Fibromyalgia

The latest research indicates that fibromyalgia is a stress-related condition that is a cousin of Systemic Lupus Erythematosis (often referred to as simply ‘lupus’) and Chronic Fatigue Syndrome. In all three of these conditions, there is the same predominantly female distribution, chronic fatigue, sleep disturbances, irritable bowel, as well as many other similarities. You can think about these three conditions as lying on a continuum with Fibromyalgia on one end, Lupus on the other, and Chronic Fatigue Syndrome in the middle. All three of these conditions are caused by an abnormal stress response in the body, but with Lupus, the immune system is primarily affected, causing an autoimmune reaction that attacks your healthy tissues. On the other end of the spectrum is fibromyalgia, where metabolic abnormalities are primary. These metabolic changes are 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 several important hormones, such as the growth hormone-releasing hormone (somatotropin) and the thyroid-stimulating hormone. These hormonal changes lead to abnormal muscle healing, borderline or full-blown hypothyroid, as well as memory and cognitive changes.

One of the major physical abnormalities that occurs with fibromyalgia lies in the muscle itself, where there is a build up of a protein called “Ground Substance.” Ground substance is normally found in muscle, bone and connective tissue all over the body and is responsible for making the tissues stronger and less susceptible to tearing. In a normal person, when a muscle is injured, the muscle tissue itself is able to regenerate and over time, completely heal itself. In a person with fibromyalgia, the muscle is unable to completely heal itself. Instead, an abnormally large amount of ground substance builds up in the injured area. It is the ground substance, coupled with local muscle spasm it creates that creates the muscle ‘knots’ associated with fibromyalgia.

A number of tests may be done to rule out other disorders and 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. Unlike its cousin lupus, there are currently no diagnostic laboratory tests for fibromyalgia. Because there are no clinical tests for fibromyalgia, some doctors, unfortunately, conclude that a patient’s pain is not real, or they may tell them that there is little they can do. But a combination of chiropractic, trigger point therapy, and lifestyle changes has proven to be very effective in decreasing the severity and duration of the physical pain and disability of fibromyalgia.

Fibromyalgia can be difficult to treat. Not all doctors are familiar with fibromyalgia and its treatment, so it is important to find a doctor who is. Fibromyalgia treatment often requires a team approach, utilizing chiropractic care, trigger point therapy, massage, dietary changes, as well as exercises and stretching.

Chiropractic care is critical for those who suffer from fibromyalgia to keep the spine and muscles from losing too much movement. Because fibromyalgia causes the muscles to tighten up and lose some of their natural pliability, it results in a global loss of movement in the spine. The loss of movement in the spine results in a neurological reflex that causes the muscles to tighten further. This vicious cycle will continue and over time will lead to increased pain, increased muscle tightness, a loss of movement, more difficulty sleeping, and the development of more and more trigger points.

The only option is to continually adjust the spine and keep it moving. It is not uncommon for those with fibromyalgia to be adjusted three to four times per month to keep everything mobile and relaxed. The biggest concern in treating people with fibromyalgia is that their muscles have a diminished healing ability. For this reason, chiropractic adjustments are usually modified slightly to be more gentle than normal. This helps to decrease the stress on all of the small supporting muscles of the spine, which can be easily injured. It is important when seeking chiropractic care, to make sure that the doctor is familiar with the muscular changes that occur with fibromyalgia so that they can adjust their treatment accordingly.

The overwhelming characteristic of fibromyalgia is long-standing, body-wide pain with defined tender points, and frequently, trigger points. Trigger points are often confused with “tender points.” They are not the same. A trigger point needs firm pressure to elicit pain, while tender points are painful with even very light pressure. Trigger points will refer pain to other areas of the body, whereas tender points will not. Unlike tender points, trigger points can occur in isolation and represent a source of radiating pain, even in the absence of direct pressure. As discussed earlier, trigger points are purely comprised of spasmed muscle fibers, whereas tender points are knots filled with ground substance. Those with fibromyalgia almost always have a combination of the two – trigger points and tender points – and can improve dramatically with light trigger point therapy.

Trigger point therapy for fibromyalgia is much like trigger point therapy for low back pain, neck pain, or headaches. The points are the same. The difference is just intensity. Since the muscles in patients with fibromyalgia are easily injured and take longer to heal, it is necessary to use less pressure on their trigger points.