Muscle ache

Summary
In building the best internal environment for reducing chronic muscle pain it is important to have a healthy diet with enough fibre (roughage), vitamins and minerals. This means eating plenty of fruit and vegetables and unprocessed cereals. 

The NHS Eatwell Guide shows that to have a healthy, balanced diet, people should try to:

• eat at least 5 portions of a variety of fruit and vegetables every day (see 5 A Day)
• base meals on higher fibre starchy foods like potatoes, bread, rice or pasta
• have some dairy or dairy alternatives (such as soya drinks)
• eat some beans, pulses, fish, eggs, meat and other protein
• choose unsaturated oils and spreads, and eat them in small amounts
• drink plenty of fluids (at least 6 to 8 glasses a day)

If you’re having foods and drinks that are high in fat, salt and sugar, have these less often and in small amounts.

Try to choose a variety of different foods from the 5 main food groups to get a wide range of nutrients.

Summary
If your muscle pains are stopping you sleeping, you are likely to feel tired during the day. And when you feel tired it’s tempting to reach for stimulating drinks such as tea, coffee, colas or so-called ‘energy drinks’. They can give you a quick lift, but if you rely on them they will only keep you going until your energy stores run down further. They may even exacerbate the hypervigilance often associated with chronic muscle pain. And they will stop you sleeping well.

Evidence
There is very little research on the effects of limiting caffeine on muscle pain.

Safety
If you are cutting down on large amounts of caffeine, headaches might be a problem for two or three days. It is better to reduce the amount of caffeine slowly over a few days.

Cost
here are no costs. In fact you will save money.

Summary
Cutting down on alcohol and stopping smoking are likely to improve your health generally. Like caffeine, alcohol can affect the quality of your sleep and make anxiety and low mood worse.

Moderate drinking means no more than two drinks a day for men and one drink a day for women. A unit of alcohol is half a pint of ordinary strength beer, lager or cider or a small pub measure (25 ml) of spirits or a standard pub measure (50 ml) of fortified wine such as sherry or port (20% alcohol by volume). A small (125ml) glass of basic wine is 1 and a 1/2 units.

Evidence
There is very little research on the effects on muscle pain of limiting alcohol. There have been studies into the effects of smoking but they have found different results.

Safety
Cutting down on smoking and alcohol is safe, but if you are cutting down from heavy use, there can be side effects including loss of appetite and difficulty sleeping. There are unlikely to be side effects if you are cutting down a moderate alcohol intake but if you are a very heavy drinker, it is better to get help with cutting down.

Cost
No costs are involved and think of the money you will save!

Further information
For more information, see the NHS information sensible drinking.

If you are giving up or cutting down on smoking you can order a Quit Kit from SmokefreeNHS. You can also phone the NHS Free Smoking Helpline on 0800 022 4332.

Summary
Moderate exercise and getting fitter are generally good for everyone, but if you have been avoiding exercise because you feel sore, you will need to increase your physical exercise quite slowly and gradually. The important thing is to pace yourself and know when to stop. Remember that exercise should not hurt much, though you might feel a bit achy at first. If it hurts much, stop and build up your fitness more gradually. If you have aching muscles you should not tackle anything that will make you feel more sore.

Exercise can include aerobics such as cycling, stepping and walking, strengthening exercises such as lifting weights or using resistance machines, and stretching for flexibility.

Evidence
There is good evidence that regular moderate aerobic exercise for 12 weeks can help with well-being and ease stiffness. But it doesn’t seem to help with pain or reduce the number of tender points.

Safety
Aerobic exercise training should be started rather slowly, because it’s likely your symptoms will feel worse at first, especially if you haven’t done much exercise for a while. If in doubt, check with a healthcare professional.

Anyone with severe osteoporosis, joint problems, acute back pain or recent injuries should first get advice about exercise from a doctor or physiotherapist.

Cost
You can exercise at home for nothing, remember walking and gardening are both forms of exercise. There will probably be a small cost, if you join an organised programme.

Further information
Natural England is one of several organisations that organise walking schemes designed to help people improve their health. Walk4Life Programme has about 600 local groups, and around 40,000 people take part in short local walks every week. Find out about Green Gyms where volunteers take on voluntary projects outdoors. Many local councils organise Health Walks for people who want to get active in company.

Check your local leisure centre for exercise classes. See also the Classes section for more information.

Summary
Meditation is a state of mind, not a religion, though it features in most major religions, especially Eastern ones. Meditation seems to harmonise the activity between the two sides of the frontal brain, and encourages a ‘relaxation response’. The relaxation response happens when the body and mind do the opposite of what they do when you feel stressed. In meditation the body is relaxed while the mind is alert. You don’t need an experienced teacher or a spiritual faith in order to take up meditation. You can learn the basics from a book or a podcast. Meditation is easily accessible, and it is remarkably effective, both for rapid stress reduction and as a way of promoting long-term health.

Evidence
Meditation may help with your health generally but not enough studies have looked at whether meditation specifically helps with FMS pain.

Safety
There are generally no safety problems with meditation unless you have a severe or long-standing mental health problem.

Cost
Meditation involves certain (simple) techniques that can be easily practised at home. There are many books and audio aids available and some people find it useful to join a class initially.

Summary
Progressive muscular relaxation works by tensing and relaxing various muscle groups in your body, starting from your feet and working your way up. At each level, try to notice how it feels when your muscles are tense, and how it feels when you let go and relax. Gradually you will get used to the feeling of relaxation and learn how to make it happen at will. As with most relaxation methods, you need to start by finding a quiet, relaxing place to practise. Get yourself in a comfortable position, sitting or lying, and start by allowing your out-breath to get softer, longer and deeper.

Evidence
Some studies have found that progressive muscular relaxation and visualisation (using pleasant images) can help people to cope with pain.

Safety
Relaxation techniques are generally safe unless you have a severe or long-standing mental health problem (see our section on Stress and Anxiety).

Cost
Progressive muscular relaxation can be learned from a book, CD, DVD or during exercise classes such as yoga classes (go to ‘Go see someone’ in this section for more information). No costs are involved, although you may need to buy a CD, DVD or book.

Summary
Everyone’s body is unique, and eating more, or less, of a particular food can sometimes help with painful conditions. Keeping a food diary should help you to find out whether certain foods make your symptoms worse. Write down what you eat and make a note of how you feel a up to a day afterwards, bearing in mind that the effects of food might be felt some time after you’ve eaten them.

However if you have long-term low energy the priority is to make sure you are getting the nutrients you need. Sometimes the main challenge is to make food palatable and attractive: a good cook in the house can make all the difference.

Evidence
There have been some small studies on the effects of vegetarian, vegan, raw food and Mediterranean diets in people with fibromyalgia. Although these diets didn’t help everyone, the research suggested that some people might benefit at least in the short term from a diet low in animal protein or a raw food diet.

Safety
Health warning: be careful of special diets in magazines and online! It can be quite difficult to exclude certain foods and still have a balanced diet. If you want to make big changes to what you eat, it is a good idea to see a qualified health professional like a dietician or well trained nutritionist. They can help you make sure you are still eating a healthy diet and getting all the nutrients you need.

Cost
Eating a healthy diet and excluding some foods need not cost you anything. But if you consult a professional there will be a charge, unless this is a service provided by your GP’s practice.