Active Coping Strategies Seen to Help Fibromyalgia Patients in Controlling Pain

Active Coping Strategies Seen to Help Fibromyalgia Patients in Controlling Pain

People with fibromyalgia and those with neuropathic pain often use similar coping strategies against pain, according to a study conducted by Danish scientists. They suggest that, for this reason, the same psychological treatment approach could be applied to both groups of patients.

The study, “A comparison of coping strategies in patients with fibromyalgia, chronic neuropathic pain, and pain-free controls,” published in the Scandinavian Journal of Psychologyalso found that fibromyalgia patients felt more in control of their pain compared to neuropathic pain patients, especially those using active coping strategies.

Researchers, led by Dr. Lise Gormsen from the Danish Pain Research Center at Aarhus University Hospital, examined the strategies used for coping with pain by fibromyalgia and neuropathic pain patients. They asked 28 fibromyalgia patients, 30 neuropathic pain patients, and 26 pain-free volunteers to complete the Coping Strategy Questionnaire (CSQ) and rate their daily pain.

CSQ is a self-rating scale with 48 questions. It is the most widely used measure of coping with pain among clinicians and researchers. It was first validated in a group of patients with chronic low back pain, followed by other patient groups, including fibromyalgia.

Researchers found that both fibromyalgia and neuropathic pain patients used maladaptive/passive coping strategies against pain, and, surprisingly, also more adaptive/active coping strategies compared to healthy controls.

Active coping strategies include diverting attention, reinterpreting pain, coping self-statements, ignoring pain sensations, and increasing activity level. Passive coping strategies range from catastrophizing to praying or hoping.

The study also showed that fibromyalgia patients who used high levels of passive strategies felt less in control of their pain that those who tended to shy away from passive strategies. This was not seen in neuropathy pain patients.

The authors concluded that, for clinical practice and especially for fibromyalgia patients, “passive coping strategies should be restructured into active ones.”

Neuropathy pain arises as a direct consequence of an injury or a disease affecting the sensory system. It is characterized by localized hypersensitivity in and around the area of the damaged nervous system. Hypersensitivity and spontaneous pain are also seen in people with fibromyalgia, however, pain in these people is more generalized and not confined to a certain body part.

44 comments

  1. Valarie says:

    I find this to be very true. For the most part I ignore the pain, I carry on with my life. Once in a while I will become exasperated with the pain, and will sit and feel the ache in my feet and hands, but not for long, because really, it can be quite depressing. I carry on because if I didn’t the pain would immobilize me. I don’t let having fibromyalgia control my life, although at times (often) it will limit what I can do. If I can become absorbed into a distraction the pain becomes secondary. As such, you could say I have active coping strategies.

  2. Erma says:

    I have fibromyalgia and have been suffering from this terrible illness. I don’t really like reading comments like the ones that keep telling us, how we need to stay active, to relax, and to try to deal with it, as the lyrica commercials they give the wrong impression to non sufferers that your life will be better and the pain will be less. I have a severe case of fibromyalgia, but I think they’re enough people who don’t believe that our pain can be so severe. I often wonder how a perfectly healthy person would deal and tolerate the kinds of pain we feel.

    • Denise Bault says:

      I agree whole heartedly with you! If the naysayers or pooh-poohers could live in our bodies for a month, most would be lying in a fetal possiton , balling their eyes out!

      • John Anderson says:

        well, explaining it to men is a bit easier:
        Ever spend the weekend splitting and stacking firewood? or max out during a work out – and I mean going all out tell you’re ready to collapse?
        Well, that is how I feel on an average day (no flare up) when my meds (Savella) are working well.
        On bad days, it feels like you got dragged behind a truck and then a horse kicked you down the side of a mountain.

        • Erma says:

          John,
          I hate this illness it took everything away from us!!! And left us living with pain that can’t be discribed this is the kind of pain makes you wish you were dead. But for some reason, we have it. Family, friends and co-workers don’t believe the pain, but people that actually live with us sees us but still can’t comprehend how bad the pain and how we have stop the pain, only change the way we do everything. I pray to God that he helps all of us who suffer from pain. Take care of yourself..,

        • Lagwenna says:

          That is most days for me. I don’t stop because I know if I do I can’t get back up. Most days if I can lay perfectly still and not move I can manage but who is able to do that I don’t know. I have to try and push myself until I just cannot anymore.

    • Stefanie Teschemacher says:

      You are absolutely correct. I agree 100%. This is a have to be in it to get it disease. Unless you have it, you are completely clueless. You could never endure this pain. It is indescribable.

    • PAMELA BERGMANN-KNEBEL says:

      They wouldn’t and can’t understand. I went from a perfectly healthy person to a severe fibro about 4 years ago. I tried so hard to cope and continue to work but I couldn’t and luckily I was old enough to retire early although that was not my life plan and has screwed up my finances but it is what it is. I am coming out of a severe flare with depression, fatigue, fog, balance problems, insomnia and of course terrible pain. I think about suicide often. As for all that advice about exercise, diet, blah, blah; some of it is good advice. I think we have to do what we can. I try to move some every day even if its just walking around my yard. Sometime that fatigues me enough that I can’t do anything the rest of the day. I also try to do too much. I’m a list maker and my husband, bless his heart, told me to concentrate on only one or two things, if I can. He is totally supportive. I wish you the best. I do a lot of research online trying to find help. Not much does!!

      • Erma says:

        Hi Pamela, I know how much pain you have and the frustration that you feel. I also have thought about not living, but I can tell you that the world is a better place because you are here, you are not alone in this battle. I’m not stronger than you, I get stronger by reading about people like you and me. Have a little bit more of hope, we don’t know what tomorrow will bring. And, really is all that we can do. Keep writing when you can. Best of luck…

      • Laurie says:

        Hang in there, Pamela. Suicide is never the right answer. It would transfer your pain to your loved ones. And, where there is life, there’s hope. I have had this monkey on my back my entire life (lucky me). The pain part didn’t kick in until puberty. I’ve overcome many challenges, including breast cancer and divorce. One thing that helps me is listening to positive, encouraging music. Check out KLOVE.com, and best wishes to you.

    • Laura says:

      Hi…I’m a RN, and also have Fibromyalgia. It is true that exercise will help in the long run by keeping your muscles strong and working well. Exercise DOES NOT do anything for my pain at the time. Exercise also creates endorphins and releases your good feel drugs like serotonin, & dopamine. This will help depression! Hope this helps!

    • Brenda says:

      Boy, isn’t that the truth. People including Drs don’t believe you when you try to tell them where the pain is. But it is all over and you can’t pinpoint to 1 particular “hurt”, because it is all over. I can’t get anything for the pain. My dr won’t put me on lyrica due to other medical issues I have. I used to take darvocet, but can’t get that anymore.

  3. Judy says:

    There are days when the pain is so pervasive that being active is beyond what I can manage for the day. Yesterday was one of those days. This morning I had to work through the pain for an hour or so, but had to lie down afterward. This afternoon I’ve done laundry (out of necessity), but have had to rest in between loads. Mentally, I feel good that I accomplished something. I admit, however, that having an “invisible” disease leaves us open to judgement and often less than helpful advice.

    • ERMA says:

      I know the pains we feel are even hard for us to explain. I for example feel poking, twisting, burning, pressure,hot and cold pain, numbness, tingling, brain fog, etc. How can we not feel tired and exhausted;let alone ignore all pain and discomfort. Lack of sleep makes it 10 times worst, add stress and depression;tell me how many people would like to live like that????!!EVERY DAY!!!!

  4. Lisa says:

    I have had fibromyalgia for 20 years now. I worked as an RN in an acute care hospital during most of those years. I was active. Very active. The moment I finally got to rest after work, shopping, housework, kids, husband and all the other things I was responsible for, the pain overwhelmed me every time, and continues to this day. I have also found that inactivity also causes me pain. A few hours on the couch, and I can barely stand to walk. I push and push myself, and I have tried passive and active coping measures, read alot of material about this disease to understand it and help myself, and take medication for it, yet relief is no where in sight. It is hard to ignore or distract yourself from pain that is so scary, you don’t know how bad it will get “this time”.They might be “active coping strategies” but I don’t see people with other chronic or terminal pain being asked to divert attention or ignore how horrible they feel.And what does “reinterpreting pain” mean? Yes, you must help yourself. Yes, you must move your painful body.Learning muscle relaxation exercises can help. You should avoid opiates as much as possible, and TRY (cause it’s really hard to do this), to get adequate sleep. These are all ACTIVE strategies, and are being done every day by those of us who hurt, but can’t really be helped. The fibromyalgia sufferer is often a person who was too active, for too long, for too many others. Passivity doesn’t define us.

  5. Jimena D'Andria says:

    Sorry Kim, I never heard the name mirapex. I take cymbalta, elavil, gabapentin, and supplements. Today is day five of this fibroattack; flareups sounds to civilized. I feel like one giant pain pile. Hurts to type.

    BTW i agree with “The fibromyalgia sufferer is often a person who was too active, for too long, for too many others. Passivity doesn’t define us.”

    I leave you with a tip that worked for me. Recently my right pinky has gone rogue. It feels like tiny little needles poking me. I had a thought to bandage it. I took adhesive tape and wrapped it lightly. Pain supsided! I don’t like wearing compression gloves; I feel trapped and when i look at my hands It makes me very upset. Upsetting feelings; lead to upsetting thoughts and back and forth till wamo day 5 of pain.

    Thanks for listening this is my very first comment. Be blessed. J

    • Erma says:

      Hello J,

      I pray that you get relief soon. I’ve had this horrible illness for over 10 years. I also take flexeril, norco, lunesta and amitriptiline, but instead of gabapantine, I take lyrica. I know exactly how frustrated you feel and upset to all the ways we hurt everyday. We often minimize our pain because others hurt too. I just don’t know a lot of people that could go on living with so much pain, and expected to stay active and carry on the way others want to see us. God will continue to be here because he KNOWS how much we hurt. Take care and try relaxing a bit.

      • Erma says:

        Hi John,

        Hang in there!! You are not alone in this battle. People can’t understand our pain and how our world has very little to give us hope. I pray for all the people in the world that lives with pain. Try stretching, or heat. Sometimes that help, but to be honest, the only thing that gives me more immediate results, is medical marijuana. I get it from a licensed dispensary. May God give you the strength you need every day!!!

    • Laurie says:

      Hi Jimena – Just thought I’d share this with you. I’ve recently had awful pain in my right pinky as well… so, I got a smaller mouse! I’d been using a standard size mouse with my laptop for a few months, which is what caused the severe pain in my right pinky (I think). I’ve had the new mouse about 2 weeks now, and my pinky is almost back to normal. The model that works for me is M187 and the brand starts with “L”.

  6. Cheryl says:

    Ive had Fibro for 10 years now and have tried so many diffent types of meds, I’m currently on Lyrica . Sometimes I think its not working ,until I forget to take it and cant move for the muscle pain. I also have nerve pain in feet and arthtitis in both ankles, so somedays I have to use a walker or stick just to get around. I am 52 and feel like a 100. has anyone investigated medicinal marijuana? I worked hard since I was 16, had my own business for the last 5 years working 80 a week. since selling the business my fibro has got worse, its a day to day battle with pain and my family find it hard to understand that somedays I’m ok and the next curled up in a ball of pain.

    • Louise says:

      I have tried savella, cymbalta,and lyrica, however they are gave me bad side effects such as headaches,dizziness,memory loss, and actually made my body pain worse. My rheumatologist had me start on a meditarrian diet and I have been swimming at the YMCA 3 times a week and walking 3 times a week, losing weight without really trying. I am feeling so much better, a lot less flare ups, my joints and muscles feels so much better, I also am feeling emotionally and mentally better.

      • John Anderson says:

        To help you understand the emotional and mental improvements, a large part of it is probably because you are sleeping like a human being again. Sleep deprivation has huge consequences on people. So much so intelligence and law enforcement agencies world wide use it as an interrogation technique
        I am glad the swimming is helping you. But proceed with caution – You can still push yourself too hard. That is what caused my current flare up. Three consecutive days of swimming 200 yards and my fibro reared its ugly head.

        • Grace says:

          I found the same: whenever I engage in an activity I usually pay the price for it. I love walking – if I do it too much a feel like I am walking on glass (heels) and my legs are all over sore including very sore knees. Same for Pilates, table tennis (I played only about 2 months – once a week) stopped about 4 weeks ago and still cannot walk without severe pain)The only activity that was good was Water Aerobics (quick changes and low impact). Then they made it into Aqua Fitness which is with long repetitive moves and again, I had to give it up.

    • Steve Carrington says:

      I haven’t tried savella but I understand it’s in the same class …. snri as cymbalta I have absolutely no improvement with cymbalta and the side effects were too much I would expect that if you have not responded well to cymbalta you most probably will not get any benefit from savella I understand the side effects from savella are far worse than cymbalta. But everybody reacts differently to medication so if you tried everything else there’s no harm in trying.

    • Bonnie says:

      John, I tried Savella a little more than 6 yrs. ago. We were getting ready for our grandson’s baptism and the next thing I knew, I was ‘waking’ up in the ER. My family thought I was having a stroke but I didn’t. I just “went away” for 3 hours. I had just increased the dosage on the Savella. I was having a headache. The doctors didn’t think the Savella caused it. I don’t really know if what happened to me was caused by the Savella, plus it really wasn’t helping me with my pain, so I stopped it. I have a friend who was involved in the final phase of research on it more than 6 yrs. ago before it was approved by the FDA, and she is still using it. It is helping her
      tremendously as she is working, and back to doing community theater. I think it’s worth a try.

  7. Lagwenna says:

    I’ve been dealing with this pain for so long now I don’t know what I would do not to have it. I too take lyrcia,flexril and narcotic pain medicine because of chronic back pain and most days I feel like none of it helps. Lately I have been in a state of depression and the stress of trying to deal with the fact that my mother is dying and I need to take care of my dad, plus trying to figure out my finial situation and if I can possible get my social security and leave my job of 30 years. I’ve had to increase my anti depressants and keep going because the world doesn’t stop just because I hurt.

    • Steve Carrington says:

      Its tough on you when you have to deal with life-changing and traumatic events when you’re already having to cope with the daily nightmare of fibromyalgia and undoubtedly magnifies all of your symptoms.
      May I ask what antidepressant you are taking and how effective is it for you?

  8. Steve Carrington says:

    I’ve heard Topomax (Topiramate) the migraine/anti seizure med is giving good results on pain in some people taking it has anyone tried it where’s positive results?

    • Mandy says:

      Hi Steve,
      I’ve been on Topiramate for about a year now and it has definitely made a positive difference for me. I was experiencing almost constant muscle spasms in my neck and had tried injections with no relief. I also tried Cymbalta, but the side effects were horrible so my specialist recommended Topiramate. It is not a pain reliever, but does help to reduce the severity and frequency of migraines and I have noticed a marked reduction in the amount of headaches I get (less than once a week, down from 3-4 times per week). There are negative side effects with this medication like all the others, but one positive one is weight loss! I hope this helps 🙂 I’ve also recently started taking Nortriptyline which is an anti-depressant, but also used to help with tight muscles. Not sure yet how well it’s working, but we’ll see…

  9. Steve Carrington says:

    I have tried almost all of the recommended FDA and non FDA medications for fibromyalgia and here is my take on two unexpected medications that significantly help me

    Lorazepam ( ativan) the benefit I get from this is that substantially improve my mind set around the pain, it cuts fatigue and restores energy (although it is a benzodiazepine) it is not a sedating one it also acts as a mild muscle relaxant and significantly helps with my early morning stiffness and spasms. In fact most days it’s the only thing that will get me moving and out of bed
    ( other benzodiazepines such as diazepam or are a disaster for me as they just add to the amount of fatigue headache and brain fog. Lorazepam also of course helps to reduce anxiety levels and improves mood when you’re at your worst.

    Zolpidem (Ambien) I was prescribed zolpidem to help with sleep but noticed that whenever I took a dose earlier than normal (i e a couple of hours before sleep ) most of my symptoms pain stress stiffness immediately melted away , over time it became apparent that even very small doses of zolpidem would provide significant relief for me of all symptoms and has significantly boosted my mood. Clearly it’s not something you can take during the day because of the eventual sedation but on really bad days when you just have no other option it’s a lifesaver to have in your toolkit and even the smallest tiny doses can have a marked improvement. Taking it in the early evening when you can afford to feel a little bit more relaxed it does make those last hours of the day much more comfortable. I believe the pharmaceutical community need to look at the Z drugs because I think something interesting lies in the compounds which could be developed into a specific and effective fibromyalgia treatment.

    • Laurie says:

      Steve – Have you heard anything about low-dose naltrexone (LDN) as a treatment for chronic pain? It is helping some Fibromyalgia sufferers, and I plan to look into it this week.

      • Steve Carrington says:

        Thanks Laurie, I have heard of it but never explored it like you I will do some further research it does seem to be something that many have tried with some success.

        • Bonnie says:

          Laurie, I have been taking Low Dose Naltrexone for a little over a year. I started on the lowest dose, 1.5 mg. and now taking the highest they will give, 4.5 mg. You cannot be on a narcotic with this or it will not work as well for you. I was taking Vicodin for pain and had to get off of it. At first, the LDN was like heaven. I felt so good in the mornings and it kept me going through the day. I didn’t notice any help with my aching at first, only after quite awhile later. I have been on the 4.5 mg dose for maybe about 8 months or so. I do not feel as good as I did, but then, that is how my body reacts to almost everything. I am now in more pain than I’ve been, so it definitely isn’t helping my pain. I have read that some people’s pain is relieved by it and some not. Mostly take it before you go to bed and it helps to raise your serotonin and other neuro-transmitters by morning so that you are feeling good. I’m glad I tried it. My doctor suggests that I stay on it for now. I go to an integrative/holistic doctor and I am having a DNA test done so we can find out what is really happening in me so we know how I may have to be treated. Yes, DNA testing costs, but we feel if it shows something that is happening to cause my problems, then we’ll know what to do – it’s worth it. I have had FM for over 20 yrs. and I have a pretty long list of what I have tried.

  10. Steve Carrington says:

    I have been on a combination of Fluoxetine 20mg + Mirtazapine 15mg for 10 weeks and the difference in fatigue and brain fog has been miraculous.
    The mirtazapine promotes deep sleep cycle and a fast overall mood kick, it also stops nausea, reduces my headaches and took away hot flashes. The fluoxetine (Prozac) gives a boost in energy which is synergistically increased with the mirtazapine.
    Before i wS waking up every day being unable to move, get out ofbed, had brain fog and no energy all day.
    Thats all gone now, i sleep 7to 8 hours, wake refreshed, get up and my day is much more active. There is a slight improvement in pain levels and muscle stiffness, but that’s probably from being more active. I still for the moment need other pain medication.
    I recommend this combo to anybody eith bad fatigue, brain fog and low mood.

  11. StevefromMA says:

    It’s unbelievable how we have similar symptoms and react so differently to meds. I’ve tried most mentioned here with no pain relief, my major symptom, and numerous side effects. I tried to make edible chocolate from medical MJ, very difficult to dose and need to experiment with various strains. I tried oxycodone last week, toxic to me, sedated me for hours with no pain relief even using 1/4 tab. Back to Tramadol and Tylenol and minimal relief but I’ve run out of meds to try. Every day is pretty much hell with this, has been for three years.

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