Fibromyalgia / Fibrositis / Fibromyositis / Trigger Points
Here’s the Facts About Fibromyalgia, Fibrositis, And Fibromyositis
If you are tired all the time with burning pain, muscle spasms and tender ‘trigger’ points, you may be suffering from fibromyalgia.
Other terms or diagnoses for this condition are fibrositis and fibromyositis but generally this condition is identified as a group of common nonspecific illnesses characterized by pain, tenderness, stiffness of joints ( usually many, not just one or two ), stiffness & soreness of the muscles, sore joint capsules and tenderness of adjacent structures ( tendons & ligaments ).
A heightened painful response to pressure anywhere on the body is also a common symptom. Any of the fibromuscular tissues may be involved, but those of the lower back (lumbago), neck (torticollis), shoulders, chest (pleurodynia) and thighs (aches & charleyhorses) are especially affected.
But, fibromyalgia symptoms are not restricted to pain however and this has lead to the use of the alternative term fibromyalgia syndrome for the condition.
Other symptoms include
- debilitating fatigue
- sleep disturbance
- tingling of the skin
- prolonged muscle spasms
- weakness in the arms & legs
- nerve pain
- muscle twitching
- sensitivity to pain, heat, cold
- bright lights
Some patients also report difficulty swallowing, bowel & bladder problems, headaches, sleeplessness, anxiety, numbness & tingling, cognitive dysfunction ( this generally means poor memory & brain function- known as “brainfog” ),impaired concentration, problems with short-term & long-term memory, impaired speed of performance, inability to multi-task & diminished attention span.
Fibromyalgia is frequently found to exist in patients with psychiatric conditions such as depression, anxiety & stress-related disorders such as post-traumatic stress disorder.
I have had several patients in my practice over the years who have suffered from fibromyalgia who have also reported having at least one whiplash-type car accident in their lives ( or any type of fall or injury where there has been a significant injury or jolt to their body or spine ). And, whiplash does not just affect the neck. It can affect the middle back ( thoracic spine ) and the lower back ( lumbar spine ) as well. Many times these patients say to me that their fibromyalgia symptoms started after having suffered a physical trauma. In fact, spinal trauma has long been associated with fibromyalgia.
One study showed that an injury to the neck increased the occurrence of fibromyalgia by 10 times! The condition may be induced or intensified by trauma ( as we just mentioned ), subsequent trauma’s, exposure to dampness or cold, and occasionally a systemic disorder such as rheumatism. A viral infection or sometimes toxicity from a remote bacterial infection may also be causative factors. Some cases may be of a psychological origin or psycho-physiological origin ( this means mind-body ) and symptoms can most definitely be exacerbated ( this means increased in severity ) by environmental or emotional stress.
The onset of pain is frequently sudden and the pain is most often aggravated by movement. Tenderness may be present, sometimes localized in the smaller trigger zones or nodules. These are most commonly found in the neck, lower back, buttocks, throat & upper chest area, elbows and knees. It may affect all or some of these locations or other areas of the body which fall outside the typical presentation. There may be local areas of muscle spasm and fever is not characteristic & only occurs if there is a provoking systemic condition.
Diagnosis is usually by the exclusion of other systemic diseases such as the early onset of rheumatoid arthritis and ( most difficult of all to determine ) psychogenic muscle pain & spasm.( This is muscle pain & spasm that results from psychological stress.) NOTE … not all people with fibromyalgia experience all the symptoms.
So, who get’s fibromyalgia?
Typically, fibromyalgia is estimated to affect 2 – 4 % of the population, with a female to male incidence ratio of 9:1. Fibromyalgia is considered a controversial diagnosis however, due to lacking scientific consensus to its cause. Not all members of the scientific community consider fibromyalgia a disease because of a lack of abnormalities upon physical examination & the absence of specific, diagnostic tests.
But here are some hypotheses ( suspected ) as to it’s causation; GENETIC PREDISPOSITION – there is evidence that genetic factors may play a role in the development.
For example, there is a high aggregation of fibromyalgia in families but the mode of inheritance is unknown. STRESS – this may be an important precipitating factor in the development of fibromyalgia. It frequently occurs concurrent with stress-related disorders such as chronic fatigue syndrome, post-traumatic stress disorder, irritable bowel syndrome & depression.
In my clinical experience, I would strongly agree that any type of post-traumatic stress disorder could be linked to those who have developed fibromyalgia.DOPAMINE DYSFUNCTION – dopamine is a neurotransmitter. ABNORMAL SERATONIN METABOLISM – serotonin is a chemical produced in the body which regulates sleep patterns, mood, concentration and pain, and could be involved in the causation of fibromyalgia associated symptoms. DEFICIENT GROWTH HORMONE SECRETION – this has been postulated but there is no conclusive evidence. PSYCHOLOGICAL FACTORS – there is strong evidence that major depression is associated with fibromyalgia although the nature & association is controversial.
An alternative hypothesis regarding the development of fibromyalgia in relation to psychological conflict proposes that the disorder may be a psychosomatic illness, ie. chronic pain is the mind’s way of distracting painful or dangerous emotions. OTHER – an abnormal immune response to intestinal bacteria.
Treatment of fibromyalgia – treatment is usually based upon standard protocol, or the treating doctor’s guess as to what triggered the condition to develop in the first place. It may disappear spontaneously within a few days or weeks, but may become chronic or recur at frequent intervals. And it may appear only when the patient is subject to high levels of stress & I have observed this to be true more often than not.
Psychological therapy, behavioural therapy, anti-depressant drugs, anti-seizure drugs, dopamine type drugs, muscle relaxers, opioid drugs, experimental drugs, pain-killers, anti-inflammatory drugs, physical therapy, heat, counseling & support groups have had limited success in helping sufferers.
Chiropractic treatment however has reported good results with fibromyalgia sufferers. Because fibro involves primarily the nerve, muscle & joint relationship, chiropractic treatments therefore are very beneficial.
In one study, all 23 participants ( fibromyalgia sufferers age 11 to 76 ) showed 92 – 100 % improvement and maintained their improvements after a one year follow up with chiropractic care. In another study of 15 females, 60 % reported at least a 50% reduction in their pain, less fatigue & improved sleep quality with chiropractic care. And my own personal clinical observations with my fibro patients are all similarly favorable.
There is a definite improvement in the quality of life & moreover, we are achieving it without the use of drugs or medication.