Preventing Fibromyalgia?

112

Fibromyalgia (FM) is a common cause for chronic pain (pain that lasts three or more months) and afflicts 4% of the general population in the United States! FM commonly affects the muscles and soft tissues – not the joints (like arthritis); however, many FM sufferers are mistakenly diagnosed with arthritis, so it may take years before they get an accurate diagnosis. There are NO known accurate diagnostic tests for FM, which is another reason for a delayed diagnosis.

In order to answer the question, “Can fibromyalgia be prevented?” we must first find the cause of FM. There are two types of FM: PRIMARY and SECONDARY. Primary FM occurs for no known reason, while secondary FM can be triggered by a physical event such as a trauma (e.g., car accident), an emotional event or a stressful situation (e.g., loss of a child), and/or a medical event such as a condition like irritable bowel syndrome, rheumatoid arthritis, or systemic lupus erythymatosis (SLE). Any condition that carries chronic or long-lasting symptoms can trigger FM, and some argue that the lack of being able to get into the deep sleep stage may be at the core of triggering FM since sleep disorders are a common finding in FM sufferers!

The “KEY” to managing FM has consistently been and probably always will be EXERCISE and SLEEP. So, if FM is preventable, daily exercise and getting the “right kind” of sleep are very important ways that may reduce the likelihood for developing the condition! Since emotions play a KEY ROLE in the cause and/or effect of FM, applying skills that keep life’s stressors in check is also important. This list can include hobbies like reading a good book, playing and/or listening to music, or meditation. The combination of exercise with mindful meditation using approaches like Tai Chi, Yoga, Qi Gong, and others has had positive impacts on FM patients such as improved balance and stability, reduced pain, enhanced mental clarity, and generally improved quality of life. Managing physical conditions that are associated with FM (such as irritable bowel syndrome, rheumatoid arthritis, or systemic lupus erythymatosis) is also important in managing and/or preventing FM.

Another management strategy of FM is diet. As most patients with FM will agree, certain foods help and others make the FM symptoms worse. In a survey published in the Journal of Clinical Rheumatology, 42% of FM patients reported certain foods exacerbated their symptoms. Of course, each individual case is unique, so keeping a food log or journal can be very helpful to determine dietary “friends” vs. “enemies.” The first step is to eliminate certain foods for four to six weeks, such as dairy and/or gluten. Most patients report a significant improvement in energy (less fatigue) while some report less pain when problem foods are eliminated from their diet. Generally, a diet rich in fruits, vegetables, and lean proteins can have a positive impact on the FM patient. Consider eating multiple small meals vs. two or three large meals during the day, as this can keep blood sugar levels more stable and reduce fatigue.

So back to the question, can fibromyalgia be prevented? Maybe…maybe not. Since the medical community doesn’t know the exact cause, it’s hard to answer this question. However, being proactive and implementing the strategies used to better manage FM may help in preventing it as well!

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

What the heck is a trigger point?

By Bryan Cobb, Advanced Remedial Massage Therapist

trigger-point-referred-pain-shutterstock_228843211

What is a Trigger Point?

Trigger Points (TP’s) are defined as a “hyper-irritable spot within a taut band of skeletal muscle. The spot is painful on compression and can evoke characteristic referred pain and autonomic phenomena.”1

Put into plain language, a TP is a painful knot in muscle tissue that can refer pain to other areas of the body. You have probably felt the characteristic achy pain and stiffness that TP’s produce, at some time in your life.

TP’s were first brought to the attention of the medical world by Dr. Janet G. Travell. Dr. Travell, physician to President John F. Kennedy, is the acknowledged Mother of Myofascial Trigger Points. In fact, “Trigger Point massage, the most effective modality used by massage therapists for the relief of pain, is based almost entirely on Dr. Travell’s insights.”2 Dr. Travell’s partner in her research was Dr. David G. Simons, a research scientist and aerospace physician.

Trigger Points are very common. In fact, Travell and Simons state that TP’s are responsible for, or associated with, 75% of pain complaints or conditions.1 With this kind of prevalence, it’s no wonder that TP’s are often referred to as the “scourge of mankind”.

Trigger Points can produce a wide variety of pain complaints. Some of the most common are migraine headaches, back pain, and pain and tingling into the extremities. They are usually responsible for most cases of achy deep pain that is hard to localize.

A TP will refer pain in a predictable pattern, based on its location in a given muscle. Also, since these spots are bundles of contracted muscle fibres, they can cause stiffness and a decreased range of motion. Chronic conditions with many TP’s can also cause general fatigue and malaise, as well as muscle weakness.

Trigger Points are remarkably easy to get, but the most common causes are

TP’s (black X) can refer pain to other areas (red)

 

Sudden overload of a muscle

  • Poor posture
  • Chronic frozen posture (e.g., from a desk job), and
  • Repetitive strain

 

Once in place, a TP can remain there for the remainder of your life unless an intervention takes place.

 

Trigger Points Not Well Known

With thousands of people dealing with chronic pain, and with TP’s being responsible for — or associated with — a high percentage of chronic pain, it is very disappointing to find that a large portion of doctors and other health care practitioners don’t know about TP’s and their symptoms.

Scientific research on TP’s dates back to the 1700’s. There are numerous medical texts and papers written on the subject.

But, it still has been largely overlooked by the health care field. This has led to needless frustration and suffering, as well as thousands of lost work hours and a poorer quality of life.

 

How Are Trigger Points Treated?

As nasty and troublesome as TP’s are, the treatment for them is surely straight-forward. A skilled practitioner will assess the individual’s pain complaint to determine the most likely location of the TP’s and then apply one of several therapeutic modalities, the most effective of which is a massage technique called “ischemic compression”.

 

Basically, the therapist will apply a firm, steady pressure to the TP, strong enough to reproduce the symptoms. The pressure will remain until the tissue softens and then the pressure will increase appropriately until the next barrier is felt. This pressure is continued until the referral pain has subsided and the TP is released. (Note: a full release of TP’s could take several sessions.)

 

Other effective modalities include dry needling (needle placed into the belly of the TP) or wet needling (injection into the TP). The use of moist heat and stretching prove effective, as well. The best practitioners for TP release are Massage Therapists, Physiotherapists, and Athletic Therapists. An educated individual can also apply ischemic compression to themselves, but should start out seeing one of the above therapists to become familiar with the modality and how to apply pressure safely.

 

 

 

1 Simons, D.G., Travell, D.G., & Simons, L.S. Travell and Simons’Myofascial Pain and Dysfunction: the Trigger Point Manual.

Vol. 1. 2nd ed. Lippincott, Williams, and Wilkins, 1999.