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Adrienne Dellwo

Dealing With an Injury On Top of Fibromyalgia & Chronic Fatigue Syndrome

By March 14, 2009

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It almost seems unfair that those of us dealing with fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS) still get hurt. It's like life is adding insult to injury ... or maybe injury to insult is more accurate.

One thing that's almost certain when one of us gets hurt, it's going 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're going to need more aggressive pain management that 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.

It's no surprise that how we recover from injury hasn't been a hot topic of research, which means we're pretty much left to figure this out on our own. Here are some things that have worked for me and other people I've talked to:

  • Early treatment: Take steps right away - ice, anti-inflammatories, rest, pain meds, topical pain creams, whatever is appropriate to the situation. The worse the pain gets, the more likely it is to stir up your symptoms. Also, don't wait to go to the doctor.
  • Be clear with your doctor: It's always easier if you have a knowledgeable doctor, but even if you don't, it helps to go in with a game plan. Tell the doctor that your injury is exacerbating certain symptoms and that you need an aggressive treatment regimen (i.e., extra refills on pain meds, massage or physical therapy, etc.) You pay the doctor to perform a service, and it doesn't hurt the doctor to give you a referral, but it could really hurt you not to get it! If you believe something will help, don't ask - tell the doctor what you want.
  • Physical/massage therapy: If you get a referral for physical or massage therapy, ask for more visits than would be standard, so you can take things slowly and not make yourself worse. Make sure your therapist understands aspects of your illness including central sensitization and post-exertional malaise.
  • Be cautious with drugs: We tend to be sensitive to meds, so if you start a new painkiller or anti-inflammatory, don't jump straight to the full dosage. Take small amounts at first and work up over a few days. If you have a lot of inflammation, try anti-inflammatory foods so you don't need as much of the drug.
  • 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-strech 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 the doctor says your injury should be all better in 6 weeks, plan to be in recovery mode for 9-10.

What has helped you deal with an injury? What has hindered your recovery? Help the rest of us learn from your experience by leaving a comment below!

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March 15, 2009 at 11:43 am
(1) Wendy says:

Hi, my name is Wendy. I suffer from severe Fibromyalgia, anxiety, depression and a host of other health issues.

I was in a really bad accident last Sept., Sept. 15, 2008. My car was totaled. I totally agree with this article in that I have a bunch of new pain areas and issues that I never had before.

I hurt my left thumb that I have been trying to deal with thru PT and anti-inflammatory medicines. I also banged both knees into the steering column and they too are new pains I never had before. And now I have Chronic Myofascial Pain Syndrome in my neck which I never had before. I really must have smacked my neck into the headrest or something which for me since I am so small never helped me because of being so small.

I having a lot of pain and dizziness and strange feelings now from the CMP diagnosis just recently.

So I still am suffering and like this article says, I have a whole lot of new pains on top of the Fibro.


March 17, 2009 at 4:40 am
(2) veronica mary says:

I damaged all the nerves and ligaments in a fall two christmases ago, scans etc revealed no lasting damage, I had physical therapy I was on crutches for 3 months, thanks to fibro here I am two years later with an ankle that is still swollen and that still is extremley painful if I do more than an hour or so of walking to be honest i can’t ever see it getting any better.

March 20, 2009 at 3:28 pm
(3) Heather Jacoby says:

One thing that comes to mind about asking for extra physical therapy is that you should be aware that your insurance company may limit you to so many sessions — and then you’ll have to pay out-of-pocket.

Adrienne, I just want to give that warning because I can’t quite agree with what you said. I’m afraid the doctor may think you’re accepting the extra out-of-pocket cost!

March 20, 2009 at 6:32 pm
(4) Marcella says:

Even small accidents, stubbing your toe, but not breaking it, can put you on a pain cycle that lasts for many months. I got a shot in my arm at the hospital. I had gone in for a very painful crook in my neck. The pain from that shot lasted a good six months. Even now I will get a sore spot in that area.

March 25, 2009 at 12:54 am
(5) Adrienne - Your Guide to FMS & ME/CFS says:


It’s true that some insurance companies limit things like physical therapy treatments. Many of them will allow extra visits at the request of the doctor or therapist, however. Sometimes, we might have to pick up the extra cost, other times we might have to argue with the insurance company to get more visits covered. It’s also good to ask about self-referral — for example, my insurance co. allows 10 self-referrals for chiropractic per year, on top of 10 per doctor referral.

April 3, 2010 at 8:17 pm
(6) Aliyah says:

I had a fall at work in jan 2010 and pulled muscles on my left side (which is mainly effected by FM) in my shoulder/neck area. I was off work for 7 weeks, when i went back they took disciplinary action against me & i was given a 1st written warning.
Talk about adding insult to injury. now they want me to see the company doctor. They think i use the FM as and excuse not to go into work. They dont understand how recovery for a suferer of FM is not as easy as it would be for a non sufferer.

April 29, 2011 at 6:54 pm
(7) leanne says:

Hi all i also have fibro as well as arthritis and over a year ago had a fall and now have traumatic brain injury as a result its been a hard road that docs say i will never win i am constantly dizzy with head aches etc, my hubby is a qualified massuer and he massages me but i find the pain during the massage hard to deal with and the relief is only brief but i think its worth it.Having read this i think we might try massageing lighter ore often to see how that works.I also find if i cut myself it takes forever to heal i just put it down to the fact that i am a cronic asthmatic also and spend alot of time on cortisone and that stuffs your healing up also.

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