#Muscle #Fatigue and #fibromyalgia

We know that fibromyalgia pain isn't in the muscles but rather in pain dysfunction in the brain... and indications in new research suggesting possibly in small fiber neuropathy as well (which is an intriguing line of research to be sure). But what about muscle fatigue?

I know that some of our muscle fatigue must come from inactivity. We are told to exercise and like most people who are inactive... not all those muscles are used to that much activity, or the sort of exercises we might be trying. But clearly it isn't all due to that. I know in my case it has Always been the case, since I was quite young. I just lacked muscle endurance. They fatigued very quickly. I Could lift something. I had the Capacity to do so. My muscles could handle it. But... not for very long. They would tremble and shake, almost immediately and I would have to put it down... or drop it. In fact, I know from experience if something weighs a certain amount I have to lift it a certain way so that when this happens I will not drop it. This is to the extent that some of us have problems holding our arms above our heads for short periods of time... the strength is just sapped right out of the damn things right away. If our Muscles are fine, why is this?

I had always assumed it had something to do with fatigue to be honest. I didn't get why my muscles would just crap out so suddenly when there was nothing physically wrong with them. Even when I was consistently, if mildly, exercising. Made no difference in this jelly weakness issue.

One study suggests it is a brain issue as well... and maybe that is why we get this. Perhaps not the only reason. I mean if there is a neuropathy issue I expect it is more complicated than this. And I expect lack of mobility in severe cases makes this a great deal more complicated. But this might be a component to it. It does make partial sense because no matter how much you do... this issue never goes away.

"Abstract
Objective To investigate relationships between perceived and objectively measured muscle fatigue during exhausting muscle contractions in women with fibromyalgia (FM) compared with healthy controls (HC).
Methods Women with FM and HC completed an isometric muscle exhaustion task at 90° shoulder abduction. Surface electromyographic (EMG) activity in the deltoid muscle was recorded together with self-reported level of muscle fatigue.
Results 25 participants with FM and 23 HC were included. Average time to exhaustion was 254 s shorter in participants with FM than in HC. Participants with FM did not exhibit the same level of objective signs of muscle fatigue, seen as fewer changes in the EMG activity, as the HC during the exhaustion task. The task did not provoke pain in the HC, while participants with FM reported a doubling of pain.
Conclusions Women with FM had shorter exhaustion times and showed fewer objective signs of muscle fatigue during an exhausting isometric shoulder abduction compared with younger HC. This indicates that perceived muscle fatigue may be of central origin and supports the notion of central nervous dysfunction as basic pathological changes in FM" Ann Rheum Dis
So that is an interesting small study that suggests it is central nervous system dysfunction... which does fit in line with the FM MO really.


What can we do about this though? Other than know that certain limitations on lifting are an issue obviously. It is difficult I know for just general chores. And exercising. So basically what I have learned to 'get around' this is essentially break it up. You cannot exercise in large chunks of time I find when you are exercising areas of the body that involve this muscle fatigue and endurance issues... it feels like you have utterly exhausted yourself, even though you really have not. So I find I just exercise in small chunks. I reach that point, take a break, then do more later. And I get in my half hour or whatever, through the day. The exact same with housecleaning... except some things, like washing the bathtub apparently are a marathon freaking event that also cause a great deal of pain the next day. But such is life with FM. Nevertheless, we can accomplish more if we segment it up.

I do find repetitive motions with my arms absolutely draining though. Have to keep switching hands. And also the pain cannot be underestimated there. And can lead to that nasty chestwall pain. So I always had trouble with any job that required any kind of repetitive lifting, actions, heavy lifting... so you know, anything other than a desk job. And also always regret washing walls and the bathtub and so forth. My arms are just weak limp noodles really.

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