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Fibronomics: a new way of thinking for Fibromyalgia

Mark J. Pellegrino MD

Rules to live by!  There are specific ways to move your body that will minimize pain and discomfort.  As a physician who treats patients with fibromyalgia and has the illness himself, I have observed and studied this condition for many years.  As a result of this work, I have introduced a new term:  Fibronomics.  Fibronomics defines a set of rules that can help enormously in maintaining a posture that makes us feel our best.  You can think of Fibronomics as the art of properly manipulating our fibromyalgia bodies in the environment to enable pain-free, completion of our everyday activities.

The basic rules of Fibronomics are:
1.  Arms stay at home.
2.  Unload the back.
3.  Support always welcome.
4.  Be naturally shifty

Rule 1:  Arms stay home

Fibrmyalgia muscles in the neck, shoulders and upper back areas do not appreciate activities that involve reading or overhead use of the arms. Isometric contractions where muscles stay contracted continuously causes decreased oxygen in the muscle, and increased pain.  Any time the arms are away from the body, the trapezial, scapular, shoulder, and upper back muscles all go into Isometric contractions which usually results in increased pain even after only a few seconds of the offending activity.  Because we are focusing attention on our hands and on whatever objects we are reaching for or working on, we may not notice the early discomfort signals arising out our neck, shoulders and upper back until it is too late.

The favored position for our arms is at the sides and below the shoulders, with elbows touching our sides and bent at the 90 degree angle.  We should try to maintain this position to the point where we move our whole body, not just our arms to confront each specific task.  Arms stay home (with the rest of our body) and do not reach away.

Rule 2:  Unload the back

There are multiple internal and external muscles that must be equally balanced to maintain proper alignment of the lower back and pelvic areas.  If anything causes a shift in this alignment, the mechanical imbalance and subsequent misalignment can result in pain.  Any activities that tend to increase the load on the back - such as bending forward, prolonged standing, bending at the waist to pick up an object, or arching the back - should be avoided to help lessen the chance of unwanted pain.

By unloading our backs, we can avoid the offending positions in the first place.  For example, flexing our hip by putting one foot on a stool is an excellent way to unload the back when we are standing.

Crossing our legs, or putting our feet up on a foot rest unloads the back when we are seated.  Lying in the fetal positions to sleep will unload our back, and placing a pillow between the knees is especially effective at taking pressure off the hips and sacroiliac regions. 

 Rule 3:  Support always welcome

When we hold our bodies in unnatural or awkward positions, we put more strain on our joints and soft tissues.  Pain-inducing positions include:

Head turned to the side or looking up

Arms outstretched or overhead

Elbows away from the body

Wrists bent

Palms up

Leaning forward

Bending We can't always avoid putting our bodies in these positions.  to decrease the painful effects, take advantage of existing structures in our environment to relieve some of the force on our bodies.  We can support our back by sitting in a chair with a good seat and back, leaning against a wall or other object, and wearing a back brace.  We can support our arms on chair rests, tables, our laps or stomachs, or by using one arm to support the other.

The days are long, and our muscles work hard to support us and get us from one place to another.  When we have fibromyalgia, our muscles hurt before they become noticeably tired.  It's okay to use extra support to relieve our muscles whenever we can 

Rule 4:  Be Naturally Shifty

This rule emphasizes maintaining natural or neutral body and joint positions, but at the same time periodically moving the muscles around and shifting them.  Keeping our muscles moving is one way to avoid the painful tightening and spasms that occur when we are in one position for too long.  We must learn to automatically alternate between various positions such as sitting, standing, and walking to relax and stretch the various muscle groups regularly.

Our head position needs to be shifted frequently as well, If we spend too much time looking up or down, or to one side or the other for long periods of time, our neck pain will increase.

Examples of Using Fibronomics

To avoid pain-inducing behavior when performing your daily activities, here are some examples of applying Fibronomics.

1. Reaching up to change a light bulb.

Use a stable stool or ladder to stand on and get closer to the light fixture.  Support your arm with your other hand at your elbow while turning the bulb.

2.  Prolonged driving:

For part of the time, keep you hands at 10:00 and 2:00 positions on the steering wheels.  After a while, shift your hands to the 4:00 and 8:00 positions.  Use armrests, and move your seat slightly closer to the steering wheel.

3.  Washing dishes:

Keep your back straight and elevate on leg on a stool.  Use sponges and scrubbers with long handles

4.  Applying makeup:

Don't tilt your head back to use a wall mirror.  Instead, place a magnifying mirror on a counter top or dresser.

5. Reading and studying:

Prop your book on your desk or table so you are holding your head in a more comfortable position.  Cross and recross your legs periodically.  Set a timer to remind you to alternate positions at least every thirty minutes.  Move from a chair at your desk to another char in your office.  If you're at home, lie down on a couch with a pillow propped behind your head.

6.  Standing up from a lying-down position:

Use a "log roll"  technique.  Roll on your side then curl your legs so your knees come forward and over the edge of the bed or couch.  Use your arms to push yourself to a sitting position while swinging your legs off the edge.

Use the rules of Fibronomics to examine everything you do in your day.  First determine why an activity may be causing pain by identifying the Fibronomics rule that are being violated.  Then analyze how you can correct the violations and practice new strategies until they become automatic.  Keep these in mind, so you don't have the Fibropolice ticketing you for repeated violations!

Mark J. Pellegrino, M.D. is a physical medicine specialist in Canton, Ohio, who focuses his practice on treating patients with fibromyalgia. The above excerpt is from Dr. Pellegrino's new book, "The Fibromyalgia Survivor. " For more, information, call Anadem Publishing, Inc., Columbus, Ohio at 1-800-633-0055.

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