Fibromyalgia syndrome is a chronic disorder that affects 3-6 million people in the United States. Symptoms include: fatigue, widespread muscle pain, and multiple tender points. The word fibromyalgia comes from the Latin word for fibrous tissue (fibro) and the Greek words for muscle (myo) and pain (algia). It is unknown why, but more than 90% of those who develop fibromyalgia are women. It is speculated that the predominance of women who suffer from the disorder is a phenomenon of the socialization of women in American culture or perhaps some combination of female reproductive hormones and other genetic predispositions.
fibromyalgia is defined, according to the American College of Rheumatology (ACR), as a history of pain in all four quadrants of the body lasting more than 3 months. Pain in all four quadrants means that you have pain above and below the waist, as well as in both your right and left sides. According to the ACR, there are 18 characteristic tender points on the body that are associated with fibromyalgia. A person must have 11 or more tender points In order to be diagnosed with fibromyalgia. Additional symptoms that people with fibromyalgia may experience are:
irritable bowel syndrome
painful menstrual periods
numbness or tingling of the extremities
restless legs syndrome
cognitive and memory problems (sometimes referred to as “fibro fog”)
Fibromyalgia can be confused with another condition called “myofascial pain syndrome” or “myofascitis.” Both disorders tend to have similar tender point locations and can cause pain in all four quadrants of the body, but the two conditions are vastly different. Fibromyalgia is caused by a stress-induced change in metabolism and healing, while myofascitis is an inflammatory condition caused by overuse or injury to your muscles. Myofascitis tends to be sudden onset and is commonly associated with a particular activity or injury, true fibromyalgia has sets in over time, usually beginning in early adulthood. Both conditions require very different treatments, so a proper diagnosis is important. Although it won’t cause damage to your joints, muscles, or internal organs, fibromyalgia is, unfortunately, a chronic condition, lasting a long time – possibly a lifetime.
The Basics of Fibromyalgia
Current research indicates that fibromyalgia is a stress-related condition and cousin to Systemic Lupus Erythematosis (often referred to as simply ‘lupus’) and Chronic Fatigue Syndrome. All three conditions share many similarities such as a predominantly female distribution, chronic fatigue, sleep disturbances, irritable bowel, and more. All three of these conditions are the results of an abnormal stress response in the body, but with different results. On continuum together, Fibromyalgia would be on one end, Lupus on the other and Chronic Fatigue Syndrome in the middle. Lupus primarily affects the immune system, causing an autoimmune response that attacks healthy tissues. Fibromyalgia primarily presents with metabolic abnormalities as the result of a stress-induced decrease in blood flow to an area of the brain called the pituitary. This, in turn causes a decrease in a number of important hormones, including the the thyroid stimulating hormone and growth hormone releasing hormone (somatotropin). These hormonal changes lead to memory and cognitive changes, abnormal muscle healing and borderline or full-blown hypothyroid.
One of the major physical abnormalities that occurs with fibromyalgia is a build up of a protein called “Ground Substance’ in the muscle. Ground substance is normally found in muscle, bone and connective tissue all over the body and is responsible for making tissues stronger and less susceptible to tearing. In a normal person’s injured muscle tissue is able to completely heal itself. In a person with fibromyalgia, the muscle is unable to completely heal, and instead, builds up an abnormally large amount of ground substance in the injured area. The ground substance, combined with local muscle spasm, creates the muscle ‘knots’ associated with fibromyalgia.
Unlike its cousin lupus, there are currently no diagnostic laboratory tests for fibromyalgia. An examination can reveal whether a person has the characteristic tender areas on the back of the neck, shoulders, sternum, lower back, hips, shins, elbows, or knees, and a number of tests may be done to rule out other disorders. Due to the lack of clinical tests for fibromyalgia, some doctors conclude that a patient’s pain is not real, or that there is little they can do to treat it. Fortunately, it has been proven to be very effective to treat fibromyalgia with lifestyle changes and a combination of chiropractic, trigger point therapy to decrease the severity and duration of the physical pain and disability of fibromyalgia.
Not all doctors are familiar with fibromyalgia and its treatment, so it is important to find a doctor who is. Fibromyalgia can be difficult to treat and treatment often requires a team approach, utilizing chiropractic care, trigger point therapy, massage, dietary changes, as well as exercises and stretching.
Treating Fibromyalgia With Chiropractic
Because fibromyalgia causes the muscles to tighten up and lose some of their natural pliability, it results in an overall loss of movement in the spine. Chiropractic care is essential for those suffering from fibromyalgia by keeping movement in the spine, otherwise a neurological reflex causes the muscles to tighten further. Otherwise, over time this vicious cycle will lead to increased pain, increased muscle tightness, a loss of movement, more difficulty sleeping and the development of more and more trigger points.
It is not uncommon for sufferers of fibromyalgia to be adjusted three to four times a month, as the only way to combat the loss of movement in the spine is to keep it moving. Because fibromyalgia causes muscles to heal at a diminished rate, chiropractic adjustments are usually modified to be gentler than normal, decreasing the stress on the easily injured, smaller supporting muscles of the spine. For proper treatment, it is important to see a chiropractor who is familiar with the muscular changes that occur with fibromyalgia.
Treating Fibromyalgia with Trigger Point Therapy
Long-standing, body-wide pain with defined tender points, and, frequently, trigger points, are the main characteristic of fibromyalgia. People often confuse trigger points and tender points, but they are very different. Trigger points are comprised of spasmed muscle fibers. Trigger points refer pain to other areas of the body and need firm pressure to elicit pain. They can occur in isolation and represent a source of radiating pain even without direct pressure. Tender points, on the other hand, are knots filled with ground substance. They elicit pain under light pressure and do not refer pain to other areas of the body or occur in isolation. Because fibromyalgia patients have both trigger points and tender points, trigger point therapy can dramatically help.
Trigger point therapy for low back or neck pain and headaches mainly varies from trigger point therapy for fibromyalgia in the intensity of the therapy. It is necessary to use less pressure on trigger points on fibromyalgia patients due to the fact that their muscles are easily injured and take longer to heal. Otherwise, the points are the same.
Treating Fibromyalgia with Cold Laser Therapy
To combat the poor healing of muscle tissue and the chronic pain, laser therapy has become an important aspect of fibromyalgia treatment. The cold laser therapy stimulates healing in tissue and decreases sensations of pain.
A study published in Rheumatology International in 2002 found that with laser therapy, many patients had significant improvement in their pain symptoms, and reduced fatigue and morning stiffness. A previous 1997 study in the Journal of Clinical Laser Medicine and Surgery reported that, out of the 846 participants in the study, two-thirds experienced an improvement in symptoms with cold laser therapy.
Self-Care for Fibromyalgia
Your daily lifestyle choices affect how much of an impact fibromyalgia will have on your life. Those who take care of themselves are able to remain more active and have a higher quality of life than those who choose not to. Here are some helpful daily care routines that you can use to help improve your life with fibromyalgia:
Getting sufficient amounts of sleep
Because people with fibromyalgia often have pain, restless leg syndrome, and brain-wave irregularities, it can sometimes be difficult to get enough restful sleep. We don’t typically recommend taking prescription drugs, but taking 5-hydroxytrytophan (5-HTP) and the prescription anti-depressant amitriptyline have been proven to be helpful in achieving a healing sleep. Alcohol, although sometimes relaxing, is shown to interfere with restful sleep, and is therefore not recommended before bed.
Starting slowly with low impact exercises like walking and swimming can help stretch and mobilize tight, sore muscles. It may be difficult to start at first, as pain and fatigue make exercise harder, but studies have shown that fibromyalgia symptoms can be relieved with aerobic exercise. Always be mindful of your body, as high-impact aerobics can increase discomfort, but overall, the more you exercise, the more improvement you will feel.
Making changes at work
While many people with fibromyalgia are able to continue working, they may need to make changes around their office or job to suit their needs. These changes might be as simple as getting a specifically designed office chair or adjustable desk or as big as reducing hours or finding a job that will allow for a flexible schedule. Your employer may be able to work with you to adapt your work conditions and help you keep your job.
Eating healthy can also reduce bodily stress and help your body heal. Avoid foods that contain: dairy, eggs, wheat, corn, as well as foods containing MSG, nitrates and nitrites. Certain environmental toxins that can contribute to bodily stress can also be found in fish, so it is suggested that it also be avoided. Sticking to clean, organically grown, fresh foods will improve your health. Consume whole foods such as: legumes, brown rice, spelt, rice milk, soy, nuts, berries, and hormone-free chicken or turkey.
While some people have had good results with magnesium malate, ginkgo biloba, and various other herbal remedies, there is no supplement to date that has proven to work for everyone. While we do not discourage the use of supplements, there has been no proof of long term benefit by taking them. If you come across a supplement that you wish to try, make sure to consult your chiropractor first, just to ensure it will not interfere with other aspects of your treatment. Contact us today!