Injuries With Fibromyalgia and Chronic Fatigue Syndrome

When you have fibromyalgia (FMS), chronic fatigue syndrome, or (CFS or ME/CFS), an injury can have intense and lasting effects on your symptoms. And your condition can heighten your body's response to injuries from accidents or contact sports.

It almost seems unfair that those of us who have (FMS) and CFS or ME/CFS still get injured. It's like life is adding insult to injury—or maybe injury to insult is more accurate.

When one of us gets hurt, it's likely to cause a flare. Our central sensitization makes us feel pain more intensely than other people—and we generally feel it for longer as well. That means you may need more comprehensive pain management than someone else with the same injury. If your exercise tolerance is low, you may not be able to handle the physical therapy recommended for recovery without suffering post-exertional malaise.

How to Recover From Injury With FMS or CFS

We know that recovery from injury can be slow and difficult for people with FMS or CFS.

Some things that can help:

• Early treatment: Take steps right away—ice, anti-inflammatories, rest, pain medication, topical pain creams, or whatever is appropriate to the situation. The worse the pain gets, the more likely it is to stir up your symptoms. Also, see your doctor promptly—don't wait to go to the doctor.
• Be clear with your doctor: It's always easier if you have a doctor who is familiar with your condition, but even if you don't, it helps to go in with a game plan. Tell your doctor that your injury is exacerbating certain symptoms and ask about treatments that have worked for you in the past (e.g., massage therapy, physical therapy, a change in pain medicines, etc.) If you believe something will help, be sure to let your doctor know.
• Physical/massage therapy: If you get a referral for physical or massage therapy, consider requesting more visits than would be standard, so you can take things slowly and avoid getting worse. Make sure your therapist understands important aspects of your illness, including central sensitization and post-exertional malaise.
• Be cautious with drugs: We tend to be sensitive to medications, so if you start a new painkiller or anti-inflammatory, talk to your doctor about taking small amounts at first and working up over a few days. If you have a lot of inflammation, try anti-inflammatory foods.
• If you have myofascial pain syndrome: MPS is extremely common with FMS. Any time you have a soft tissue injury, you'll want to do whatever you can to keep new trigger points from forming. Massage with myofascial release, spray-and-stretch physical therapy, or acupuncture may help. Talk to a knowledgeable therapist to see at what point in your recovery these treatments would be appropriate.
• Give yourself extra time to heal: When your life is structured around managing symptoms, this seems like a no-brainer. The problem is that we get into the habit of trying to do a lot on good days. With FMS or ME/CFS, that approach makes sense. An injury is different, though, and often requires a slow, gradual return to activity—not a "Hey, I feel better! Time to hit the ground running!" approach. If your doctor estimates that your injury should be all better in 6 weeks, plan to be in recovery mode for 9-10.