The Hindu Business Line : Relax those muscles

If you have gnawing painful muscles that leave you stiff and tired in the morning, it could be fibromyalgia. Relax... and that would be a good first-aid.

What do you do if you develop painful muscles and their burning ache persists, spreading through your body as if you've picked up a permanent flu bug?

It gets more worrisome when it wakes you up. It's a searing, gnawing sensation that leaves you stiff and tired in the morning. An increasingly despondent Sujata has consulted several doctors with no diagnosis. Jerry Branium, science editor, Muscle & Fitness magazine, says such persistent symptoms need a joint specialist. "The specialist presses 18 sensitive points all over the body — upper back, head, thighs, abdomen, hips, base of the skull, the shoulder blades, etc. When pain exists in at least 11 of the 18 points, it's fibromyalgia," says Branium.

`Fibro' indicates muscle-fibre. Microscopic studies reveal that it's a slackening of Type II fibre muscles. These muscles help us lift weights. Which could explain why Sujata finds even lifting a pen painful. "It's frightening," she says.

Though it sounds daunting, fibromyalgia is neither a disease nor is it terminal. So, "don't perceive yourself as disabled," says Branium. On the same lines, "Most people make a full recovery though in some cases, the symptoms recur," states The American College of Physicians' Complete Home Medical Guide.

Researchers say fibromyalgia sufferers place excessive value on achievement and success and keep themselves under constant, tense dissatisfaction. This relentless pressure keeps the muscles contracted... even when they sleep. With their mind carrying on a continuous dialogue, these uneasy sleepers wake up frequently at night or remain half-awake. This is significant because they do not spend sufficient time in stage four or slow-wave sleep when maximum muscle-tissue restoration occurs. At this vital stage, when the muscle should be relaxed enough for cellular amino acid uptake and protein synthesis, it is contracted and closed. This all-night strain on the tendon causes pain. And over the years, the undernourished muscle-fibre loses its tone, resulting in fibromyalgia.

Vacation in your mind

The first step towards healing is to understand how the muscle-tone has weakened, and recognise the role your attitude has played in the process. Don't underestimate or ignore your attitude. It's living and sleeping on a roller coaster with jaw clenched, to paraphrase New York-based Dr Paul J. Rosch, president, American Institute of Stress. Let this awareness flash through you so that you put your health first, well above your preoccupation with perfection.

To get off the roller coaster onto solid healing ground, yoga has a splendid evening exercise called `reflection'. Reflect over 10 good things that have happened over the day without editorialising on how they could have been better. Open hearted reflection relaxes the mind and, hence, the body.

Then, before sleeping, "take a mini-vacation in your mind," advises Dr Ronald Nathan, co-ordinator, behavioural science, Albany Medical College, New York. "Visualise yourself lying in warm sand on a beach, a cool wind blowing in off the ocean, the surf rolling in quietly in the background. It's amazing what this can do to relax you." In this state of mind, gently rub balm on painful spots, lie down, and drift into sleep in the warmth induced by the balm. Sujata has found these techniques very effective.

Branium also suggests ultrasound treatment. Here, high-energy sound waves create heat and help ease pain, particularly in soft tissues of the muscles. The attendant applies gel to the skin and places an ultrasound probe on the painful areas. After the treatment, a slight tingling in the spots replaces the pain.

Sometimes, if the patient is absolutely despondent, the doctor may prescribe a muscle-relaxant or even an anti-depressant. The idea is to reach and remain in the slow-wave stage-four sleep long enough for the muscle-restoration to take its healing course.

`Exorcise' that ache

Then there is the fitness aspect that cannot be ignored. Most people suffering from body-aches loathe exercising. It feels like adding on more pain, they say. However, the fact remains that their poor muscle-tone hinders their muscles from being nourished by oxygen and nutrients. This lowers their energy. So, while exercising is a must, the key words here are `moderate' and `gradual'. Exercise up to a point where you feel fresh and relaxed, and stop when you're on top.

The best oxygen-carrying exercises for fibromyalgia are non-weight bearing ones such as swimming and stationary cycling. Light weights of two-and-a-half pounds are fine for strengthening muscles. Avoid exercises that have you bending your elbows to lower weights (called negative contraction exercises). Do weight-training where your arms and elbows remain straight. And pay special attention to the stretch, holding it a few seconds to feel good. Finally, exercise to the degree where you feel drowsy in the night and realise it's your afternoon workout session that's caused it. You can be sure that the quality of your sleep will be deeper and more relaxed — which is exactly what you need. And, never exercise in the evening — it stimulates and keeps your body `awake' at night. An afternoon session is best for you.

The writer is co-author of the book, `Fitness for Life'.

Picture courtesy: Ananda in the Himalayas.

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