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Adrienne Dellwo

Muscle Spasms in Fibromyalgia & Chonic Fatigue Syndrome

By October 14, 2013

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Do you sometimes have muscles that tighten up and won't relax, no matter what you do? A lot of us with fibromyalgia and chronic fatigue syndrome have this problem.

As I write this, I've got an ice pack on my left shoulder and neck, trying to head off another migraine like I had all last week. If I can't get it to loosen up in the next few hours, I'll be calling my rheumatologist to see about an injection of either lidocaine (a local anesthetic) or anti-inflammatories.

No one knows exactly why we get these muscle spasms. It could be due to abnormal nerve function, nutrient deficiencies in the muscle cells (due to mitochondrial dysfunction or digestive problems,) or something else entirely. They can range anywhere from a minor annoyance to a major source of pain and disability.

Treating Muscle Spasms

We've got a lot of options for trying to get rid of muscle spasms, and that's a good thing, since they can be hard to treat. Things you can try at home include:

Nutritionally, several things are believed to help with muscle pain. While they generally haven't been studied specifically for our conditions, foods and supplements that may help include:

  • Magnesium and malic acid (separately or together, as magnesium malate);
  • Potassium-rich foods such as dates, bananas, apricots, cantaloupe, grapefruit, peas, beans, potatoes, fish, and beef liver;
  • Calcium (because cells need twice as much calcium to relax a muscle as they do to tighten one);
  • Vitamin D (which tends to be deficient in fibromyalgia).

Health-care providers also have a variety of tools for helping relax tight muscles, such as:

I tend to have muscle spasms mainly in my neck, lower back, hips, and thighs. They've been a major source of pain for me for most of my life, and it usually takes a variety of treatments to get rid of them.

What are your muscle spasms like? What helps? Have you noticed anything that seems to trigger them? Leave your comments below!


Photo © Dylan Ellis/Getty Images

October 14, 2013 at 9:24 pm
(1) Donna says:

I have been having these spasms for a few years with my fibro. They tend to be more in the neck or shoulders. I do have them in my legs sometimes, but mostly the neck and shoulders. I put an ice pack on the area and add ibuprofen to my pain regimen. My pain management doctor told me to add it the the pain meds I already take when the spasms occur. I also take the ibuprofen with my imitrex for my migraines. That has helped a lot. I know it different for everyone. But the ice cold really help. I pray the best for all of you.

October 14, 2013 at 9:43 pm
(2) Julie says:

I get severe muscle cramps and have found that drinking tonic water helps to relieve the cramp. The quinine acts as a muscle relaxant and it usually works pretty quickly.

October 15, 2013 at 7:46 am
(3) Iain says:

Vallium or good quality strong ale (Marston.s IPA), relaxation, topical aspirin liniment

October 15, 2013 at 1:10 pm
(4) Michelle says:

I have muscle cramps all day every day. With fibro, and low vit D and migraines, it dosen’t seam like there isn’t a muscle that’s not cramped up. With taking lidocane shots in my neck and back of my head, lidocane patches, muscle relaxers, tens unit, heating pads, over the counter muscle relief patches. And being on warfarin limits my NSADS intake leaving we only anle to take tylenol for pain. And we know how well that works…
THANK YOU for this usefull blog that gives us ideas opinoons and personal experiences from so many people it is just what us newbies need.

October 16, 2013 at 1:59 am
(5) Bobbi says:

I used to get them really bad in my lower legs but a combination of muscle relaxers, Vitamin D (2000 IUs) and potassium has done the trick, I haven’t had one since I started taking the potassium. When I still got the spasms they were weird, they’d actually twist my foot to one side or the other. It was incredibly painful.

October 16, 2013 at 9:49 am
(6) HypoGal says:

The constant muscle spasms throughout my body are exhausting. I eat a lot of raw ginger to help with inflammation. I also try to have acupressure on my trigger spots once a week.

October 18, 2013 at 5:52 pm
(7) Sophie says:

I get spasms but more like convulsions where my body/muscles jump. It seems to happen when more tired or no apparent reason. Been told by m.e clinic it’s not a symptom!! But just caused by not using the muscles enough. Nothing in particular helps. Mine are different to what u describe though, the muscles aren’t tight.

October 18, 2013 at 6:16 pm
(8) Beth says:

I get spasms that encircle my ribcage. They usually start in my back between my shoulder blades and spread right around my body until they meet around my sternum. The only thing that stops them is Ativan SL, which is put under the tongue. If I don’t take one or two before it starts to spread the pain the spasm causes is horrible. If anyone else has this type of spasm and has any solutions for it I would love to know. I am literally rendered immobile by them.

October 19, 2013 at 9:42 am
(9) Maria says:

Spasms gradually became a big problem for me with this illness. I have used Soma, a muscle relaxer. I also get Voltaren Gel, an Rx, which I believe is an NSAID, but you put it right on where you’re spasming. I have used all the alternative methods Adrienne described, which helped somewhat at different times. My sister, who has both CFIDS and FM as well, takes multi-minerals which she is sure help with her spasms. And yes, that “jumpy” thing that someone else described is absolutely a part of FM (the minerals that help symptoms for my sister).
I finally developed incapacitating pain in my low back that went all down the backs of my legs, creating both spasming and a lot of pain. Two days ago I had an outpatient minor surgery done by my pain management specialist. I believe the technical term is “Epidural lysis of adhesions” — catheter injections of steroids into the relevant nerves of certain vertebrae (mine were in the lower lumber region in the back), preceeded by enzymes to help the absorption of the steroids. The treatment was not painful or difficult. So far so good. My legs seem much better since yesterday.

October 19, 2013 at 9:47 am
(10) Maria says:

Another thing I wanted to mention under the topic of spasms: Restless Leg Syndrome. I find this one of the most torturous symptoms there is. I use Requip (Rx) and it helps ALOT. The other drug used most often for RLS is Mirapex, but made me itch. There is a new one now, but I don’t know the name.

October 19, 2013 at 11:52 am
(11) Darla says:

I have continual pain on the right side of my leg. I have had many injections for my sciatica, but no real relief. The muscles on the right side of my thigh are always as tight as a rope. My pain meds help some, as does heat. Bit nothing lasts for long. Has anyone ever tried acupuncture? I’m thinking that’s my next strategy.

October 19, 2013 at 3:05 pm
(12) julie dakin says:

does anyone get muscle pain in between the shouder blades, that creases you up. The pain is quite severe, and usually goes away after two or three days, until the next time.

October 19, 2013 at 6:42 pm
(13) Pam says:

I get jumpy and twitch whilst I’m asleep but only know because it makes my husband jump in surprise! Does anyone get this?

October 20, 2013 at 5:21 am
(14) roy says:

I have ME/CFS. I used to get light whole body tight muscles which ache. Since taking 100mg of Ubiquinol CoQ10 *; 3 times a day this has significantly reduced and I can do a lot more physically before I have muscle problems. If I overdo things physically I get muscle problems which normally start the next day along with fatigue and sweat cycles. Diazepam significantly relieves the muscle problems and sweat cycles but only rest and time reduces my fatigue.
For light muscle problems I have been taking ½ 5mg diazepam three times a day.
For muscles spasms in the stomach and back I immediately take 5 mg of diazepam 3 times a day. Iíve also had acupuncture which got me out of a chair when my back went. Iíve recently discussed at length with my doctor alternative ways of relieving bad muscle spasms and whole body muscle pain/ tightening. I am now going to try:-
1 200mg of Quinine Sulphate at night for whole body muscle problems.
2 Up to 2 off 10mg dicycloverine hydrochloride to take immediately if I get stomach cramps/spasms.
3 To keep to 5mg diazepam three times a day for back spasms.
I will continue to take CoQ10 and only take these medicines as and when required.
* The M (Myalgic) in ME is defined as a problem with muscles. CoQ10 I believe directly addresses the production of energy in the mitochondria and delivery of oxygen to muscles -there are a lot of papers on this and more work is being done and reported every 6 months. I take the Ubiquinol version since I am over 50 and this works better /is better absorbed then the Ubiquinone CoQ10. I purchase the Ubiquinol version myself since the doctor can only give me the Ubiquinone version Ėthe Ubiquinol is an antioxidant which the government will not let him prescribe.

October 20, 2013 at 3:50 pm
(15) Mrs Lynn Staples says:

#8 Beth.
Yes I get spasm’s around my ribcage! I’ve had them for many years, and I haven’t found anything yet which helps apart from to sit and ‘try’ to relax until the spasm passes. I’ve even had to pull over in my car, and sit at the side of the road and wait for one to pass. The pain usually begins in my side, and then spreads all around (usually one side) then down my arm, often up into my shoulder and neck. It’s the most intense pain, I wouldn’t wish on my worst enemy. I wish there was some cure for it.

October 21, 2013 at 6:29 pm
(16) Julie says:

before I was diagnosed I started getting charlie horses every morning, then they expanded to cramps throughout my body -at times I would get them bad in my back or side while driving home. When I am having a bad flare it starts with twitches on my face. When i was put on Lyrica the cramps went away and stayed away for years. I was on Lyrica for 5 years then lost my insurance. Its been 3 years since I had it -I have insurance now but I had moved and got a new Dr. who insists on starting at step 1 in my diagnosis and I can’t afford it so I still do not have my meds, and the charlie horses have returned. They are worse than before now my calf muscle cramps behind my knee usually early morning. Last time it happened I couldn’t walk most of the day from the latent pain. No supplements or dietary changes help these, either. Been there, done that.

October 22, 2013 at 4:33 pm
(17) Liz K says:

Beth #8 & Mrs Lynn Staples #15:

I get this also and get chest pain with it. I had a trip to emA & E as I thought I was having a heart attack!!! I too haven’t found anything that helps them and I too find I just have to sit through them which is incredibly painful at times!

I have issues with my rib cage all the time. I broke some ribs years ago and I find the fibro seems to attack it. I get rib pain everyday now and it wakes me at night, I even got concerned that I’d broken them again!!! Then the spasm comes along and hurts them even more.

October 25, 2013 at 4:58 pm
(18) Beth says:

#15 Miss Lynn Staples and #17 Liz K. It’s nice to know that I’m not going crazy, at least! I also fractured/bruised my ribs 30 years ago and hadn’t even thought about that being a factor until you mentioned it, Liz. I have also suffered with costochondritis in the past so that may be part of it.

Sometimes it’s just nice to know you’re not the only one going through this. I don’t know anybody else who has fibromyalgia or pain to the extent I do so it’s hard to talk to anyone and have them understand. Thanks.

October 25, 2013 at 7:11 pm
(19) Diane says:

I get horrible muscle spasms, cramps throughout my chest, shoulders, neck & rt hip & leg. It’s worse on my Lt side as I am left handed. The more I use my arms or upper body the more spasm & pain.I believe my rt. hip leg pain is because my upper back muscles (mostly left side) are always pulling therefore causing other muscles to be torked & twisted. Antiinflammatories have never helped me one bit. I tried everyone on the market for long periods. I’ve tried tons of things but nothing that has helped long term. I live a very low key life, rest daily, & take the lowest dose of oxycontin I can manage & Percocet for worse days. I have spent a fortune on alternatives but have found nothing that’s helped yet.

October 25, 2013 at 10:51 pm
(20) cheryl says:

The spasms that you are experience, I believe is actually called myofacial pain. It is where your fascia contracts, like a spasm, but doesn’t let go. I find that pressure points or holding a stretch for a few minutes releases the “spasm”.

December 18, 2013 at 3:21 pm
(21) APRIL says:

WAAAA You mean others have this too!! Theres no cure. I keep thinking this fibro will get better but over the years it gets worse. Im just learning now to adjust my life to this as it may never go away. Im on disability now. Thank goodness at least for that.

December 25, 2013 at 9:18 pm
(22) Shari says:

I get spasms in my upper back between my shoulder blades that feels like a red hot poker. I had to quit riding my horses years ago due to the severe spasms that I would get after each ride. The spasms would last for days afterwards that left me unable to move without sending my middle back and entire upper torso into a painful, gripping spasm. I would love to be able to figure out what is going on since I live with some sort of muscle pain/spasms/fatigue every single day.

December 29, 2013 at 3:22 pm
(23) Becky says:

To pam- I do have twitching and awake from pain or numbness. My husband won’t go to sleep wth me snuggled behind him b/c he says that I pinch him and it really hurts. Lol. I had a hard time believing him until I woke myself up while doing it.so he snuuggles to me mostly now. I have been dx wth sleep apnea, but I don’t feel like I am asleep, my mind is awake and I can hear things through the night just as if I am only lying there wth my eyes closed. Back to muscle spasems , just had one last night across the top of my shoulder while bending down to grab something from floor , the muscle went into a ball, wow that really hurt and even left a bruse. Is that normal ? I have nerve damage and back problems but was dx wth fybermylgia about 10 yrs ago , I always feel like a fool when I go to docters apt or talk to a nurse . They always ask what is your pain score today 1-10? Well I can tell you this # now but by the time I turn my head or aits time to leave it can change. I just feel like its not a dx that they believe in ,they think its a drug seeking excuse. Of cource I am addicted to meds they have been in my system for years, I hate it b/c your body becomes amuned to it then you need stronger meds so I don’t want that.but this tmj (dx at 15yrs old and OA) I have lightning sharp pain tat is unbearable, and my head hurts so bad it feels like it weighs 50pds on my shoulders. Lord the list goes on but docter may think its all in my head but test surport complaints when they do finally do test. I feel so bad for people who really are going through this because who likes going to the docter , Really!!!!! I have other bills to pay or things I would like to have , like new teeth from all the teeth I have pulled due to pain and I just thought by pulling them the pain would go away.

February 5, 2014 at 8:09 pm
(24) jaki says:

Have recently been diagnosed with signs of fibro..muskelltol…in the last six months the pain has become so unbareable allover my body…more so in shoulders…arms,wrists,hips legs…
I have been given morhphiene …methocarbol…now amtriline …and nothing seems to touch the pain or calm down these spasms…
Tho find heat does help,in sauna espeacially.and looking for any advice on simlar condition.
I am under a reumtology consultant,therapy in which only involing talking at momemt!!!

February 9, 2014 at 7:16 am
(25) Jennifer says:

Beth #8 – that sounds like what happens to me when I dislocate a rib in the back. It feels a little different if it starts in the front. Sometimes it’s really painful and sometimes debilitating. I have problems with hyper-flexibility. My chiropractor taught me how to re-set my ribcage myself, and it helps. In years when I’ve gotten regular strength-building exercise it rarely happens (just stretching and yoga alone can make it worse).

February 9, 2014 at 7:23 am
(26) Jennifer says:

Restless Leg Syndrome – Speaking for myself, I’ve found the cause of it to be the muscles in my low-back, hips and butt–they don’t release properly, and that causes all the leg stuff. The thing that helps me is to roll around on top of a couple of tennis balls in bed, I do it when I lay down to sleep at night, I roll my low-back, glutes and hip muscles across them. If I find a painful spot I hang out and breathe for a minute. Using a foam roller on the floor also does the trick, not as easy to use, but is better in some ways.

February 12, 2014 at 12:08 pm
(27) Gwen says:

I have lupus, fibromyalgia, RA and numerous other inflammatory diseases. I awaken at night with unbearable pain from leg cramps. Starts little above knee and goes down my legs. The area behind my knees locks up. Most time I am unable to move my legs. The pain is severe and pulsates. Takes more than 10 minutes to lessen. Then, need help in getting up and moving around.

February 16, 2014 at 11:52 am
(28) Kim says:

Hi, my name is Kim. I have been diagnosed with lupus, ,fybromyalgia , chronis fatigue syndrome, and Reynolds phenomenon. To name a few, anyways for the last year..if not longer I have had this spasming around my rib cage. It feels as if I’m getting a major bear hug or squeezed in a vice. I only get about 5 hours sleep at a time and then I’m woke up with this awful pain. Sometimes trying to catch my breath because the muscles are so tight I can’t expand my diaphragm. Does this happen to anyone else if so, What kind of medicine, muscle relaxer seems to help for you? Please help

February 19, 2014 at 4:18 pm
(29) Daniel says:

I am a 31 y.o. male diagnosed with fibromyalgia 1.5 years ago, after about a decade of dealing with constant pain.

This by far is my worst symptom. It seems like every. single. muscle. in my body, whenever it is used even the slightest amount, will react by tensing up and not releasing for hours, if not days. My record is about 4 days with a ball of knotted muscles in my right hamstring.

The tightness and pain get so bad in my legs that I start limping, then get to the point where I cannot even walk anymore. Even the muscles in my hands and fingers, as I am typing this, are beginning to tighten up.

For years I thought the tightness was simply inflammation, but after a number of tests showed negative for inflammation markers I didn’t think much of it until today I finally realized that the tensed muscles were acting much like inflammation.

I’m currently on 150mg of Lyrica twice a day which helps with the nerve pain, and 10mg of Flexeril twice a day for the muscle tightness… but I’m beginning to doubt if it’s even working. The next time I see my doctor I’m going to ask him about other muscle relaxants.

So I guess my question is if this is at all normal for fibromyalgia symptoms? I guess I’m already one of the outliers considering I’m male and young. Also, I did not have the pressure point reactions during my diagnosis… maybe 2 or 3 at most.

Any help or insight would be appreciated. I’m sure most of you know what it’s like to be in agony day after day.

February 22, 2014 at 10:10 am
(30) Vinu says:

My muscle spasms seem to relieve when I do strength training with smaller weights. Even when I feel worse pain I strech and do couple of free weight exercises which instantly relieves the spasm. I am only taking 75 mg Lyrica and managing pain well with the strength training program. I would highly recommend exercise to relieve symptoms if the patient is able to do them

February 23, 2014 at 11:19 am
(31) Kevin Cavanaugh says:

Im otherwise a fit person when symptoms dissipate I bike and lift but Im always exhaustedand when I begin to feel spasm in lower left back I know its going to spread throughout my body.It takes many days to alleviate and stretching or minor exercise seems to bring no relief.I know caffeine is like poison to me but struggle to stay away from it being so tired.I have no insurance and Im becoming desperateand very depressed.

February 23, 2014 at 2:11 pm
(32) Kathe says:

Kevin (31), run, don’t walk, to your city or county health clinic and discuss the depression -TODAY! Depression can exacerbate pain, spasms, and other symptoms. I don’t know how much help they will be for you, but it’s better than nothing! Also, sign up for national health care. Look for help wherever you can because it’s out there. Also, are therapy groups that can help you deal with with pain andn depression. Don’t give up!

March 12, 2014 at 7:43 am
(33) Michelle says:

I have not been diagnosed with fibromyalgia although with the muscle spasms getting worse I fear that diagnoses will be coming soon. I started with cramping legs and feet. A charlie horse pain in calf along with one in the arch of my foot. It is so tight my toes look deformed. Now I’m having it in most of my body, hands, neck, back legs and feet. Worse at night which I think is due to constant tightness that causes me to stretch and then I spasm and wake up screaming! I HAVE been diagnosed with myligia, spinal stenosis, degenerative disc disease, bulging disc…. also have bp1, a.d.d, ocd and major depressive disorder. I feel like I don’t get any rest due to spasms and am tired all day even with the amphetamines I take for a.d.d. For back problems and spasms I take baclofen (muscle relaxer) klonopin and and sinemet. Which is prescribed for Parkinson’s. Nothing helps. I have had many steroid inj. And nerves burnt. My pain management doctor only prescribes me 5 mg of Norco a day, believing that I will be able to know if treatment is working or not by the amount of pain I’m in. Anyway sorry for being so long winded. I was wondering if anyone else has similar symptoms and if you think it sounds like fibromyalgia

March 20, 2014 at 11:07 pm
(34) Gina says:

Most of what you people are describing sounds like Dystonia. I have it and what you need is to see a Neurologist specializing in movement disorders. It is a living hell!

March 22, 2014 at 7:10 pm
(35) Jacqueline says:

I suffered with spasms in my back on and off for a few years and there wasn’t much that really helped. Then I discovered Bowen therapy, it’s a cure for this, whenever I had these spasms the Bowen therapy got rid of them, if not immediately, they were gone by the next day. No chiropractor or physio could ever achieve that result. The spasms gradually diminished altogether, now I can’t remember when I last had one.

March 28, 2014 at 2:43 am
(36) sarah says:

33 michelle..I can`t say for certain if your symptoms are due to fibro ,but a lot of them are the same as mne ,and I`ve been diagnosed with FMS now for 15 yrs.When I was first seen by a dr ,I was lucky ,as he knew a lot about fibro ,and the various symptoms.
Mine began with swelling and really tender “spots” ,but I`ve had nasty painful bouts of cramping in my legs (calves and thighs ,and back).Oh I also have DDD and RA.
Recently my FMS has been not so much “flaring” ,as constant.The cramps are back with a vengeance ,and boy are they painful:(
I rarely sleep more than an hour or two ,and then only with plenty of meds (Zomorph/valium).I`m severely allergic to all anti inflammatorys ,and am set to pull my hair out.Also ,again ,sorry if this is TMI ,but if I try and go to the bathroom ,the leg/back pain is excrutiating!
What does everyone else recommend for this ,it`s the most painful FMS symptom I`ve had ,and the most debilitating.
My heart goes out to you all ,and Michelle ,ask for a proper dxsis.It helps stop some of the stress (worrying about diff symptoms) ,and may just get u the right help/support and meds.This condition is often described as “Invisible”..well ,with all this pain and cramping ,I`d hardly call it invisible now ,as I`m always being told I look pale ,and am in in pain?>I guess the one positive thing is FMS is a recognised disability and u can claim.Not what we`d choose I`m sure ,but it helps financially when so many of us are declared unfit/unable to work anymore.*Hugs*..me thinks we all could use some!x

April 11, 2014 at 7:58 pm
(37) Teresa Epley says:

I have suffered with muscle spasms and charlie horses for several years now. Also have been diagnosed with Fibromyalgia by my Doctors. I do drink tonic water daily it helps a lot, however I have a “tonic” I have discovered and I will not go with out it. If you will google “How to stop leg cramps in about a minute” you will see a hugh improvement and will discover quick re-leaf. I do not have any marketing connection with this product, I have just stumbled upon it ordered it, and now I have to have it! Best of Blessings to you all whom suffer with this disorder.

April 22, 2014 at 2:16 am
(38) Faye says:

I have muscle cramps in rib cage,stomack,legs,hands,fingers,arms,toesfor a very long time. The only thing I do is get up and stand beside my bed & put pressure on ft. or leg until I get relief. Sometimes it is in my ankle & I have to move my feet back & forth to get relief. I will be seeing my Dr. next week to see he can help me figure out what can give me some relief. The ones in my stomack are very painful all I can do is strech the muscle out. So very sore after it has relaxed. I will take in consideration all that I have read on this blog tonite.

April 25, 2014 at 1:04 pm
(39) vonnie aldrete says:

Muscle spasms everywhere were one of my first signs of fibro, although not diagnosed till several yrs later. Spasms were so bad I ended up in
ER. Cat scan revealed all muscles were inflamed but they did not know why. Once diagnosed yrs later due to other symptoms, I finally realized these were all part of fibro. I continue to get these today, sometimes very severe throughout body. Anything can trigger them. I am limited to what I can take in meds and supps due to heart condition. Guess I will always have to suffer from these.

May 16, 2014 at 9:21 am
(40) George says:

2010 April 3rd – Hit by Mini-Van while on bicycle, he was going about 45 mph. Got lucky he didn’t run me completely over, instead flew threw the air with bike and hit another car 45+ feet away.

Up to 2012 – Things were healing as expected, until things got around to my spine and shoulder, which didn’t hurt up to that point.

After mid 2012 – Have been in extreme pain dealing with muscles and tendons in NECK, RIGHT SHOULDER, SPINE.

Symptoms: Tightness everywhere, Dull penetrating pain in shoulder which was extremely aggravated due to caffeine (after two years just figured that one out.). Joints everywhere would crack and pop due to overall body tightness. Would wake up every morning and feel like someone hit my mid spine with a baseball bat. Heart palps. Strange feeling from armpit to armpit when laying down before sleep. Armpits stinging. Rib cage felt as if it was crushing my lungs. Most major symptoms were from lower rib cage and above. Neck was so tight that I couldn’t bend my neck without pain. Appetite was weird and I felt like my body was not digesting things properly. Constantly depressed due to pain and more pain. Mind was full of anxiety and couldn’t think or concentrate. I’ve gained 40 lbs in a year and a half from being pretty fit.

At this point I have tried every supplement and vitamin known to man with no success until two days ago. Even CoQ10 with little success. I am 44 years old.

Two things that got me back to normal: I cut out caffeine from my diet by 90% and started taking UBIQUINOL 100 MG twice a day. The effect with the UBIQUINOL was immediate and amazing. The first day of taking it made me extremely fatigued. By the second day I was back to my old self. I have NO clue what was wrong with me, I’ve been to several specialist to no avail, hence me trying to find a solution for myself. It looks like I might have found it.

Just wanted to share my story with others after 2 1/2 years of frustration and depression from intense pain.

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