Fibromyalgia (FM) management can be as difficult as making a definitive diagnosis. FM is characterized by generalized body aches and feeling exhausted, and yet, in spite of the exhaustion, the inability to sleep is a “classic” FM complaint. FM sufferers, as well as the caregivers, know how physically and mentally difficult it is to manage this controversial condition. Many management strategies that have been published and SHINE is one approach. SHINE stands for Sleep, Hormones, Infections, Nutritional supplements, and Exercise. By focusing treatment strategies on these five areas, significant benefits can be achieved.

SLEEP: Some feel this is the most important problem to manage in order to gain control of FM. If we cannot reach “deep sleep” (which is the sleep stage that is usually reached after about the 4th hour into sleep), then the body cannot fully rest. When discussing sleep problems with the FM patient, it is common to hear them say, “…I wake up every 1-2 hours and can’t get back to sleep for at least 15-30 minutes.” This results in NEVER getting to the deep sleep stage and eventually, because the body hasn’t fully relaxed often for years, everything starts hurting. This is the hallmark of FM. Some “tips” to help us get to sleep and stay sleeping include: keeping the bedroom cool (such as 65° F or ~18° C), taking a hot bath before sleep to relax your tight muscles, spraying the pillow with lavender oil (helps promote sleep), and taking 75-150 mg of magnesium, avoiding caffeine (especially later in the day). Taking valarian root (a muscle relaxing herb) and/or melatonin (an amino acid that promotes sleep) can also help. The goal is to try to get 8-9 hours of sleep a night. Establish a routine in the evenings and go to bed at the same time or close to it.

HORMONES: These chemicals are produced by our endocrine glands (pituitary, thyroid, parathyroid, adrenals, ovaries/testes, and part of our pancreas). Normally, they are in balance with each other and somehow in the FM patient they often fall out of balance. Have your healthcare provider perform tests (usually blood and/or urine) to determine your hormone levels and get them balanced!

INFECTION: The lack of sleep lowers our immune function, and infections can occur more readily. In addition to treatments, there are nutritionally based approaches to improve immune function, and if recurrent illnesses are part of your FM profile PLEASE consult with your doctor regarding ways to boost your immune system!

NUTRITIONAL SUPPLEMENTS: This topic is related to the last as there are MANY supplement recommendations that have been found to boost immune function, increase energy, enhance sleep quality, and more. This is an area of FM management that is largely overlooked by traditional medical management approaches. Remember, a “team” of providers offers the FM sufferer the best way to manage this challenging to treat condition. Look for healthcare providers who are willing to work together as a team on your behalf.

EXERCISE: This is a MUST! For example, in a 2010 Oregon Health & Sciences University study, women with FM who practiced yoga for 8 weeks had a 24% pain reduction, 30% fatigue reduction, and 42% depression reduction when compared with FM patients in a control group who did not do yoga.