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Fibromyalgia.....possible cause of chronic pain
Fibromyalgia is a condition that causes widespread muscle pain, fatigue, poor sleep, headaches and mood changes. Though there is no conclusive cause or cure it is thought by some French researchers that it may be linked to the way the brain interprets pain through research with Single Photon Emission Computed Tomography (SPECT).
People with fibromyalgia will have often experience a collection of symptoms for a considerable amount of time before a diagnosis is made. There is no one diagnostic tool or method of diagnosis due to the nature of the condition, with people having variable or collective symptoms. One common tool to distinguish the muscular component of fibromyalgia from other musculoskeletal complaints is a ‘map’ of tender points.
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In 1990 the American College of Rheumatology developed the tender point exam, which maps 18 specific points on the body that are extremely sensitive in people with fibromyalgia. In order for a diagnosis to be made, a person with fibromyalgia will need to have been experiencing pain in at least 11 of these points. The symptoms will also have been constant, widespread and present for at least three months.
When mild pressure is applied to any of these soft-tissue tender point areas it will usually be experienced as pain which is not the norm. There is heightened skin and muscle sensitivity and reactions to pressure being aberrant. Pressure applied to a ‘tender point’ may also illicit pain in a surrounding area such as pressure to the hip and pain within the leg.
Other collective symptoms of fibromyalgia are fatigue after mild to moderate exertion, poor concentration, poor sleep, mood swings, irritable bowel symptoms, restless leg syndrome, anxiety, headaches and depression.
Fibromyalgia does not have one universal ‘cure’ or symptom alleviator. Therefore people with the condition often try many conventional approaches (eg medication) as well as the more alternative remedies or treatments. The type of medication prescribed will often depend on the GP or consultant. Common drugs would be tricyclic antidepressents, ibuprofen, anticonvulsants (eg pregabalin) and other neuropathic pain medications.
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What about the alternatives?
There is no conclusive evidence to prove that one alternative treatment method works. However research and anecdotal evidence supports modern acupuncture methods as a beneficial treatment method. Acupuncture needles used at precise ‘tender points’ stimulate the muscle and nerve endings creating a response between the brain and pain receptors. This stimulus and response helps the brain control the nervous response to pain.
Other techniques that have been supportive to fibromyalgia are: cognitive behavioural therapy, hypnotherapy, massage, nutritional supplements, myofascial release techniques and Chiropractic. Each will work at a different level aiming to alleviate certain aspects or symptoms of the condition.
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Cognitive behavioural therapy and hypnotherapy, though different in the method, both work on the behavioural and emotional aspect. Cognitive behavioural therapy (CBT) has been shown to be among the most effective non-medication treatments for fibromyalgia. CBT tries to help change the way one thinks about pain with the goal of changing the way the body responds to pain, therefore allowing symptoms and pain to be less severe. Hypnotherapy works at a deeper subconscious level helping the brain and body deal with inherent reactions also helping to change the brains response and reaction to pain. Both of these methods may also help improve sleep quality which can in turn have a positive effect to the condition overall. |
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Massage techniques, though positive are thought to have only a short-term effect on symptoms. The techniques work specifically to alleviate muscle tension, muscle spasm and induce general relaxation. Some might find the sense of relaxation and ease of tension helps combat the associated stress of the condition. |
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Research into the efficacy of certain nutritional supplements is still ongoing. Magnesium and SAM-e are often used to treat fibromyalgia. SAM-e is a naturally occurring compound in our bodies that helps in the production of dopamine and serotonin, which regulate mood and control the pain response. Preliminary research has shown evidence that SAM-e supplements may work to keep symptoms in check, but further study is needed. Magnesium is helpful in hundreds of ways, like converting food into energy, strengthening the immune system and maintaining normal nerve and muscle function” (King yourtotalhealth 2009). |
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Myofascial release techniques aim to help stretch, loosen, lengthen and stimulate connective tissue to ease pain where they may have become chronically taut or shortened. |
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The Chiropractic approach of easing tension or dysfunction within the spine or associated joints may help the corresponding muscles and tender points and ease the sense of pain overall. |
What works for one person may have absolutely minimal effect for the next person. Ultimately people have to find what works for them as research into this chronic condition still continues. Maintaining a healthy diet and lifestyle is always advisable. A balanced diet can help increase your energy levels and reduce the risks of other associated health conditions. Generally more research is needed before experts can identify if specific foods affect the risk of episodes of aggravation. However, many people with fibromyalgia that have avoided certain things, such as caffeine and alcohol have reported a reduction in symptoms.
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Studies have shown that walking, strength training, stretching exercises and swimming in a heated pool can alleviate fibromyalgia symptoms (King yourtotalhealth 2009). Regular exercise appears to enhance the body’s response to stress, which often triggers symptoms. It also improves endocrine function, which helps the body to process pain and regulates sleep patterns more effectively.
As with all exercise regimens, especially if new, it is important to start slowly. Begin with gentle stretching, walking, bicycling or swimming. Create a routine, making it a regular part of your life. Make time for it on your weekly routine. Make use of small opportunities to exercise throughout your day, such as using the stairs instead of the lift. Have fun with it. Where possible, taking part in Yoga, Pilates, strength training, tai chi, bicycling, walking, jogging, low-impact aerobics or swimming are all highly recommended. Mix it up so you won’t get bored.
As with many conditions, pain is a common symptom that is best not ignored. Pain especially is the body’s alert system to a current or potential problem. Always seek medical or further advice if you are not sure about any symptoms you may be experiencing.
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HSA launches new Chiropractic Plan
HSA have worked closely with the British Chiropractic Association to develop a dedicated Chiropractic Plan.
"It's great that a provider is working with the profession to try and enhance the patient experience, and also to encourage patients to visit the chiropractor when they need it, not simply when finances allow."
- Dr. Tony Metcalfe, President of the British Chiropractic Association
For more information click www.hsa.co.uk/chiropractic or call 0800 072 6720
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