Fibromyalgia and Neuropathic Pain

“Pain is real when you get other people to believe in it”, Naomi Wolf

As I have frequently written there are two kinds of pain: noiciceptive and neuropathic. Those of us with fibromyalgia suffer from the latter. It is the most difficult to live with as it is long term damage to the nervous system that has become chronic. It cannot be treated with opioids long term as it only gives temporary relief. Many find some degree of effectiveness with Gabapentin ( I do) or Pregabalin.

So many readers write of their pain challenges , often resorting to opioids which result in addictions. However, noiciceptive pain such as I had recently from a hip replacement does produce relief from such medications. Burns, operations, broken limbs, usually all of a temporary nature, are examples of this type of pain. But, I quickly found that my highly sensitive pain receptors as a result of sensitization of the Central Nervous System rebelled and did not tolerate the morphine I was prescribed after surgery. Nausea was the side effect I suffered with, resulting in switching quickly to Tylenol. The pain from the scar has ended. This was noiciceptive pain.

So, what are we to do with the other kind of pain? Neuropathic pain is complicated. Opioids are not the answer. While I keep advocating mild exercise as one form of self help, sometimes more strenuous activity is warranted. Many of us can hardly tolerate any excercise at all, mild or vigorous. Strenuous activity usually brings about fibro flare-ups ( I found this out with increasing activity/ stretching from following surgery in order to help with walking and avoiding limping). Now I am in a quandary as to how much to do without increasing my pain level. My brain keeps me travelling down that same old pain neural pathway. Training the brain is not an easy task, but there is little option. Mindfulness meditation, walking in spite of pain, exercise biking are my strategies and an understanding physiotherapist who tells me I expect too much of myself. I remind myself that is the bane of our existence, all of us with this dis-ease called central sensitization (fibromyalgia)… we are too hard on ourselves.

I cannot overstate how complex daily living becomes for those of us with neuropathic pain. We have to be kind to ourselves and recognize that while this is a permanent condition, self compassion is key to our quality of life.

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