regular mindfulness practise, mediation or yoga can form part of a successful migraine management plan.
  8. Keep regular sleep patterns. It is not the amount of sleep you receive but the regularity of your sleep pattern that is a potential trigger for migraine. Changes in sleep patterns at weekends and holidays can trigger attacks so try to keep a regular sleep pattern even when your daily work/life pattern changes.
  9. Assess your workplace as a potential triggering environment. Fluorescent lights and flickering computer screens can trigger migraine attacks. Some people find certain smells and air-conditioning can also cause attacks. Ensure you have healthy snacks and water to hand throughout the day at work. Talk to your employer or the occupational health nurse to see what modifications and adaptations can be made to make your workplace more migraine friendly. Get regular exercise. Oxygen is hugely beneficial to your brain health. Regular exercise can help prevent the frequency and intensity of your migraine attacks. Some people favour the gym but many migraine sufferers find that outdoors exercise is more beneficial to their condition. If you feel an attack is imminent a moderate outdoor walk can often stave off the attack or reduce the length and intensity of the attack


Migraines are often undiagnosed and untreated. If you regularly experience signs and symptoms of migraine attacks, keep a record of your attacks and how you treated them. Then make an appointment with your doctor to discuss your headaches5


1. Date Accessed 12th October 2017
2. Date Accessed 12th October 2017
3. Date Accessed 12th October 2017
4. The Migraine Association of Ireland.
5. Date Accessed. 6th November 2017



Date of Preparation: October 2017

Cancer Pain

Having cancer does not always mean having pain. But if you do have pain, there are many different kinds of medicines, different ways to take the medicines and non-drug methods that can help relieve it.

Facts About Cancer Pain1

Having cancer does not always mean having pain. But if you do have pain, there are many different kinds of medicines, different ways to take the medicines and non-drug methods that can help relieve it.

Pain can affect all parts of your life. If you have pain, you might not be able to take part in your normal day-to-day activities. You may have trouble sleeping and eating. You may be irritable with the people you love. It’s easy to get frustrated, sad, and even angry when you’re in pain. Family and friends don’t always understand how you’re feeling, and you may feel very alone.

You should never accept pain as a normal part of having cancer. All pain can be treated, and most pain can be controlled or relieved. When pain is controlled, people can sleep and eat better, enjoy being with family and friends, and continue with their work and hobbies.

What is pain?2

Pain is not just a sensation that hurts. It is an unpleasant sensory and emotional experience associated with actual or possible tissue damage.

People experience pain in different ways and even people with the same type of cancer can have different experiences. The way pain is felt is influenced by emotional, environmental and physical factors These factors act directly or indirectly on the body’s nervous system (the brain, spinal cord and nerves). The type of cancer, its stage, the treatment you receive, other health issues, your attitudes and beliefs about pain, and the significance of the pain to you will also affect the pain experience. Health professionals assess all these factors to help treat the pain.

If left untreated, pain can lead to anxiety or depression, loss of function and changes to your day-to-day activities. Learning to control pain may allow you to return to many of the activities you enjoy and improve your quality of life.

Different types of pain3

Here are the common terms used to describe different types of pain:

  • Acute pain ranges from mild to severe. It comes on quickly and lasts a short time.
  • Chronic pain ranges from mild to severe. It either won’t go away or comes back often.
  • Breakthrough pain is an intense rise in pain that occurs suddenly or is felt for a short time. It can occur by itself or in relation to a certain activity. It may happen several times a day, even when you’re taking the right dose of medicine. For example, it may happen as the current dose of your medicine is wearing off.

Cancer Related Pain4

Pain caused by the actual cancer generally falls into two categories.

  • Nociceptive pain is caused by damage to tissue. It is usually described as sharp, aching, or throbbing pain. It is often due to cancer that is growing larger, cancer that has spread to the bones, muscles or joints, or a blockage of an organ or blood vessels.
  • Neuropathic pain happens when there is actual nerve damage. It may be caused by a tumor pressing on a nerve or a group of nerves. People sometimes describe this pain as a burning or heavy sensation, or numbness.

What causes cancer pain?2

People with cancer may have pain for a variety of reasons. It may be caused by the cancer itself or by the cancer treatment, or it may have another cause. Some reasons for pain include:

  • a tumour pressing on organs, nerves or bone
  • a fracture if the cancer has spread to the bones
  • side effects from chemotherapy, radiotherapy or surgery
  • poor circulation due to blocked blood vessels
  • blockage of an organ or tube in the body, such as the bowel
  • infection or swelling and redness (inflammation)
  • muscle stiffness from tension or inactivity
  • poor posture, which can lead to back pain, for example.

New pain or an increase in pain doesn’t necessarily mean that the cancer has advanced or spread to another part of the body (metastasised). This is a common concern for people with changing pain levels.

How much pain you might have5

The amount of pain you have with cancer depends on:

  • the type of cancer you have
  • where it is
  • the stage of your cancer
  • whether the cancer or treatment has damaged any nerves

Other factors can also affect how you feel pain - such as fear, anxiety, depression and a lack of sleep.

It’s very important to let your medical team know straight away if you have pain. Don’t try to put up with it – this can cause nerve changes that could make the pain harder to control in the future

How is cancer pain different from chronic pain?6

Cancer pain is different from other types of pain for several reasons, and there are special considerations that pain management specialists need to be aware of with cancer patients. Pain associated with cancer can actually arise from many different causes. A tumour can be painful and as it spreads, it can injure other tissues, causing increased pain. Bone pain in particular can be especially severe. Cancer can also affect nerves, resulting in the shooting, burning, or aching characteristics of neuropathic pain. There can be pain associated with some cancer treatments such as chemotherapy, radiation, or surgery. Complications from cancer such as infection, bone fractures or even bruises from multiple intravenous lines can cause additional pain. In addition, weakness and fatigue (which may occur with chemotherapy) may make any type of pain worse, and this can be especially true for cancer patients.

What can you do to help?7

Early treatment for pain is always more effective. As an active participant in your health care, you can take the following steps:

  • Inform your doctor or nurse that you are experiencing pain. Don't wait to be asked! Pain should be evaluated at every visit.
  • Keep a diary of your pain – where it is, when it begins, when it peaks, when you take medications, and what helps relieve the pain.
  • Be precise when describing your pain. Use words like sharp, radiating, aching, pounding, prickly, tight, deep, stabbing, dull, pinching, and tingly.
  • Report the severity of your pain. On a scale from 0 to10, where 0 is no pain and 10 is the worst pain you can imagine, how would you rate it?
  • Take your medication exactly as prescribed. You may be taking several medications. Be sure you understand when and how to take them, and report any side effects – they can be helped.
  • Know how to reach your doctor or nurse after hours, and when you should contact them. For example, severe pain should be reported right away, not at your next appointment.
  • Take medication before pain builds up. Pain control is harder to achieve if it is allowed to build to a severe level.
  • Use the same pharmacy. They will know what pain medicines to keep on hand and can answer questions about the medicines and side effects.
  • Consider non-drug interventions that might help you, including distracting yourself, relaxation techniques, use of heat and cold, massage, and light exercise. Consult members of your health care team (nurse, social worker, and physical therapist) for help in these areas.


1. Date Accessed: 5th July 2017
2. Date Accessed 5th September 2017
3. Date Accessed 5th September 2017
4. Date Accessed 5th September 2017
5. Date Accessed 5th September 2017
6. Date Accessed 5th September 2017
7. Date Accessed 5th September 2017


Date of Preparation: September 2017


Fibromyalgia is a condition characterised by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues.

What is Fibromyalgia?1

Fibromyalgia is a condition characterised by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals.

Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress. In other cases, symptoms gradually accumulate over time with no single triggering event. More women than men are diagnosed with the condition with a ratio of 6:1. Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression.

What causes Fibromyalgia?2

Doctors don't know what causes fibromyalgia, but it most likely involves a variety of factors working together. These may include:

  • Genetics. Because fibromyalgia may run in families, there may be certain genetic mutations that may make you more susceptible to developing the condition.
  • Infections. Some illnesses appear to trigger or aggravate fibromyalgia.
  • Physical or emotional trauma. Fibromyalgia can sometimes be triggered by a physical trauma, such as a car accident or a psychological stress such as bereavement.

What are the symptoms of Fibromyalgia?3,4

Because the classic symptoms of fibromyalgia -- widespread muscle and joint pain and fatigue -- aren't very distinctive, the condition is often misdiagnosed and misunderstood. You may not have all of the symptoms, and you may have other medical issues, too.

Most common symptoms of fibromyalgia

  • Chronic, widespread pain all over the body
  • Tenderness, soreness and flu-like aches
  • Extreme tiredness (Fatigue) difficulties with sleeping, restless sleep
  • Headaches, migraine, rhinitis
  • Morning stiffness
  • Impaired memory and concentration
  • Difficulty performing daily functions

The effects of these symptoms vary from person to person and from day to day. Many people have flare-ups from time to time when their symptoms become suddenly worse.

People with fibromyalgia often say that fatigue is the worst part of the condition and that they can't seem to think clearly or remember things properly (this is sometimes called 'fibrofog' or 'brainfog').

The pain may feel as though it affects your whole body, and may be particularly bad in some areas. Some people find that their pain feels worse in very hot, cold or damp weather.

Fibromyalgia often co-exists with other painful conditions, such as:2

  • Irritable bowel syndrome
  • Migraine and other types of headaches
  • Interstitial cystitis or painful bladder syndrome
  • Temporomandibular joint disorders

Less common symptoms of fibromyalgia

Less frequent symptoms of fibromyalgia include:

  • poor circulation – tingling, numbness or swelling in the hands and feet
  • headaches
  • irritability or feeling miserable
  • feeling an urgent need to urinate, especially at night
  • irritable or uncomfortable bowels (diarrhoea or constipation and abdominal pain) sometimes separately diagnosed as irritable bowel syndrome (IBS).

Risk factors2

Risk factors for fibromyalgia include:

  • Your sex. Fibromyalgia is diagnosed more often in women than in men.
  • Family history. You may be more likely to develop fibromyalgia if a relative also has the condition.
  • Emotional or physical abuse. Children who are abused are more likely to have the condition when they grow up. This may happen because abuse changes the way the brain handles pain and stress.
  • Other disorders. If you have osteoarthritis, rheumatoid arthritis or lupus, you may be more likely to develop fibromyalgia

Fibromyalgia: Self-care tips5

Fibromyalgia symptoms fluctuate over time, even from day to day. Try these self-care tips to help you cope with difficult days.

Lifestyle changes and medications can lessen the severity of fibromyalgia pain and fatigue, but you'll probably still have some bad days. Knowing that, you can plan ahead for those bad days. The following tips may help take your mind off the pain and possibly ease your discomfort.

Getting a good night’s sleep

Getting into a good sleep pattern will help reduce symptoms. Establish a regular go to bed-time and wake-up time. No TV/computer/laptops 1-2 hours before bedtime. Make sure your room isn’t too warm. Have a winding down routine and use an affirmation such as, sleep is a natural process and it’s ok for me to rest and let go.

Put on some music

Music can have a powerful effect on moods and emotions. Music also helps reduce pain and increase mobility. What music works best? Any music you like. So turn on some of your favourite tunes and let the music carry you away.

Music that's embedded with delta waves — a type of brain wave — may help improve your sleep.

Mindful movement

Exercise is known to be beneficial for people with fibromyalgia. Combining exercise with an awareness of your body, movements and the moment (mindfulness) may be even more helpful.

Research suggests that tai chi — a practice originating in China that involves moving the body slowly, gently and with awareness — may provide a benefit to people with fibromyalgia. Yoga and the Chinese healing art of qi gong, which combines meditation, controlled breathing and movement exercises, also have shown promise.

Keep your sense of humour

Even on tough days, it helps if you can keep your sense of humour. Spend time with people who have a positive outlook and a great sense of humor. Rent a funny movie. Laughter can help ease pain by releasing brain chemicals that enhance a sense of well-being.

Take a bath

Several studies have looked into balneotherapy for fibromyalgia. Balneotherapy, which means bathing to treat an illness, appears to reduce pain and stiffness. This isn't surprising, given that warm water helps reduce muscle tension, promote relaxation and lessen pain. Epsom bath salts can also help. But it's important not to spend too much time in the bath, or to frequently take long soaks. Instead look at taking an occasional short soak in your home tub or a spa as a treat.

If visits to a spa aren't possible, try creating a spa-like ambience at home and have a soak in your own bathtub. Or look for a community center or gym with a heated pool or sauna rooms.


Meditation involves focusing your mind to pay attention only to what's happening right now, this moment. If you're not sure about meditation, try paced breathing — controlled breathing designed to lower your heart rate. Or listen to a CD designed to help you relax and ease into a more mindful state.

Eat Healthily

It’s tempting to comfort eat when you’re not feeling well but try to find another way to ‘treat’ yourself. Make sure to eat as healthy as you can. Although there is no one diet for fibromyalgia, reducing in-take of processed foods, sugars and alcohol may help reduce symptoms. It could be an opportunity to get the whole family eating well and so recruit family members to help out. Using an online grocery delivery service may help save you time and energy.

Try guided imagery

With guided imagery, you focus on pleasant images to replace stressful or negative thoughts. This allows you to imagine a different internal reality. This can be guided by a practitioner, or you can do it at home using a CD, DVD or phone app.

Get a massage

Massage therapy has been widely used as a complementary and alternative treatment for fibromyalgia. Most of the studies have found that massage therapy significantly improves pain, anxiety and depression in people with fibromyalgia.

But not everyone finds massage helpful. For some people, massage may make their pain worse. If you'd like to try massage, find a therapist you like and who is familiar with fibromyalgia. The massage therapist may need to start with very gentle massage and work up to a greater intensity for your comfort. Reflexology is very gentle and has been shown to aid sleep.

Your doctor, physical therapist or other health care providers may be able to suggest reputable therapists in your area. Be sure to check with your insurance plan to see if massage therapy is covered.

Focus on something meaningful to you

Focusing on something else can help take your mind off your symptoms for a little while, and you may discover rewarding experiences. Getting creative through art or joining an adapted salsa class are just some of the ways that people have found to give themselves a boost and sense of achievement.

Explore your options

Although fibromyalgia can’t be cured, it can be managed. It's important to have a variety of strategies for dealing with your symptoms. It can be useful to get a friend or family member to be your ‘wellness partner’. This is someone who helps you plan your management strategy and motivate you. It may be useful to keep a diary to identify patterns and notice the difference between your good days and bad days. If you haven't already, talk with your doctor or other health care provider about non-drug self-care strategies.

Not all therapies will help everyone and there is no quick fix with fibromyalgia. Remember to be gentle and patient with yourself. Experiment and see what works for you.


1. Date Accessed 11/09/2017
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5. Date Accessed 11/09/2017


Date of Preparation: October 2017


Arthritis is an inflammation of the joints that causes pain and immobility, ranging from mild to severe.

There are over 100 types of arthritis but the most common forms are osteoarthritis (OA), rheumatoid arthritis (RA) (also known as rheumatoid arthritis) and fibromyalgia.

What is Arthritis?1

Arthritis is an inflammation of the joints that causes pain and immobility, ranging from mild to severe.

There are over 100 types of arthritis but the most common forms are osteoarthritis (OA), rheumatoid arthritis (RA) (also known as rheumatoid arthritis) and fibromyalgia.


As there are many types of arthritis, there's also a wide range of symptoms.

With inflammatory arthritis there’s likely to be more swelling of the joints and more variation in the pain (which can't be explained simply by the level of physical activity). Other common symptoms include:

  • early morning joint stiffness
  • tiredness
  • a general feeling of being unwell
  • weight loss
  • mild fevers or night sweats
  • skin rashes.

Symptoms may come and go. They can be mild, moderate or severe. They may stay about the same for years, but may progress or get worse over time. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs. Arthritis can cause permanent joint changes. These changes may be visible, such as knobby finger joints, but often the damage can only be seen on X-ray. Some types of arthritis also affect the heart, eyes, lungs, kidneys and skin as well as the joints.

What Causes Arthritis Pain4

Understand why you hurt, and learn the different types of pain.4

Types of Pain4

Doctors classify pain into two categories based on its duration:

Acute pain happens when you have a disease or injury. It is part of your body’s warning system. You’ll experience acute pain if you burn your hand on the cooker, pull a muscle, have knee surgery or get a kidney stone. The pain may be momentary – the cut of a knife before you pull your hand away. Or, it can last for days or weeks – like a tooth that throbs until you can get to the dentist to have it filled. Some acute pain – for example an arthritis flare or gout attack – comes and goes.

Acute pain is often described as sharp, throbbing, shooting or stinging, though it can also be mild. It usually improves once the cause has been treated. Acute pain that isn’t resolved can eventually turn into chronic pain.

Chronic pain lasts for at least three months, but it can continue for many more months, and even years. Arthritis pain, migraine headaches, nerve damage, and low back pain are examples of this type of pain. Chronic pain is often described as an aching, dull, burning or throbbing.

Pain can continue long-term because there’s no treatment for your condition, or your doctor can’t find the source. Pain can also be self-perpetuating. Over time, the constant barrage of pain signals can change nerve cells in your brain and spinal cord. So even after the injury has healed or the condition has been treated, you’ll still feel the discomfort. In a sense, chronic pain becomes its own disease. This is the case with complex regional pain syndrome, fibromyalgia and other chronic pain conditions.

The Pain Process4

Though pain is never pleasant, it’s an important signal our bodies use to warn there’s something wrong. Usually, what’s wrong is that you have an injury of some kind, but in some cases what is wrong is that your body is misfiring pain signals.

When you have an injury – in the case of arthritis, an injury to your joints – the damaged tissues release chemicals that alert nearby sensory nerves. These nerves carry the message up your spinal cord to your brain. Your brain processes the message and sends a signal to your motor nerves to take action. So if you start to cut yourself while chopping tomatoes or you touch a hot pan you’ll pull away before you cause more damage.

Besides removing the source of injury, your body has other ways of managing pain. One method is to release painkilling chemicals, called endorphins. The brain also sends signals through the nerves to block additional pain messages from being received – thereby cutting off the sensation of pain

Arthritis Pain: Do’s and Don’ts5

Whatever your condition, it will be easier to stay ahead of your pain if you:


  • Learn all you can about your condition, including what type of arthritis you have and whether any of your joints are already damaged
  • Enlist your doctor, friends and family in managing your pain
  • Tell your doctor if your pain changes

Everyday routines

Pay attention to your joints, whether sitting, standing or engaging in activity.

  • Keep your joints moving. Do daily, gentle stretches that move your joints through their full range of motion.
  • Use good posture. A physical therapist can show you how to sit, stand and move correctly.
  • Know your limits. Balance activity and rest, and don't overdo.

In addition, lifestyle changes are important for easing pain.

  • Manage weight. Being overweight can increase complications of arthritis and contribute to arthritis pain. Making incremental, permanent lifestyle changes resulting in gradual weight loss is often the most effective method of weight management.
  • Quit smoking. Smoking causes stress on connective tissues, which can increase arthritis pain


When you have arthritis, movement can decrease your pain and stiffness, improve your range of motion, strengthen your muscles, and increase your endurance.

What to do

Choose the right kinds of activities — those that build the muscles around your joints but don't damage the joints themselves. A physical or occupational therapist can help you develop an exercise program that's right for you.

Focus on stretching, range-of-motion exercises and gradual progressive strength training. Include low-impact aerobic exercise, such as walking, cycling or water exercises, to improve your mood and help control your weight.

What to avoid

Avoid activities that involve high impact and repetitive motion, such as:

  • Running
  • Jumping
  • Tennis
  • High-impact aerobics
  • Repeating the same movement, such as a tennis serve, again and again


Many types of medications are available for arthritis pain relief. Most are relatively safe, but no medication is completely free of side effects. Talk with your doctor to formulate a medication plan for your specific pain symptoms.

What to do

Over-the-counter pain medications can help relieve occasional pain triggered by activity your muscles and joints aren't used to — such as gardening after a winter indoors.

Cream may be applied to skin over a painful joint to relieve pain. Use alone or with oral medication.

Consult your doctor if over-the-counter medications don't relieve your pain.

What to avoid

  • Overtreatment. Talk with your doctor if you find yourself using over-the-counter pain relievers regularly.
  • Undertreatment. Don't try to ignore severe and prolonged arthritis pain. You might have joint inflammation or damage requiring daily medication.
  • Focusing only on pain. Depression is more common in people with arthritis. Doctors have found that treating depression with antidepressants and other therapies reduces not only depression symptoms but also arthritis pain.

Physical and emotional integration

It's no surprise that arthritis pain has a negative effect on your mood. If everyday activities make you hurt, you're bound to feel discouraged. But when these normal feelings escalate to create a constant refrain of fearful, hopeless thoughts, your pain can actually get worse and harder to manage.

What to do

Therapies that interrupt destructive mind-body interactions include:

  • Cognitive behavioral therapy. This well-studied, effective combination of talk therapy and behaviour modification helps you identify — and break — cycles of self-defeating thoughts and actions.
  • Relaxation therapy. Meditating, doing yoga, deep breathing, listening to music, being in nature, writing in a journal — do whatever helps you relax. There's no downside to relaxation, and it can help ease pain.
  • Acupuncture. Some people get pain relief through acupuncture treatments, when a trained acupuncturist inserts hair-thin needles at specific points on your body. It can take several weeks before you notice improvement.
  • Heat and cold. Use of heat, such as applying heating pads to aching joints, taking hot baths or showers, or immersing painful joints in warm paraffin wax, can help relieve pain temporarily. Be careful not to burn yourself. Use heating pads for no more than 20 minutes at a time.

Use of cold, such as applying ice packs to sore muscles, can relieve pain and inflammation after strenuous exercise.

  • Massage. Massage might improve pain and stiffness temporarily. Make sure your massage therapist knows where your arthritis affects you.

What to avoid

  • Smoking. If you're addicted to tobacco, you might use it as an emotional coping tool. But it's counterproductive: Toxins in smoke cause stress on connective tissue, leading to more joint problems.
  • A negative attitude. Negative thoughts are self-perpetuating. As long as you dwell on them, they escalate, which can increase your pain and risk of disability. Instead, distract yourself with activities you enjoy, spend time with people who support you and consider talking to a therapist.


1. Date Accessed 21/09/2017
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Date of preparation: September 2017